Medicine
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This repository contains the published and unpublished research of the Faculty of Medicine by the staff members of the faculty
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Item Role of Aedes albopictus in transmitting dengue virus in some endemic areas in Kurunegala District.(University of Kelaniya, 2003) Hapugoda, M.D.; de Silva, N.R.; Abeysundara, S.; Bandara, K.B.A.T.; Dayanath, M.Y.D.; Abeyewickreme, W.Abstract AvailableItem Detection of dengue virus in Aedes albopictus mosquitoes by Reverse Transcription Polymerase-Chain Reaction-Liquid Hybridization (RT-PCR-LH) based assay.(Sri Lanka College of Microbiologists, 2003) Hapugoda, M.D.; Gunasekera, M.B.; de Silva, N.R.; Gunasena, S.; Prithimala, L.D.; Dayanath, M.Y.D.; Abeyewickreme, W.Dengue is an important public health problem. In this study an RT-PCR-LH assay was developed for the detection of dengue virus in Ae.albopictus, a vector of dengue. Laboratory bred Ae.albopictus (adults inoculated with dengue prototypes were tested by RT-PCR-LH assay. RT-PCR products of NS3 gene of 4 dengue prototypes were hybridized in liquid phase with 32P) labelled cocktail of dengue serotype-specific ologonucliotides. Semi-Nested-PCR agarose gel electrophoresis (Semi-Nested-PCR-AGE) assay with dengue type specific oligonucliotides was carried out for typing of RT-PCR products. Wild-caught Ae.albopictus (larvae (n=89 pools) and adults (n=69 pools) collected from dengue case reported stations during the period of 1999-2002 were also tested by RT-PCR-LH and typed by Nested-PCR-AGE assay). A DNA band (470bp) specific for dengue virus was observed in all pools of Ae.albopictus (inoculated with dengue prototypes in RT-PCR-LH assay. When RT-PCR products of dengue prototypes inoculated mosquitoes were typed by Semi-Nested-PCR-AGE assay, bands of 169,362, 265, 426 bp sizes corresponding to DEN1, DEN2, DEN3 and DEN4 respectively were observed. The DNA band specific for dengue virus (470bp) was also observed in 6 pools of wild-caught adults in RT-PCR-LH assay. They were found to be infected with DEN3 (265bp DEN3 specific DNA band was detected) by Semi-Nested-PCR-AGE assay. None of the wild-caught larvae showed dengue specific DNA band (470bp) in RT-PCR-LH assay). RT-PCR-LH with Semi-Nested-PCR-AGE assays are useful for the detection and typing of dengue virus in Ae.albopictus. Ae.albopictus (in Sri Lanka is competent in transmitting DEN3 and possibly other serotypes. Detection of dengue virus for the first time in Ae.albopictus in Sri Lanka confirms earlier observations that it may play an important role in transmitting dengue). Acknowledgements: Financial assistance by the International Atomic Energy Agency (Technical Co¬operation grant no SLR/ 06 / 024) and University of Kelaniya (Research grant no RP/03/04/06/01/00) is gratefully acknowledged.Item Breeding of aedes Aegypti and Aedes albopictus in some dengue endemic areas.(Sri Lanka College of Microbiologists, 2000) Hapugoda, G.P.G.M.D.; de Silva, N.R.; Abeyewickreme, W.Dengue fever (DF)/Dengue haemorrnagic fever (DHF) is now- the most important and rapidly spreading vector borne disease in the world. Since 1956, over 350 000 patients have been hospitalized and nearly 12 000 deaths have been reported. In Sri Lanka the incidence of DF/DHF has increased cyclically since the first outbreak in Sri Lanka during which 26 deaths were reported. Aedes aegypti is classified as the predominant vector of dengue in Sri Lanka. Ae, albopictus is considered as an important vector in the absence of Ae. aegypti. In this study, larval surveillance was carried out in fixed monitoring stations / hot-spots and random monitoring stations. Fixed monitoring stations were selected based on high incidence of DF/DHF recorded since 1996 in Kurunegala district. Ten premises within one fixed monitoring station were checked for mosquito breeding weekly using ovitraps and the average monthly ovitrap index (%) was calculated. During outbreaks larval surveillance was conducted in fifteen random monitoring stations including 66 houses which were selected based on serologically confirmed DPI DHF cases in and around Kurunegala and Ragama. Observations on average monthly ovitrap index (%) in the fixed monitoring stations showed that the highest ovitrap index was in Kurunegala town area, Ovitrap index of Ae. albopictus was higher than of Ae. aegypti all localities in and around Kurunegala throughout the study period. Data obtained from random monitoring-stations in and around Kurunegala and Ragama revealed that only Ae. albopictus larvae were present in seven stations. There were no stations in which only Ae.aegypti larvae were present. House index of Ae. albopictus was 28% whereas it was 10.6% for both species in random monitoring stations. Results suggest that Ae.albopictus may play a major role in transmitting dengue in some localities in Sri Lanka. This investigation received financial support from University of Kelaniya (Research Grant no-97/1-23) and from the IAEA (Technical Corporation Grant no-SRL/06/024).Item Correlation between clinical and laboratory diagnosis of dengue in Sri Lanka.(Faculty of Tropical Medicine, Mahidol University, 2007) Hapugoda, M.D.; Khan, B.; de Silva, N.R.; Gunasekera, J.; Abeyewickreme, W.BACKGROUND: In Sri Lanka, diagnosis of dengue mainly depends on clinical signs and symptoms. Very few suspected patients from the state and private sector health institutions are tested by laboratory diagnostic assays compared to the number of dengue cases recorded all over the island. OBJECTIVES: To correlate clinical parameters with laboratory diagnosis in confirmation of dengue. RESEARCH DESIGN: Patients, clinically suspected of having dengue (n=201) were selected based on WHO criteria. Serum samples were tested using major 3 types of laboratory diagnostic assays; molecular, virus isolation and serology. Differences in clinical and laboratory data were analyzed on the basis of the final diagnosis assigned as dengue or non-dengue. Chi-square test was used for comparison of data. RESULTS: The proportion of laboratory diagnosed dengue patients were 80% (162/201). Mean platelet value and PCV in laboratory confirmed dengue patients were 92 247/mm3 (range 20 000-318 000) and 45% (range 31-59%) respectively. On comparison of the presence of clinical features that are used by the WHO for diagnosis of dengue, headache (129/162 vs 18/39, x2=23, p=0.00), limb pain (107/162 vs 18/39, x2=4.56, p=0.03) and external bleeding (67/162 vs 00/39, X2=27, p=0.00) showed significant association, with dengue infection. The infection was confirmed as definitive dengue in 75% (121 /162) and probable dengue in 25% (41/162). DISCUSSION: Surveillance based on clinical diagnosis may result in over estimation of the disease as clinical diagnosis is not specific enough. Laboratory confirmation of dengue suspected patients is important to measure the real incidence of the disease is needed in country like Sri Lanka.Item Potential use of IGR Pyriproxifen for control of dengue vector Aedes albopictus(Sri Lanka College of Microbiologists, 1999) Gunawardene, Y.I.N.S.; de Silva, N.R.; Abeyewickreme, W.Dengue Fever (DF) Dengue Haernorrhagic Fever (DHF) is now a significant problem in Sri Lanka. The incidence of DHF has increased cyclically since the first recognized outbreak in 1989. Of the 203 suspected DHF cases recorded in 1989, 87 were confirmed and 26 deaths were reported. By 1997, 5882 clinical cases, 1558 serologically confirmed cases and over 300 deaths have been reported. Without an effective vaccine against dengue, and considering the clinical difficulty in managing DHF cases, vector control has become an important com¬ponent in the integrated attempts for dengue con¬trol. Aedes aegypti and Aedes albopictus not only transmit dengue but are also a nuisance and cause annoyance by their day biting behaviour. In this study an attempt was made to control Ae. albopictus by exploiting its oviposition behaviour, us¬ing an Insect Growth Regulator (IGR), Pyriproxifen. The IGR is known to interfere with the synthesis and deposition of chitin in insects and thereby prevent growth and development. Different concentrations of the IGR (0.01 g/1 -0.08g/1) were tested against Ae.albopictus, in laboratory experiments. The most effective larvisidal concentration of Pyriproxifen for Ae.albopictus was determined to be 0.03g/1. Field trials were also carried out to determine the feasi¬bility of employing used automobile tyres contain¬ing Pyriproxifen as ovitraps against Ae.albopictus. Tyres containing water were treated with Pyriproxifen (0.03g/1) and the emergence of adults was recorded. Pyriproxifen at a concentration of 0.03g/1 was found to inhibit the emergence of adult Aedes mosquitoes up to 6 weeks.Item A Comparative retrospective study of novel Reverse-Transcription Polymerase Chain Reaction-based Liquid Hybridization (RT-PCR-LH) assay with Polymerase Chain Reaction (PCR) amplification, virus isolation and serological techniques for early, definitive laboratory diagnosis of dengue infection(Malaysian Society of Parasitology and Tropical Medicine, 2007) Hapugoda, M.D.; de Silva, N.R.; Khan, B.; Gunasena, S.; Dayanath, M.Y.D.; Abeyewickreme, W.Dengue is an important vector borne viral infection in South East Asia. Dengue virus is responsible for dengue fever, dengue haemorrhagic fever and dengue shock syndrome. Early diagnosis of infection helps in monitoring the disease, determining when hospital admission is necessary and in reducing case fatalities. The objective of the study was to carry out a comparative retrospective study of a novel Reverse Transcription-Polymerase Chain Reaction-based Liquid Hybridization (RT-PCR-LH) assay with PCR amplification, virus isolation and serological techniques for laboratory diagnosis of dengue infection. Amplified products of Non Structural-3 gene were hybridized with a mixture of the 4 dengue type-specific Deoxyribonucleic Acid (DNA) probes in liquid phase. The assay was validated in a comparative retrospective study using acute serum samples collected from 88 patients with dengue confirmed by Haemagglutination Inhibition (HAI) assay. The assay was highly specific for diagnosis of dengue infection. As an early (<5 days of fever) laboratory diagnostic method, this assay had 100% sensitivity for detection of dengue patients confirmed by HAI assay. A high analytical sensitivity of 2 fluorescent focus units of dengue virus/reaction was achieved. Novel RT-PCR-LH assay using a single serum specimen offers distinct advantages of specificity and sensitivity over other diagnostic techniques for early definitive laboratory diagnosis of dengue infection at the time during which serological methods cannot be used.Item Density of Aedes aegypti and Aedes Albopictus in some dengue endemic areas(University of Kelaniya, 2000) Hapugoda, G.P.G.M.D.; de Silva, N.R.; Abeyewickreme, W.; Rajamanthri, R.