Medicine
Permanent URI for this communityhttp://repository.kln.ac.lk/handle/123456789/12
This repository contains the published and unpublished research of the Faculty of Medicine by the staff members of the faculty
Browse
2 results
Search Results
Item Use of routinely collected past surveillance data in identifying and mapping high-risk areas in a malaria endemic area of Sri Lanka(SEAMEO Regional Tropical Medicine and Public Health Project, 2002) Wickremasinghe, A.R.; Gunawardena, D.M.; Mahawithanage, S.T.C.Stratification of malaria endemic areas on eco-epidemiological criteria is an important step in planning and implementing malaria control programs. The uses of stratification of malaria endemic areas lead to better targeting of control measures such as residual insecticide spraying in countries where unstable malaria transmission occur. In this study, two methods that can be used for stratification of malaria endemic areas in Sri Lanka usingroutinely collected surveillance data over a period of 9 years are described. In the first method, the median Annual Parasite Incidence (API) was used as the criterion to classify an area as at risk for malaria while in the second method, the API and the Falciparum Rate (FR) were used as the criteria. Risk maps were produced by plotting the results of the analyses on maps generated by EPIMAP. The potential uses of risk maps are discussedItem Malaria risk factors in an endemic region of Sri Lanka, and the impact and cost implications of risk factor-based interventions(American Society of Tropical Medicine and Hygiene, 1998) Gunawardena, D.M.; Wickremasinghe, A.R.; Muthuwatta, L.; Weerasingha, S.; Rajakaruna, J.; Senanayaka, T.; Kotta, P.K.; Attanayake, N.; Carter, R.; Mendis, K.N.In an 18-month study of malaria in a population of 1,875 residents in 423 houses in an endemic area in southern Sri Lanka, the risk of malaria was found to be 2.5-fold higher in residents of poorly constructed houses than in those living in houses of good construction type. In residents of poorly constructed houses but not in others, the risk was even greater when the house was located near a source of water that could act as a potential breeding place for malaria vector mosquitoes (P = 0.0001). Based on previous findings that confirmed that house construction type was itself a risk determinant, and not merely a marker of other behavioral factors, we have estimated the potential impact of two feasible interventions to reduce the risk of malaria: 1) the imposition of a buffer zone of 200 meters around bodies of water from which houses of poor construction were excluded, which was estimated to lead to a 21 percent reduction of the malaria incidence in the overall population and a 43 percent reduction in the relocated community; and 2) the conversion of houses of poor construction type located in the buffer zone to those of a good construction type, which was estimated to lead to a 36 percent reduction in the incidence rates in the whole population and a 76 percent reduction in the residents of houses whose construction type was improved. Taking into consideration the cost to the Government of malaria prevention, we estimated the worth of a Government's investment in improving house construction type. The investment in housing was estimated to be offset in 7.2 years by savings to the Government on malaria costs alone, and beyond this period, to bring a return on the Government's investment by way of savings to the malaria control program.