Browsing by Author "Fernando, M.P."

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Actual exclusive breastfeeding rates and determinants among a cohort of children living in Gampaha district Sri Lanka: A prospective observational study
(BioMed Central, 2012) Perera, P.J.; Ranathunga, N.; Fernando, M.P.; Sampath, W.; Samaranayake, G. B.
BACKGROUND: Exclusive breastfeeding (EBF) during the early months of life reduce infant morbidity and mortality. Current recommendation in Sri Lanka is to continue exclusive breastfeeding up to six months of age. Exclusive breastfeeding rates are generally assessed by the 24 recall method which overestimates the actual rates. The objective of this study was to determine actual exclusive breast feeding rates in a cohort of Sri Lankan children and to determine the reasons that lead to cessation of breastfeeding before six months of age. METHODS: From a cohort of 2215 babies born in Gampaha district, 500 were randomly selected and invited for the study. They were followed up at two (n = 404), four (n = 395) and six (n = 286) months. An interviewer administered questionnaire asked about feeding history and socio-demographic characteristics. Child health development record was used to assess the growth. RESULTS: Exclusive breastfeeding rates at two, four and six months were 98.0%, 75.4% and 71.3% respectively. The main reasons to stop exclusive breastfeeding between two to four months was concerns regarding weight gain and between four to six months were mothers starting to work. Majority of the babies that were not exclusively breastfed still continued to have breast milk. Mothers above 30 years had lower exclusive breastfeeding rates compared to younger mothers. Second born babies had higher rates than first borns. There was no significant association between maternal education and exclusive breastfeeding rates. CONCLUSIONS: Exclusive breastfeeding rates were high among this cohort of children. A decrease in EBF was noted between two and four months. EBF up to six months does not cause growth failure. Mothers starting to work and concerns regarding adequacy of breast milk were the major reasons to cease EBF. The actual exclusive breastfeeding rates up to six months was 65.9%.
Effect of feeding practices on dental caries among preschool children: a hospital based analytical cross sectional study
(HEC Press, Australia, 2014) Perera, P.J.; Fernando, M.P.; Warnakulasooriya, T.D.; Ranathunga, N.
Feeding practices during early childhood play an important aetiological role in early childhood caries (ECC). The role of feeding practices in causation of ECC is debated. The objective of this study was to assess the aetiological role of feeding practices on ECC. A descriptive cross sectional study was conducted at a paediatric unit in Sri Lanka. Two hundred and eighty-five children between 36 to 60 months, admitted to the unit were randomly selected for the study. An interviewer administered questionnaire asked about socio-demographic characteristics and feeding practices. The mouths of children were examined for dental caries. Out of 285 children, 61% had exclusive breast feeding up to six months, 69% continued breast feeding beyond two years and 82% had overnight feeding after two years of age. One hundred and thirty-six children (47.7%) had dental caries with a mean deft score of 1.81. Overnight feeding with any type of milk beyond two years significantly increased dental caries incidence and severity. Children exclusively breast fed for six months or had breast feeding beyond two years had a higher prevalence of caries than children not exclusively breast fed or who were not breast feed beyond two years, but the difference was not significant. Overnight feeding with any type of milk beyond two years should be discouraged.
Head circumference during infancy in a birth cohort of Sri Lankan children: are we using the correct chart?
(Sri Lanka Medical Association, 2014) Perera, P.J.; Fernando, M.P.; Samaranayake, R.
INTRODUCTION: Measuring head circumference and plotting it in centile charts is a routine practice in paediatrics. However if wrong charts are used, serious misinterpretations can ensue. OBJECTIVES: This study was carried out to ascertain the appropriateness of charts used in Sri Lanka. Out of a birth cohort of 2215 children, 250 from each sex were invited for a follow up study. Head circumference was measured at 2, 4, 6, 9 and 12 months. Statistical characteristics of head circumference for each sex, at each age were calculated. RESULTS: At the first follow up 244 boys and 241 girls were assessed. Out of this, 85% of boys and 86% of girls completed the follow up. CONCLUSIONS: Head circumference of both sexes deviated significantly at all ages from the charts available in the Child Health Developmental Record (CHDR). Head circumference charts available in the CHDR are inappropriate for use in Sri Lankan children.
Hypocalcaemia leading to supra ventricular tachycardia in a three-month old Sri Lankan infant with vitamin D deficient rickets: a case report
(Sri Lanka Medical Association, 2017) Fernando, M.P.; Perera, P.J.; Muthukumarana, O.J.; Uyangoda, K.
No Abstract Available
Knowledge and practices related to helminth infections among mothers living in a suburban area of Sri Lanka
(SEAMEO Regional Tropical Medicine and Public Health Project, 2012) Perera, P.J.; Disanayake, D.; Fernando, M.P.; Warnakulasooriya, T.D.; Ranathunga, N.
Intestinal helminth infections are a global problem. We assessed maternal knowledge among Sri Lankans about helminth infections and patterns of anthelmintic use to treat their children. We conducted this cross sectional study at the University Pediatric Unit in Teaching Hospital Ragama, during September 2011 to November 2011. Two hundred children admitted to the Pediatric Unit and their mothers were randomly recruited into the study. An interviewer administered questionnaire asking about socio-demographic factors, availability of sanitary facilities and safe drinking water, knowledge about intestinal infections and anthelmintic use. Nearly all the mothers interviewed reported having a safe toilet and 62% reported having safe drinking water. Eighty-four percent of children were given anthelmintic medication periodically irrespective of symptoms. Of these, 39.3% were treated every 3 months, 55.3% every six months and 5.3% annually. Of the children who received routine anthelmintic treatment, 81% had risk factors for helminth infection and 62.5% had evidence of a helminth infection in the past. There was no statistically significant association between routine anthelmintic medicine use and the presence of risk factors (odds ratio 0.28; confidence interval 0.04-1.31) or having symptoms of helminth infection (odds ratio 1.67; CI 0.73-3.8). Maternal knowledge regarding helminth infection was poor. Health education programs regarding helminth infections and their treatment are indicated.
Prevalence of dental caries among a cohort of preschool children living in Gampaha district, Sri Lanka: a descriptive cross sectional study
(BioMed Central, 2012) Perera, P.J.; Abeyweera, N.T.; Fernando, M.P.; Warnakulasuriya, T.D.; Ranathunga, N.
BACKGROUND: Dental caries among young children are a global problem. Scant attention is paid towards primary teeth, leading to high prevalence of dental caries. There are only few studies done in Sri Lanka, addressing oral hygiene among preschool children. Scientific evidence is in need to persuade authorities to establish a programme promoting oral hygiene among preschool children. METHODS: A descriptive cross sectional study was conducted in Ragama Medical officer of Health area. Consecutive children between 2 - 5 years of age, attending child welfare clinics were recruited for the study. Practices related to dental hygiene and socio-economic characteristics were obtained using an interviewer administered questionnaire. Mouth was examined for evidence of dental caries. Data collection and examination were done by two doctors who were trained for this purpose. The data were analysed using SSPS version 16. RESULTS: Total of 410 children were included. None had a routine visits to a dentist. Practices related to tooth brushing were satisfactory. Prevalence of dental caries gradually increased with age to reach 68.8% by 5 years. Mean total decayed-extracted-filled (deft) score for the whole sample was 1.41 and Significant caries index (SIC) was 4.09. Decayed tooth were the main contributor for the deft score and Care index was only 1.55. Girls had a significantly higher prevalence of caries than boys. CONCLUSIONS: Dental care provided for Sri Lankan preschool children appears to be unsatisfactory as prevalence of dental caries among this cohort of preschool children was very high. There is an urgent need to improve dental care facilities for Sri Lankan preschool children.
Statistical characteristics of anterior fontanelle size at birth of term Sri Lankan new borns: a descriptive cross sectional study
(Sri Lanka Medical Association, 2013) Perera, P.J.; Wickremasinghe, A.R.; Ranathunga, N.; Fernando, M.P.; Warnakulasooriya, D.
INTRODUCTION: Assessing the anterior fontanelle size is an important component of routine neonatal examination. For meaningful interpretation of fontanelle size, normal reference values are essential. Normal values for the fontanelle size in Sri Lankan newborns are not available. OBJECTIVES: To investigate characteristics of anterior fontanelle size at birth in Sri Lankan babies. METHODS: A descriptive cross sectional study was carried out between October and November 2010. Horizontal and vertical dimensions of the anterior fontanelle were measured in 2215 normal term babies, between 12 to 24 hours after birth. A practical and simple method was used to measure fontanelle size. Average fontanelle size was calculated by adding horizontal and vertical dimensions and dividing by two. RESULTS: Mean of the average fontanelle size for the total sample was 2.55 cm (for males 2.57 cm and for females 2.52 cm). Longitudinal dimension was significantly higher than the horizontal in both sexes (p<0.001). Frequency distribution curves of fontanelle size followed a normal distribution in both sexes. The ninety seventh centile and third centile for the average fontanelle size were 4.5 cm and 0.9 cm respectively. CONCLUSIONS: Babies with an average anterior fontanelle size more than 4.5 cm or less than 0.9 cm need further follow up. Further studies are needed to evaluate the accuracy of these cut off values