Browsing by Author "Caldera, A."

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Assessing mental well-being in a Sinhala speaking Sri Lankan population: validation of the WHO-5 well-being index
(BioMed Central., 2020) Perera, B.P.R.; Jayasuriya, R.; Caldera, A.; Wickremasinghe, A.R.
PURPOSE: The WHO-5 well-being index is a widely used, short rating scale that measures subjective well-being. We translated the WHO-5 index into Sinhala and tested its psychometric properties including measurement invariance among diverse groups in a community sample in Sri Lanka. METHODS: The sample of 267 persons aged between 16 and 75 years was recruited from a semi-urban area. 219 completed a paper-based questionnaire and 48 responded to an online survey. Construct validity was tested for factorial validity (Confirmatory Factor Analysis -CFA), convergent validity and known group validity. Composite reliability for congeneric measures and test-retest reliability were also tested. Multi-group CFA (MG-CFA) was used to test measurement invariance. RESULTS: The translated Sinhala version demonstrated good content and face validity. Internal consistency reliability of the five items had a Cronbach's alpha of 0.85 and test-retest reliability over 2 weeks was satisfactory (Pearson r = 0.72, p < 0.001, ICC = 0.82). Confirmatory factor analysis supported factorial validity with a [Formula: see text] =4.99 (p = 0.28), a RMSEA of 0.03 (90% C.I. =0.00-0.10), a SRMR of 0.02, a TLI of 0.99 and a CFI of 0.99; factor loadings were between 0.55 and 0.89. Measurement invariance was acceptable for configural, metric and scalar invariance for gender. WHO-5 scores were significantly negatively correlated with the Patient Health Questionnaire (PHQ-9) (Pearson's r = - 0.45, p < 0.001) scores and the Kessler Psychological Distress Scale (K10) scores (Pearson's r = - 0.56, p < 0.001). CONCLUSION: The Sinhala translation of WHO-5 well-being index has shown acceptable psychometric properties and can be used for assessing mental well-being in the community in Sri Lanka. Further testing of the measure with larger and diverse (including different ethnic/cultural) groups are indicated to test measurement invariance of the measure. KEYWORDS: Sri Lanka; Validation; WHO-5 Sinhala version; Well-being.
Designing a tool to monitor development of 2-5 year old children by preschool teachers in Sri Lanka: A preliminary report
(Sri Lanka Medical Association, 2018) Caldera, A.; Mendis, M.; Muttiah, N.; Wijesinghe, T.M.; Godamunne, P.K.S.; Chathurika, L.K.E.; Jayasena, B.N.; Wickremasinghe, A.R.; Perera, K.M.N.; Tilakarathne, N.; Peiris, M.K.R.R.; Sumanasena, S.P.
INTRODUCTION AND OBJECTIVES: Identifying neurodevelopmental impairments and providing early intervention positively impacts later academic and functional outcomes of children. Globally available child development screening tools are not readily accessible or validated for Sri Lanka. As a large proportion of Sri Lankan children aged 2-5 years attend preschools, teachers can complement developmental monitoring. The aim of this study was to design a tool to monitor the development of 2-5 year old children by preschool teachers. METHODS: Twelve local and global tools including the tool developed by Plan International and the Child Health Development Record (CHOR) were reviewed. All tools were mapped according to the domains and subdomains in the National Early Childhood Developmental Standards for Sri Lankan Children. A Delphi process was carried out by a panel of experts to include culture specific activities that assess all domains and subdomains across age groups. RESULTS: The existing tool developed by Plan International lacked indicators for health, daily living and social and emotional development. The CHOR was deficient in cognitive, receptive language, social and emotional indices. Several activities in some instruments were common to more than one age group. The domains incorporated into the proposed tool included motor, cognitive, language, social and emotional and self- help skills. Approximately 50 items per each age group were included in this tool CONCLUSION: A preliminary play-based tool for monitoring development of children 2-5 years of age across five main domains in natural settings for preschool children was developed. A pilot study is required to assess the validity of the tool.
Initial response to SARS-CoV-2 (COVID-19) outbreak in Sri Lanka; views of public health specialists through an International Health Regulations lens
(Public Library of Science, 2023) Caldera, A.; Wickremasinghe, R.; Newby, G.; Perera, R.; Mendis, K.; Fernando, D.
The COVID-19 pandemic affected Sri Lanka despite having developed an International Health Regulations (IHR) steering committee in 2016 and a national action plan for health security following the Joint External Evaluation in 2018. Many steps were taken to improve the disaster management skills of healthcare workers even before the COVID-19 outbreak. We interviewed seven public health specialists to obtain their views on the country's response to the pandemic. A thematic analysis was conducted, leading to the emergence of three major themes and seven subthemes. The major themes included health security preparedness; COVID-19 management; and effects of COVID-19. The subthemes were; preparedness prior to pandemic and gaps in the preparedness (under health security preparedness); dual burden for the curative sector, strategies to reduce transmission and barriers to managing COVID-19 (under COVID-19 management) and negative and positive effects of COVID-19 (under effects of COVID-19). When COVID-19 reached Sri Lanka, healthcare workers, border control authorities and those involved with infectious disease control were overwhelmed by the magnitude of the pandemic. Healthcare workers' hesitation to work amidst the pandemic due to fear of infection and possible transmission of infection to their families was a major issue; the demand for personal protective equipment by health workers when stocks were low was also a contributory factor. Lockdowns with curfew and quarantine at government regulated centers were implemented as necessary. Perceptions of the public including permitting healthcare workers to perform field public health services, logistical barriers and lack of human resources were a few of the barriers that were expressed. Some persons did not declare their symptoms, fearing that they would have to be quarantined. The pandemic severely affected the economy and Sri Lanka relied on donations and loans to overcome the situation. Pandemic also brought about innovative methods to maintain and upgrade health service provision. Individuals with non-communicable diseases received their regular medications through the post which reduced their risk of being infected by visiting hospitals. Improvement of laboratory services and quarantine services, a reduction of acute respiratory infections and diarrhoeal diseases, improved intersectoral coordination and public philanthropic response were other positive effects.
Malaria control, elimination, and prevention as components of health security: A review
(American Society of Tropical Medicine and Hygiene, 2022) Perera, R.; Wickremasinghe, R.; Newby, G.; Caldera, A.; Fernando, D.; Mendis, K.
International travel, a major risk factor for imported malaria, has emerged as an important challenge in sustaining malaria elimination and prevention of its reestablishment. To make travel and trade safe, the WHO adopted the International Health Regulations (IHR) which provides a legal framework for the prevention, detection, and containment of public health risks at source. We conducted a systematic review to assess the relevance and the extent of implementation of IHR practices that can play a role in reducing malaria transmission. Selected studies addressed control, elimination, and prevention of reestablishment of malaria. Study themes focused on appraisal of surveillance and response, updating national policies to facilitate malaria control and elimination, travel as a risk factor for malaria and risk mitigation methods, vector control, transfusion malaria, competing interests, malaria in border areas, and other challenges posed by emerging communicable diseases on malaria control and elimination efforts. Review results indicate that malaria has not been prioritized as part of the IHR nor has the IHR focused on vector-borne diseases such as malaria. The IHR framework in its current format can be applied to malaria and other vector-borne diseases to strengthen surveillance and response, overcome challenges at borders, and improve data sharing-especially among countries moving toward elimination-but additional guidelines are required. Application of the IHR in countries in the malaria control phase may not be effective until the disease burden is brought down to elimination levels. Considering existing global elimination goals, the application of IHR for malaria should be urgently reviewed and included as part of the IHR.
Measuring mental well-being in Sri Lanka: validation of the Warwick Edinburgh Mental Well-being Scale (WEMWBS) in a Sinhala speaking community
(BioMed Central, London, 2022) Perera, B.P.R.; Caldera, A.; Godamunne, P.; Stewart-Brown, S.; Wickremasinghe, A.R.; Jayasuriya, R.
Background: Well-being is an important aspect of people's lives and can be considered as an index of social progress. The Warwick Edinburgh Mental Well-being scale (WEMWBS) was developed to capture subjective mental well-being. It is a widely tested measure of mental well-being at the population level and has 14 items and a short-form with 7 items. This study was carried out to culturally validate and adapt the WEMWBS among a Sinhala speaking population in Sri Lanka. Methods: A forward and backward translation of the scale into Sinhala was done followed by a cognitive interview. The translated and culturally adapted scale and other mental health scales were administered to a sample of 294 persons between the ages of 17-73 using a paper-based version (n = 210) and an online survey (n = 84). Internal consistency reliability and test-retest reliability were tested. Construct validity, and convergent and discriminant validity were assessed using the total sample. Results: The translated questionnaire had good face and content validity. Internal consistency reliability was 0.91 and 0.84 for the 14-item and 7-item scales, respectively. Test-retest reliability over two weeks was satisfactory (Spearman r = 0.72 p < 0.001). Confirmatory factor analysis supported a one factor model. Convergent validity was assessed using WHO-5 well-being index (Spearman r = 0.67, p < 0.001), Patient Health Questionnaire (PHQ-9) (Spearman r = (-0.45), p < 0.001) and Kessler psychological distress scale (K10) (Spearman r = (-0.55), p < 0.001). Conclusions: The translated and culturally adapted Sinhala version of the WEMWBS has acceptable psychometric properties to assess mental well-being at the population level among the Sinhala speaking population in Sri Lanka.
Reactive Case Detection (RACD) and foci investigation strategies in malaria control and elimination: a review
(BioMed Central, 2020) Perera, R.; Caldera, A.; Wickremasinghe, A.R.
BACKGROUND: Reactive case detection (RACD) and foci investigation are key strategies in malaria elimination and prevention of its re-establishment. They are a key part of surveillance that has been recommended by the World Health Organization (WHO) to be considered as a core intervention and as one of the three pillars of the Global Technical Strategy for Malaria 2016-2030. METHODS: A search using the key words "Reactive Case Detection", "RACD", "RCD" and "Malaria" was carried out in PubMed, Scopus, Taylor and Francis online databases for studies published until 31st July 2019. The inclusion criteria for selection of articles for review included (1) how RACD is implemented in each country; (2) challenges faced in RACD implementation; (3) suggestions on how the effectiveness of RACD process can be improved. RESULTS: 411 titles were identified, 41 full text articles were screened and 29 were found eligible for inclusion in the review. Published literature on RACD, and case and foci investigations has mostly assessed the process of the activity. Most studies have documented that the yield of positives in RACD has been highest in the index case's household and the immediate neighbourhood of the index case. Microscopy and RDTs are the common tests used in RACD. The guidelines for case and foci investigation, and RACD and PACD, are not universally adopted and are country-specific. Some of the limitations and challenges identified include lack of proper guidelines, logistic issues and problems with public compliance. CONCLUSIONS: Although there is no documented evidence that RACD is useful in malaria elimination settings, most authors have opined that RACD is necessary for malaria elimination. Lack of knowledge in the target populations, a target radius and how to carry out the RACD process is a major challenge in the decision-making process. KEYWORDS: 1-3-7 strategy; Foci investigation; Malaria control; Malaria elimination; Reactive case detection.