Browsing by Author "Jayarathna, T.D.S.S."

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    Clinical and virological features of dengue in 2010
    (Sri Lanka College of Microbiologists, 2011) Hapugoda, M.D.; Manamperi, H.; Gunasena, S.; Athapaththu, A.M.M.H.; Premawansa, G.; Wellawaththage, C.; Jayarathna, T.D.S.S.; Abeyewickreme, W.
    INTRODUCTION: Dengue is an important viral infection in Sri Lanka. All 4 serotypes co-circulate in Sri Lanka. OBJECTIVE: To study the clinical and virological features of dengue in 2010. DESIGN, SETTING AND METHODS: A hospital-based study was carried out at North Colombo Teaching Hospital, Ragama in 2010. Patients clinically suspected of having dengue, with fever less than 5 days were recruited. Acute and convalescent blood samples were collected within 7 days after obtaining informed written consent. Demographic, clinical information and laboratory results were obtained. Acute serum samples were tested using molecular (RT-PCR and Semi-Nested PCR) and serological (ELlSAs and HAI) assays. Convalescent samples were tested by serological assays. RESULTS: Of 209 patients enrolled, 93 % (195/209) were laboratory confirmed as recent positive cases of dengue viral infection; of these, 5% (9/195) were classified as dengue fever; 85%(1G5/195) dengue haemorrhagic fever (DHF) and 0.5% (1/195) dengue shock syndrome. Mean platelet value and packed cell volume (PCV) in laboratory confirmed dengue patients were 56,107/mm3 (range 10,000-306,000) and 42%(range 34-61 %) respectively. Patients infected with DHF showed both primary (n=45) and secondary (n=102) infections. Interestingly, secondary infection was not significantly correlated with DHF (x2-0.3:p=0.6). DEN-1 was responsible for the majority of cases, with a minority due to other three serotypes; all serotypes contributed to severe disease. CONCLUSION: DEN-1 was responsible for the majority of cases in 2010 but it circulated at a low level during previous epidemics. Majority of patients had severe clinical symptoms. In this epidemic, the clinical presentation of dengue differed according to the geographic region and viral serotype. ACKNOWLEDGMENTS: Financial assistance and technical co-operation by International Center for Genetic Engineering and Biotechnology (ICGEB CRP SRL 08/02), National Science Foundation (NSF/RG/2009/BT/01) and International Atomic Energy Authority (lAEA/SRL/5/042) is acknowledged.
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    Correlation of clinical presentation and laboratory confirmation of dengue patients
    (Sri Lanka Association for the Advancement of Science, 2010) Manamperi, N.H.; Athapaththu, A.M.M.H.; Premawansa, V.; Wellawaththage, C.; Jayarathna, T.D.S.S.; Abeyewickreme, W.; Hapugoda, M.D.
    Dengue is one of the most important arthropod-borne diseases in the world and it has become a very important disease in Sri Lanka, today. In Sri Lanka, diagnosis of dengue depends mainly on clinical signs and symptoms. Only a few suspected patients are confirmed by laboratory assays based on aetiological agents. The objective of this study was to determine the correlation between clinical presentation and laboratory confirmation of dengue patients. Acute serum samples (n=100) collected from patients clinically suspected of having dengue fever ("'ª-"ý¦> 5 days) warded at the North Colombo Teaching Hospital, Ragama were used for the present study. Serum samples were collected after obtaining informed written consent frompatients and samples were tested by RT-PCR which has high sensitivity (10 FFU/reaction) and specificity. Final diagnosis as dengue or non-dengue was assigned based on the results of RT-PCR assay. Differences in clinical and laboratory data were analyzed in dengue and non dengue patients. Chi-square test was used for comparison of data. The proportion of laboratory confirmed dengue patients were 56% (56/100). Mean platelet count and PCV in laboratory confirmed dengue patients were 60 269/mm 3 (range 3000-306000) and 41% (range 27-61%) and in non dengue patients were 106 318/mm 3 (range 5000-290000) and 41.6% (range 29-53%). Based on WHO criteria for diagnosis of dengue, heada (48/56 vs 41/44, ÝÖ 2 =0.7, p=0.38), retro-orbital pain (30/56 vs 14/44, ÝÖ 2 =3.8, p=0.04), limb pain (51/56 vs 30/44, ÝÖ 2 =7, p=0.00) and external bleeding (29/56 vs 4/44, ÝÖ 2 =18, p=0.00) showed significant association with dengue. Neck pain (10/56 vs 09/44, ÝÖ 2 =0.01, p=0.94), and lymphadenopathy (3/56 vs 02/44, ÝÖ 2 =0.08, p=0.78) did not show significant association with dengue. The infection was confirmed as dengue fever in 11% (6/56) and dengue hemorrhagic fever in 89% (50/56) based on WHO criteria. 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 which leads implementation of control measures. Further, thisis important for efficient management of patients.Acknowledgements: Financial and technical assistance from the International Centre for Genetic Engineering and Biotechnology (ICGEB CRP/ SRI08-02) and International Atomic Energy Agency (IAEA SRI 5/042)