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This repository contains the published and unpublished research of the Faculty of Medicine by the staff members of the faculty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 Dengue and leptospirosis infection during the coronavirus 2019 outbreak in Sri Lanka(Oxford University Press, 2021) Niriella, M.A.; Ediriweera, D.S.; de Silva, A.P.; Premaratna, B.A.H.R.; Jayasinghe, S.; de Silva, H.J.ABSTRACT: A significant decrease in dengue fever cases and a contrasting increase in leptospirosis cases were reported for the second quarter of 2020 compared with 2019 in Sri Lanka. In the absence of significant environmental and weather-related differences to account for these changes in incidence, we investigated the possibility that the effects of the COVID-19 pandemic on public health, social behaviour and the restrictions imposed during the lockdown influenced the fluctuations in dengue and leptospirosis infections. KEYWORDS: COVID-19; dengue fever; leptospirosis; pandemic; tropical infections.Item Efficacy of a dengue vaccine candidate (TAK-003) in healthy children and adolescents two years after vaccination(University of Chicago Press, 2022) López-Medina, E.; Biswal, S.; Saez-Llorens, X.; Borja-Tabora, C.; Bravo, L.; Sirivichayakul, C.; Vargas, L.M.; Alera, M.T.; Velásquez, H.; Reynales, H.; Rivera, L.; Watanaveeradej, V.; Rodriguez-Arenales, E.J.; Yu, D.; Espinoza, F.; Dietze, R.; Fernando, L.; Wickramasinghe, P.; Moreira Jr, E.D.; Fernando, A.D.; Gunasekera, D.; Luz, K.; da Cunha, R.V.; Tricou, V.; Rauscher, M.; Liu, M.; LeFevre, I.; Wallace, D.; Kosalaraksa, P.; Borkowski, A.; TIDES study group.BACKGROUND: Takeda's dengue vaccine is under evaluation in an ongoing Phase 3 efficacy study; we present an update after 2 years. METHODS: 20,099 children (4-16 years old) were randomized to receive two doses of TAK-003 or placebo three months apart and are under long-term febrile surveillance to detect dengue by serotype-specific RT-PCR. (NCT02747927). RESULTS: Cumulative efficacy against dengue over ~27 months since first dose was 72.7% (95% CI: 67.1 - 77.3), which included efficacy of 67.0% (95% CI: 53.6 - 76.5) in dengue-naïve and 89.2% (82.4 - 93.3) against hospitalized dengue. In the second year after vaccination, a decline in efficacy was observed [56.2% (42.3 - 66.8)] with the largest decline in 4 - 5 year-old children [24.5% (-34.2 - 57.5)]; efficacy was 60.6% (43.8 - 72.4) in 6 - 11 year and 71.2% (41.0 - 85.9) in 12 - 16 year age groups. As TAK-003 efficacy varies by serotype, changes in serotype dominance partially contributed to the efficacy differences in year by year analysis. No related serious adverse events occurred during the second year. CONCLUSION: TAK-003 demonstrated continued benefit independent of baseline serostatus in reducing dengue with some decline in efficacy during the second year. Three-year data will be important to see if efficacy stabilizes or declines further. KEYWORDS: Dengue; TAK-003; efficacy; immunogenicity; persistence; safety; vaccine.Item Knowledge and practices of dengue control and their effect on breeding sites and vector populations(Sri Lanka Medical Association, 2010) Pinidiyapathirage, M.J.; Gunethilake, M.A.G.N.; Wijegunawardana, N.D.A.D.OBJECTIVE: To describe the association between knowledge and practices of dengue control with the observed dengue breeding sites and vector populations in a community. METHODS: A cross-sectional survey was conducted among households in Negombo area in July 2009 during the height of the dengue epidemic in the country. Knowledge and practices in this community were measured using two methodologies. The first was a questionnaire, to be answered by the household respondent; the second, a mosquito larval survey, to identify potential and actual mosquito breeding sites in the corresponding household. The use of the two instruments allowed comparison of respondent knowledge and reported practice with the actual condition of the compound. RESULTS: All respondents (n=120) have heard of dengue, 89% knew at least one symptom of dengue and 93% knew that a mosquito was responsible for transmission. 60% correctly stated the preferred biting times of the vector and 80% knew that discarded tyres, bottles and plastic containers with water collections were the potential vector breeding sites. On inspection, 104 (87%) households had at least one potential breeding source. However, Aedes aegypti/albopictus larvae/pupae were observed only in water samples collected from 3 (2.5%) households. Knowledge about dengue symptoms, methods of prevention or level of education had no association with the potential breeding sites found. Low income was significantly associated with having at least one potential breeding source in the household. CONCLUSION: Although the level of knowledge about dengue was high in this community, we found only httle evidence that this knowledge was put into practice.