Browsing by Author "Ginige, S."

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Comparison of clinical criteria and laboratory criteria used for the diagnosis of bacterial vaginosis
(Sri Lanka College of Microbiologists, 2013) Mendis, K.H.C.; Dassanayake, K.M.M.P.; Kasturiratne, A.; Ginige, S.
OBJECTIVES: To determine the prevalence of BV among women who present with vaginal discharge.To determine the usefulness of Amsel's clinics' criteria to diagnose BV by comparing it with the Nugent criteria, which is the gold standard. METHODOLOGY: 300 patients who presented with vaginal discharge to the sexually transmitted diseases (STD) clinic, gynecology clinics and gynecology wards at North Colombo Teaching Hospital,Ragama and STD clinic -Colombo, between 1 st January 2011 to 30th April 2011 were included in the study Four high vaginal swabs were collected during the speculum examination and examined according to the Amsel's and Nugent's criteria. Appearance of the vaginal discharge was observed. RESULTS: The prevalence of BV among women who presented with vaginal discharge was 25.3% (76/300) by the Nugent's method. Among the women with vaginal discharge BV was diagnosed more in STD group which is 33.8% (52/ 154) compared to the non STD group which is 16.4% (24/146). The sensitivity, specificity, positive and negative predictive values were calculated to assess the validity of the Amsel's method considering the Nugent's criteria as the goid standard. Diagnosis of BV by performing Amsel's method exhibit a low sensitivity (55.3%) and high proportion of false positives (positive predictive value-59.2%) when compared against Nugent's method. CONCLUSIONS: The Amsel's method is not a satisfactory method to be used as a diagnostic tesffor BV. At present BV is diagnosed by examining the nature of vaginal discharge or by using some of the Amsel's criteria. As we have found that Amsel's criteria cannot diagnose BV satisfactorily, we have to establish Nugent's method to diagnose BV in Sri Lanka.
Spatial epidemiologic trends and hotspots of leishmaniasis, Sri Lanka, 2001-2018
(Centers for Disease Control and Prevention (CDC), 2020) Karunaweera, N.D.; Ginige, S.; Senanayake, S.; Silva, H.; Manamperi, N.; Samaranayake, N.; Siriwardana, Y.; Gamage, D.; Senerath, U.; Zhou, G.;
ABSTRACT: Leishmaniasis, a neglected tropical disease, is on the decline in South Asia. However, cases of cutaneous leishmaniasis have risen in Sri Lanka since 2001, and the lack of in-depth research on its epidemiologic characteristics hampers control efforts. We analyzed data collected from patients with cutaneous leishmaniasis in Sri Lanka during 2001-2018 to study temporal and geographic trends and identify and monitor disease hotspots. We noted a progression in case rates, including a sharp rise in 2018, showing temporal expansion of disease-prevalent areas and 2 persistent hotspots. The northern hotspot shifted and shrank over time, but the southern hotspot progressively expanded and remained spatially static. In addition, we noted regional incidence differences for age and sex. We provide evidence of temporally progressive and spatially expanding incidence of leishmaniasis in Sri Lanka with distinct geographic patterns and disease hotspots, signaling an urgent need for effective disease control interventions. KEYWORDS: Asia; Indian subcontinent; Leishmania donovani; Sri Lanka; cutaneous leishmaniasis; dermatological pathologies; epidemiology; infectious diseases; leishmaniasis; parasites; protozoa; skin lesions; vector-borne infections.
Spatiotemporal distribution of cutaneous leishmaniasis in Sri Lanka and future case burden estimates
(Public Library of Science, 2021) Karunaweera, N.D.; Senanayake, S.; Ginige, S.; Silva, H.; Manamperi, N.; Samaranayake, N.; Dewasurendra, R.; Karunanayake, P.; Gamage, D.; de Silva, N.; Senarath, U.; Zhou, G.
BACKGROUND: Leishmaniasis is a neglected tropical vector-borne disease, which is on the rise in Sri Lanka. Spatiotemporal and risk factor analyses are useful for understanding transmission dynamics, spatial clustering and predicting future disease distribution and trends to facilitate effective infection control. METHODS: The nationwide clinically confirmed cutaneous leishmaniasis and climatic data were collected from 2001 to 2019. Hierarchical clustering and spatiotemporal cross-correlation analysis were used to measure the region-wide and local (between neighboring districts) synchrony of transmission. A mixed spatiotemporal regression-autoregression model was built to study the effects of climatic, neighboring-district dispersal, and infection carryover variables on leishmaniasis dynamics and spatial distribution. Same model without climatic variables was used to predict the future distribution and trends of leishmaniasis cases in Sri Lanka. RESULTS: A total of 19,361 clinically confirmed leishmaniasis cases have been reported in Sri Lanka from 2001-2019. There were three phases identified: low-transmission phase (2001-2010), parasite population buildup phase (2011-2017), and outbreak phase (2018-2019). Spatially, the districts were divided into three groups based on similarity in temporal dynamics. The global mean correlation among district incidence dynamics was 0.30 (95% CI 0.25-0.35), and the localized mean correlation between neighboring districts was 0.58 (95% CI 0.42-0.73). Risk analysis for the seven districts with the highest incidence rates indicated that precipitation, neighboring-district effect, and infection carryover effect exhibited significant correlation with district-level incidence dynamics. Model-predicted incidence dynamics and case distribution matched well with observed results, except for the outbreak in 2018. The model-predicted 2020 case number is about 5,400 cases, with intensified transmission and expansion of high-transmission area. The predicted case number will be 9115 in 2022 and 19212 in 2025. CONCLUSIONS: The drastic upsurge in leishmaniasis cases in Sri Lanka in the last few year was unprecedented and it was strongly linked to precipitation, high burden of localized infections and inter-district dispersal. Targeted interventions are urgently needed to arrest an uncontrollable disease spread.