Browsing by Author "Jayasinghe, K.S.A."

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Efficacy of single dose combinations of albendazole, ivermectin and diethylcarbamazine for the treatment of bancroftian filariasis
(Oxford University Press, 1998) Ismail, M.M.; Jayakody, R.L.; Weil, G.J.; Nirmalan, N.; Jayasinghe, K.S.A.; Abeyewickreme, W.; Sheriff, M.M.R.; Rajaratnam, H.N.; Amarasekera, N.; de Silva, D.C.; Michalski, M.L.; Dissanaike, A.S.
In a 'blind' trial on 50 male asymptomatic microfilaraemic subjects with Wuchereria bancrofti infection, the safety, tolerability and filaricidal efficacy of a single dose of albendazole (alb) 600 mg alone or in combination with ivermectin (iver) 400 microg/kg or diethylcarbamazine citrate (DEC) 6 mg/kg was compared with a single dose of the combination DEC 6 mg/kg and iver 400 micro g/kg over a period of 15 months after treatment. All but one subject, with 67 micro filariae (mf)/mL, had pre-treatment counts 100 mf/mL. All 4 treatments significantly reduced mf counts, but alb/iver was the most effective regimen for clearing mf from night blood: 9 of 13 subjects (69 percent) were amicro filaraemic by membrane filtration 15 months after treatment compared to one of 12 (8 percent), 3 of 11 (27 percent), and 3 of 10 (30 percent) in the groups treated with alb, alb/DEC, and DEC/iver, respectively. Filarial antigen tests suggested that all 4 treatments had significant activity against adult W. bancrofti; alb/DEC had the greatest activity according to this test, with antigen levels decreasing by 77percent 15 months after therapy. All 4 regimens were well tolerated and clinically safe, although mild, self-limited systemic reactions were observed in all treatment groups. These results suggest that alb/iver is a safe and effective single dose regimen for suppression of micro filaraemia in bancroftian filariasis that could be considered for control programmes. Additional benefits of this combination are its potent, broad spectrum activity against intestinal helminths and potential relative safety in areas of Africa where DEC cannot be used for filariasis control because of co-endemicity with onchocerciasis or loiasis
Lipid profiles, anthropometry and dietary habits of adolescent school boys in Sri Lanka
(HEC Press, Australia, 1997) Athukorala, T.M.S.; de Silva, L.D.R.; Jayasinghe, K.S.A.
Serum lipid profiles, anthropometric parameters, dietary habits and smoking practice were determined in 637 adolescent school boys in the 10th to 13th year of school (mean age 16.7 ± 1.3 years), to determine the prevalence of risk factors for cardiovascular disease in later life. They all attended schools in Colombo, the capital city (n=416), and two other cities, Negombo and Kurunegala. Seven percent of the subjects had body mass index (BMI) values above a reference range (for age 14-16, > 23.5 kg/m2; older than 16 years > 24.5 kg/m2). The mean serum total cholesterol concentration was within the reference range (158.9± 27.2 mg/dL: 4.11± 0.70 mmol/L), but 16.5% had values >185 mg/dL. The percentages of subjects with high LDL (low density lipoprotein)cholesterol (>110 mg/dL) and apolipoprotein B (>85 mg/dL) concentrations were 21.9 % and 23.0% respectively, while low HDL (high density lipoprotein) cholesterol (<35 mg/dL) levels were noted in 27.3% of subjects. A significant (p<0.001) positive association was noted between serum total cholesterol concentration and BMI. There was no significant difference in the mean BMI or total cholesterol levels of subjects from the three areas in the age group 15-16.9 years. However, in the age group 17-18.9 years, subjects in the Kurunegala area had a lower prevalence of risk factors ie. significantly lower BMI and serum total cholesterol and apolipoprotein B concentrations than those in other areas. Overall, smoking prevalence was 4.5%, and higher in Colombo than in Negombo and Kurunegala. Further, the mean intake of cholesterol was significantly lower and the fibre intake was higher among subjects in Kurunegala, than those in other areas. Thirty two percent of subjects had a family history of coronary artery disease, hypertension or diabetes and these subjects had significantly higher BMI values than those who did not have a family history of the above diseases, but their lipid patterns were similar. Thus high BMI was a major factor leading to hypercholesterolaemi.
Prolonged clearence of microfilaraemia in patients with bancroftian filariasis after multiple high doses of ivermectin of diethylacarbamizine
(Oxford University Press, 1996) Ismail, M.M.; Weil, G.J.; Jayasinghe, K.S.A.; Premaratne, U.N.; Abeyewickreme, W.; Rajaratnam, H.N.; Sheriff, M.M.R.; Perera, C.S.; Dissanaike, A.S.
In a double-blind trial on 37 asymptomatic microfilaraemic subjects (minimum 400 microfilariae [mf] per mL) with Wuchereria bancrofti infection, the safety, tolerability and macrofilaricidal efficacy of 12 fortnightly doses of ivermectin, 400 microg/kg (ivermectin group), was compared with 12 fortnightly doses of diethylcarbamazine (DEC), 10 mg/kg (DEC group), over a period of 129 weeks after treatment. A control group (LDIC group) was treated with low dose ivermectin to clear microfilaraemia, for ethical reasons. Both ivermectin and DEC in high multiple doses were well tolerated and clinically safe. Macrofilaricidal efficacy was assessed by prolonged clearance of microfilaraemia, appearance of local lesions, and reduction of circulating W. bancrofti adult antigen detected by an antigen capture enzyme-linked immunoassay based on the monoclonal antibody AD12. Mf counts fell more rapidly after ivermectin than after DEC, but low residual mf levels were equivalent in these groups after week 4. Conversely, filarial antigen levels fell more rapidly after DEC than after ivermectin, but low residual antigen levels in these groups were statistically equivalent at all times beyond 12 weeks. Mild, self-limited systemic reactions to therapy were observed in all 3 treatment groups. Local reactions, such as development of scrotal nodules, were observed in several subjects in the DEC and ivermectin groups. These results suggested that high dose ivermectin and DEC both had significant macrofilaricidal activity against W. bancrofti, but neither of these intensive therapeutic regimens consistently produced complete cures. Thus, new drugs or dosing schedules are needed to achieve the goal of killing all filarial parasites in the majority of patients.
Social determinants of obesity in Kalutara District
(Sri Lanka Medical Association, 2014) de Silva, A.P.; de Silva, S.H.P.; Liyanage, I.K.; Rajapakse, L.C.; Jayasinghe, K.S.A.; Kotulanda, P.; Wijeyaratne, C.N.; Wijeratne, S.; Haniffa, R.
INTRODUCTION AND OBJECTIVES: To describe social, cultural and economic determinants of obesity in a representative population in Kalutara METHODS: A cross sectional survey carried out among adults of 35 to 64 years. Applying a stratified random duster sampling method from urban, rural and plantation sectors, 1300 participants were selected. Data gathered using an interviewer administered questionnaire. The body mass index of 23.01 kg/m2-27.50kg/ m2 was considered as overweight and >27.51kg/m2 as obese. Waist circumference (WC) of >90cm and >80cm was regarded as high for men and women respectively. Significance of prevalence of diseases and risk factors across different socio-economic strata were determined by chi square test for trend. RESULTS: Of 1234 adults who were screened age and sex adjusted prevalence of overweight, obesity and abdominal obesity (high WC) were 33.2%, 14.3% and 33.6% respectively. The Muslim population had the highest prevalence of all three categories. Sector, education, income, social status quintiles and area level deprivation categories show-an inverse gradient in obesity categories, mean BM! and mean WC. The differences observed for mean BM! and mean WC between the lowest and .highest groups in these socioeconomic factors were significant. CONCLUSION: There is an inverse gradient of overweight, obese and centrally obese with higher prevalence observed in the more affluent, educated, urban and high income segments of society. In Sri Lanka those in the higher socio economic categories are still at a higher risk of being overweight, obese and having abdominal obesity.
Treatment of bancroftian filariasis with ivermectin in Sri Lanka, evaluation of efficacy and adverse reaction
(Malaysian Society of Parasitology and Tropical Medicine, 1991) Ismail, M.M.; Premaratne, U.N.; Abeyewickreme, W.; Jayasinghe, K.S.A.; de Silva, W.A.S.; Atukorala, S.; de Abrew, K.; Dissanaike, A.S.