Browsing by Author "Mendis, K."

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Accessing emergency test results on ward computers: Introduction of electronic communication alone would not improve clinical care
(British Medical Association, 2001) Fernando, B.; Mendis, K.
No Abstract Available
A Comparative analysis of the outcome of malaria case surveillance strategies in Sri Lanka in the prevention of re-establishment phase
(BioMed Central, 2021) Gunasekera, W.M.K.T.A.W.; Premaratne, R.; Fernando, D.; Munaz, M.; Piyasena, M.G.Y.; Perera, D.; Wickremasinghe, R.; Ranaweera, K.D.N.P.; Mendis, K.
BACKGROUND: Sri Lanka sustained its malaria-free status by implementing, among other interventions, three core case detection strategies namely Passive Case Detection (PCD), Reactive Case Detection (RACD) and Proactive Case Detection (PACD). The outcomes of these strategies were analysed in terms of their effectiveness in detecting malaria infections for the period from 2017 to 2019. METHODS: Comparisons were made between the surveillance methods and between years, based on data obtained from the national malaria database and individual case reports of malaria patients. The number of blood smears examined microscopically was used as the measure of the volume of tests conducted. The yield from each case detection method was calculated as the proportion of blood smears which were positive for malaria. Within RACD and PACD, the yield of sub categories of travel cohorts and spatial cohorts was ascertained for 2019. RESULTS: A total of 158 malaria cases were reported in 2017-2019. During this period between 666,325 and 725,149 blood smears were examined annually. PCD detected 95.6 %, with a yield of 16.1 cases per 100,000 blood smears examined. RACD and PACD produced a yield of 11.2 and 0.3, respectively. The yield of screening the sub category of travel cohorts was very high for RACD and PACD being 806.5 and 44.9 malaria cases per 100,000 smears, respectively. Despite over half of the blood smears examined being obtained by screening spatial cohorts within RACD and PACD, the yield of both was zero over all three years. CONCLUSIONS: The PCD arm of case surveillance is the most effective and, therefore, has to continue and be further strengthened as the mainstay of malaria surveillance. Focus on travel cohorts within RACD and PACD should be even greater. Screening of spatial cohorts, on a routine basis and solely because people are resident in previously malarious areas, may be wasteful, except in situations where the risk of local transmission is very high, or is imminent. These findings may apply more broadly to most countries in the post-elimination phase. KEYWORDS: Active case detection; Malaria case surveillance; Malaria in Sri Lanka; Passive case detection; Prevention of re-establishment of malaria; Proactive case detection; Reactive case detection; Spatial cohorts; Travel cohorts; Yield.
DFM - '90 - A Look back by three family practitioners
(College of General Practitioners of Sri Lanka, 1996) Corea, E.; Nanayakkara, S.; Mendis, K.
Ecology of healthcare: Symptom prevalence and health care seeking behaviour in Gampaha District, Sri Lanka
(Sri Lanka Medical Association., 2019) Withana, S. S.; Mendis, K.; Nandasena, S.; Wickremasinghe, A.R.
INTRODUCTION & OBJECTIVES: In 20 J 5, the Ministry of Health reported that 55 million outpatient visits were made to government OPDs and estimates 100 million visits by 2027. We studied the community symptom prevalence, associated factors and the trends in healthcare seeking behaviour in the Gampaha district. METHODS: A community-based prospective study, using a participant held symptom diary and interviews was conducted from May to June 20 J 8 in three Public Health Midwife areas each from Raga ma (urban) and Mirigama (rural) MOH areas. RESULTS: We invited 2330 individuals from 557 households and 2046 participated. Majority were: females. (n=l 127, 55.1%). Highest recruitment was from Mirigama area (n=1207, 59%). Of the study population 1919 (93.8%) reported at least one symptom. Phlegm (n=4871, 7.2%) had the highest frequency, musculoskeletal symptoms were the highest (26.8%) as a group. Females had a higher symptom prevalence (p = 0.001). Employment, income, having a chronic disease and distance to healthcare institution were significantly (p < 0.05) associated with both symptom prevalence and healthcare seeking behaviour. How the symptoms were managed: Ignored symptoms (n=l53, 8%), Self-care (n=560, 29.2%) and Seeking healthcare (n=924, 48.1%). Majority (n=763,82.6%) sought allopathic treatment, of whom 515 (55.7%) chose private sector ambulatory care. Of the 43 (2.2%) hospital admissions, 28 (65%) were to government hospitals. CONCLUSION: People in Gampaha District have a high symptom prevalence (93.8%) and healthcare seeking behaviour (48.1%) compared to USA which was (80%) and (32.7%) respectively. Gender did not influence the healthcare seeking behaviour. Majority (55%) preferred private allopathic ambulatory care.
Effectiveness of passive case detection for imported malaria in a hospital setting in Sri Lanka during the prevention of re-introduction phase of malaria
(Oxford University Press, 2019) Dharmawardena, P.; Premaratna, R.; Mendis, K.; Wickremasinghe, A.R.; Rodrigo, C.; Harintheran, A.; Fernando, D.
INTRODUCTION: The effectiveness of the passive case detection (PCD) system for imported malaria was assessed in government hospitals in Sri Lanka post-elimination of malaria. METHODS: In 18 medical wards (test wards) in four government hospitals, the referral for malaria testing and the diagnosis of malaria by the ward physicians were monitored. Concurrently, in-ward febrile patients were assessed independently for their eligibility for referral for malaria diagnosis and were tested for malaria. The malaria incidence in 16 other wards (control wards), which the study did not screen, served as controls. RESULTS: Four imported malaria patients were diagnosed within the PCD system among 25 874 febrile patients admitted during the 14-month study period, two of whom were diagnosed in the test wards and two in the control wards. The study's screening programme did not detect any more malaria patients than detected by the routine PCD system of the wards. However, far fewer patients were screened for malaria (1.3%) than were eligible for screening (29.4%), and some infections were detected incidentally, rather than by a request for a malaria test. CONCLUSION: A continuous effort to maintain awareness of the disease among physicians would be required if the PCD system is to be effective for the detection of imported malaria, post-elimination.
Epidemiological profile of imported malaria cases in the prevention of reestablishment phase in Sri Lanka
(Taylor & Francis, 2022) Dharmawardena, P.; Premaratne, R.; Wickremasinghe, R.; Mendis, K.; Fernando, D.
ABSTRACT: Sri Lanka reported the last case of indigenous malaria in October 2012, and received malaria-free certification from WHO in September 2016. Malaria cases have since, shifted from indigenous to imported, and the country remains receptive and vulnerable to malaria. A case-based epidemiological study was conducted on all imported malaria cases reported in the country in 2015 and 2016 with the aim of profiling imported malaria to improve the effectiveness of the surveillance and case management system for malaria. Data were obtained from case reports of the Anti Malaria Campaign, hospital records and laboratory registers. Over the 2 years, 77 imported malaria infections were diagnosed in 54 Sri Lankans and 23 foreign nationals. A majority of the infections were reported among males (93%) in the age group of 21-50 years (85.8%), and all were recent travelers overseas. Most patients were detected by passive case detection, but 10% of cases were detected by Active Case Detection. Only 25% of patients were diagnosed within 3 days of the onset of symptoms. In 32% of patients, the diagnosis was delayed by more than 10 days after the onset of symptoms. Plasmodium falciparum infections manifested significantly earlier after arrival in Sri Lanka than did P.vivax infections. The majority of patients (74%) were diagnosed in the Western Province, which was not endemic for malaria. A third of patients were diagnosed in the private sector. The shift in the epidemiology of malaria infection from before to after elimination has implications for preventing the reestablishment of malaria. KEYWORDS: Imported malaria; case surveillance; delayed diagnosis; epidemiology; prevention of reestablishment; receptivity; risk factors.
Evaluation of the undergraduate family medicine programme of Faculty of Medicine, University of Kelaniya: quantitative and qualitative student feedback.
(BioMed Central, 2019) Perera, D.P.; Withana, S.S.; Mendis, K.; Kasunjith, D.V.T.; Jayathilaka, W.T.S.; Wickramasuriya, S.
BACKGROUND:Worldwide there is an increasing emphasis on the importance of primary care. The ministry of health Sri Lanka issued a directive in 2016 that training of doctors in primary care should be strengthened. Medical students of the Faculty of Medicine, University of Kelaniya follow a 1 month long clinical appointment in family medicine in their fourth year of study. METHODS:Feedback is taken from students on completion of the appointment. Half the students from each group complete a pre tested structured feedback questionnaire that consists of answers to questions based on a likert scale with a space for free comments. The other half provide qualitative feedback. In this evaluation data were gathered from 185 (98%) students from all eight clinical groups throughout the year 2016. Quantitative data were analysed using SPSS version 22. Inductive thematic analysis was used to analyse the qualitative data from the Round Robin activity and free comments from the questionnaire. RESULTS:The qualitative feedback provided a richer indepth overview of student ideas on the appointment compared to the quantitative data. In reflection of a desire for learning to be of relevance students wanted clinically oriented teaching focused on management. They preferred active teaching learning methods such as the opportunity to conduct consultations and receive immediate feedback. Students had a high regard for the teaching sessions by general practitioners at their clinics. The appointment had created an interest in the discipline of family medicine which could have an impact on future choice of career. There were indications to suggest that student attitudes towards patients may have evolved to be more patient centred. Students appreciated the inclusive and low stress ambience of the learning environment. CONCLUSIONS AND RECOMMENDATIONS:Regular evaluation of teaching programmes helps maintain accountability of faculty and paves the way for more student centred teaching through the incorporation of students' views in devising teaching methods. This evaluation found that qualitative feedback provided more descriptive material to reflect on and therefore improve teaching on the programme. It is recommended that more use should be made of qualitative methodologies in programme evaluations.
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.
Internet for General Practitioners/Family Physicians
(1997) Mendis, K.
Includes a general introduction to the internet, how to access and the services. Indicates briefly how doctors may use internet and e-mail.
Is the combination of Advanced Level aggregate, attempt, and IQ a better criteria for medical school selection?
(Sri Lanka Medical Association, 2001) Jayawardana, D.R.K.C.; Mendis, K.
INTRODUCTION: Admission criteria to Sri Lankan medical faculties are based on the Advanced Level (AL) aggregate and district. The student's medical school performance at examinations (MSPE) does i not correlate well with their AL marks. OBJECTIVE: To ascertain the association of medical school performance at examinations with IQ, AL aggregate and AL attempt. METHOD: The students of the first batch of the Faculty of Medicine, University of Kelaniya, were given Ravens IQ test during the final year. Subject marks in the first attempt at 2", 3rd and Final MBBS were extracted from the official records. Final MBBS total marks and grand total marks of all subjects, AL aggregate and the AL attempt were also recorded. Results were analysed using EPI 6. RESULTS: The AL aggregate did not have a significant correlation with MSPE either in the Final MBBS or with the grand total mark. A significant positive correlation was obtained between the mean IQ and the Final MBBS examination marks (p=0.006). Although there was a positive trend there was no significant correlation between the mean IQ and the grand total marks. The AL first attempt students fared significantly better in the Final MBBS (p~0.002) and throughout their undergraduate career (p=0.001).There was no significant correlation between AL attempt and IQ. CONCLUSIONS: Although traditionally AL marks are taken for university entrance, a higher mark at the AL did not correlate well with MSPE. IQ and AL attempt were better indicators of MSPE.
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.
A malaria death due to an imported Plasmodium falciparum infection in Sri Lanka during the prevention of re-establishment phase of malaria
(BioMed Central, 2023) Seneviratne, S.; Fernando, D.; Chulasiri, P.; Gunasekera, K.; Thenuwara, N.; Aluthweera, C.; Wijesundara, A.; Fernandopulle, R.; Mendis, K.; Wickremasinghe, R.
BACKGROUND: Sri Lanka has maintained a rigorous programme to prevent the re-establishment of malaria ever since the disease was eliminated in October 2012. It includes efforts to sustain case surveillance to ensure early diagnosis and management of malaria. Yet, in April of 2023 the death occurred of an individual with imported malaria. CASE PRESENTATION: The deceased was a 37-year-old Sri Lankan male who returned to Sri Lanka on the 10th of April after a business trip to several countries including Tanzania. He was febrile on arrival and consulted three Allopathic Medical Practitioners in succession in his home town in the Western Province of Sri Lanka, over a period of 5 days starting from the very day that he arrived in the country. Malaria was not tested for at any of these consultations and his clinical condition deteriorated. On the evening of 14th of April he was admitted to the medical intensive care unit of a major private hospital in the capital city of Colombo with multiple organ failure. There, on a request by the treating physician blood was tested for malaria and reported early the next morning as Plasmodium falciparum malaria with a high parasitaemia (> 10%). The patient died shortly after on the 15th of April before any anti-malarial medication was administered. The deceased had been a frequent business traveller to Africa, but with no past history of malaria. He had not taken chemoprophylaxis for malaria on this or previous travels to Africa. DISCUSSION: The patient's P. falciparum infection progressed rapidly over 5 days of arriving in Sri Lanka leading to severe malaria without being diagnosed, despite him seeking healthcare from three different Medical Practitioners. Finally, a diagnosis of malaria was made on admission to an intensive care unit; the patient died before anti-malarial medicines were administered. CONCLUSIONS: This first death due to severe P. falciparum malaria reported in Sri Lanka after elimination of the disease was due to the delay in diagnosing malaria.
Malaria elimination does not cost more than malaria control: Sri Lanka a case in point
(BioMed Central, London, 2022) Mendis, K.; Wickremasinghe, R.; Premaratne, R.
Background: Malaria was endemic in Sri Lanka for centuries and was eliminated in 2012. It is widely assumed that the costs of elimination are generally greater than that of control. The costs of malaria elimination in Sri Lanka with that of malaria control in the past using periods in which starting transmission dynamics were similar were compared. Methods: The expenditure of the Anti-Malaria Campaign (AMC), total and by budget category, during 2002-2010 is compared with that of malaria control during the period 1980-1989, using regression analyses and the Mann Whitney U statistic. Results: The expenditure on malaria control and malaria elimination was similar ranging from 21 to 45 million USD per year when adjusted for inflation. In both periods, external funding for the malaria progamme constituted around 24% of the total budget; during the control phase in the 1980s, external funds came from bilateral agencies and were disbursed in accordance with government budget guidelines. In the elimination phase in the 2000s, most of external funding was from the Global Fund and had flexibility of disbursement. In the 1980s, most funds were expended on commodities-insecticides, diagnostics and medicines and their delivery; in the elimination phase, they were spent on programme management, human resources, technical assistance and monitoring and evaluation; monitoring and evaluation was not a budget line in the 1980s. Although the cost per case of malaria was considerably higher during the elimination phase than in the control phase, expenditure was not on individual cases but on general systems strengthening. Conclusion: Malaria elimination in Southeast Asia may not require more funding than malaria control. But sustained funding for an agile programme with flexibility in fund utilization and improved efficiencies in programme management with stringent monitoring and evaluation appears to be critically important.
Morbidity pattern and process of care at a teaching hospital outpatient department in Sri Lanka
(Sri Lanka Medical Association, 2017) Mendis, K.; de Silva, A.H.W.; Perera, D.P.; Withana, S.S.; Premasiri, B.H.S.; Jayakodi, S.
INTRODUCTION & OBJECTIVES: There is paucity of published data regarding outpatient department (OPD) morbidity in spite of 55 million OPD visits to government hospitals in 2014. OPD morbidity has been assumed to be similar to indoor morbidity for two decades. The recent Ministry of Health focus to strengthen primary care skills of medical graduates, requires reliable data from primary care to align medical curricula towards this goal. This is an initial step to identify the primary care morbidity profile. METHODS: In a cross-sectional pilot study doctors trained as data collectors observed a representative sample of doctor patient encounters and recorded the reason for encounters (RFE) and process of care. The problem definition (PD) was provided by the consulting doctor. RFEs and PDs were later coded using International Classification of Primary Care (ICPC2). Analysis was done using ‘R Ver3.2.3’ programming language. RESULTS: A total of 2923 clinical encounters resulted in 5626 RFEs and 3051 health problems. Patients mean age was 39.1(±22) with 64.5% females. Top ranking PDs were (n=3051): acute upper respiratory infection (11.3%), other respiratory infection (8.1%), viral fever (4.7%), lower respiratory tract infection (4.7%), muscle symptoms and complaints (3.8%), gastritis (3.3%), bronchial asthma (2.6%), dermatitis (2.5%), fungal infections (1.6%) back pain (1.5%), sinusitis (1.4%), joint pains (1.2%) and tonsillitis (1.2%). Psychological problems accounted for 0.4% and no social problems were recorded. During 2923 encounters, 540 (18%) were referred to clinics and 66 (2.3%) admitted to hospital. Prescriptions were issued for 2349 (80%), examination carried out in 2322 (79%), advice given to 946 (32%) and investigations ordered for 348 (12%). CONCLUSION: The morbidity pattern of OPD patients is different from inpatients - almost two thirds were females and more than 30% were respiratory problems.
One day general practice morbidity survey in Sri Lanka
(Sri Lanka Medical Association, 1998) de Silva, N.; Mendis, K.
OBJECTIVE : To identify people's needs from the reasons for encounter with family physicians, to illustrate the pattern of morbidity in general practice and determine the workload of general practitioners(GPs) in Sri Lanka METHOD : A random sample of GPs completed a Practitioner Profile Questionnaire (PPQ) and recorded in an encounter from (EF) the rcason/s for encounter (RFE) and problems defined during consecutive consultations on the fourth of July 1996. Central coding of the RFEs and problems defined \vas done using the International Classification of Primary Care (ICPC). RESULTS : Forty GPs (53.3%) completed the PPQ, while the response to the EF was 43.3%. The GP profile showed none below 35 years and none qualified after 1984. The average daily workload was 74. It was estimated that GPs handle 26.5% of the primary care morbidity. Children accounted for 32% of consultations. There was a significantly higher proportion of children (pO.OOOI) and the elderly (p<0.05) in the consulting population compared to national statistics. In 2068 encounters, 3448 RFEs and 2087 problems had been recorded. By ICPC rubrics, 27 of the top thirty RFEs were for common symptoms. Acute illness, asthma, hypertension, diabetes and preventive care were among top twelve problems defined. CONCLUSION : The findings indicate the necessity to include family medicine/general practice in the undergraduate curriculum of all medical schools. Care of children and the elderly should receive priority in family training programmes. Suitable incentives may be necessary to motivate younger doctors to become GPs to meet the medical care needs of the community.
One day general practice morbidity survey in Sri Lanka
(Oxford University Press, 1998) de Silva, N*.; Mendis, K.
BACKGROUND: National morbidity surveys provide valuable data for monitoring the health needs of populations, health policy planning and design of medical curricula. In order to meet a long-standing need for such information in Sri Lanka, a nationwide general practice morbidity survey was conducted for the first time in 1996. OBJECTIVES: We aimed to identify people's needs by determining the reasons for encounter or the demand for care with GPs/family physicians, to illustrate the pattern of morbidity in general practice and to determine the average daily workload of GPs in Sri Lanka. METHOD: A random sample of 75 GPs were requested to complete a Practitioner Profile Questionnaire (PPQ) and to record on an encounter form (EF) the reason/s for encounter (RFE) and problems managed during all consultations on 4 July. Central coding of the RFEs and problems defined was done using the International Classification of Primary Care (ICPC). RESULTS: Forty GPs (53.3 percent) completed the PPQ, while the EF received a response from 34 (43.3 percent). The GP profile showed a male to female ratio of 7:1, none below 35 years and none qualified after 1984. The average daily workload was 74. It was estimated that GPs handle at least 26.5percent of the primary care morbidity. Children accounted for 32 percent of consultations. There was a significantly higher proportion of children (P 0.0001) and of the elderly (P 0.05) in the consulting population compared with the general population. In 2068 encounters, 3448 RFEs and 2087 problems had been recorded. Respiratory and General chapters included 55 percent of the RFEs. By ICPC rubrics, 27 of the top thirty RFEs were for common symptoms. In addition to acute illnesses, asthma, hypertension and diabetes as well as preventive care activities were within the top 12 problems managed. CONCLUSIONS: The fact that many common illnesses, chronic diseases and preventive treatments are dealt with in general practice shows the necessity to include family medicine in the undergraduate curriculum of all medical schools. Undergraduate and postgraduate training in family medicine should concentrate more on child care and care of the elderly. Suitable incentives may be necessary to motivate younger doctors to become GPs to meet,the medical care needs of the community.
Patient satiasfaction with consultation in ambulatory care setting in Sri Lanka
(Department of Family Medicine, Aga Khan University Pakistan, 2006) de Silva, N*.; Abayasekera, S.; Mendis, K.; Ramanayake, J.
Perspectives from China, India and Sri Lanka on the drivers and potential solutions to overuse and overdiagnosis
(BMJ Publishing Group Ltd, 2023) Pathirana, T.; Wang, Y.; Martiny, F.; Copp, T.; Kumar, R.; Mendis, K.; Tang, J.
No abstract available
Preventing the re-establishment of malaria in Sri Lanka amidst the COVID-19 pandemic
(BioMed Central, 2020) Ranaweera, P.; Wickremasinghe, R.; Mendis, K.
ABSTRACT: The COVID-19 pandemic has had a considerable impact on other health programmes in countries, including on malaria, and is currently under much discussion. As many countries are accelerating efforts to eliminate malaria or to prevent the re-establishment of malaria from recently eliminated countries, the COVID-19 pandemic has the potential to cause major interruptions to ongoing anti-malaria operations and risk jeopardizing the gains that have been made so far. Sri Lanka, having eliminated malaria in 2012, was certified by the World Health Organization as a malaria-free country in 2016 and now implements a rigorous programme to prevent its re-establishment owing to the high receptivity and vulnerability of the country to malaria. Sri Lanka has also dealt with the COVID-19 epidemic quite successfully limiting the cumulative number of infections and deaths through co-ordinated efforts between the health sector and other relevant sectors, namely the military, the Police Department, Departments of Airport and Aviation and Foreign Affairs, all of which have been deployed for the COVID-19 epidemic under the umbrella of a Presidential Task Force. The relevance of imported infections and the need for a multi-sectoral response are features common to both the control of the COVID-19 epidemic and the Prevention of Re-establishment (POR) programme for malaria. Sri Lanka's malaria POR programme has, therefore, creatively integrated its activities with those of the COVID-19 control programme. Through highly coordinated operations the return to the country of Sri Lankan nationals stranded overseas by the COVID-19 pandemic, many from malaria endemic countries, are being monitored for malaria as well as COVID-19 in an integrated case surveillance system under quarantine conditions, to the success of both programmes. Twenty-three imported malaria cases were detected from February to October through 2773 microscopic blood examinations performed for malaria in quarantine centres, this number being not much different to the incidence of imported malaria during the same period last year. This experience highlights the importance of integrated case surveillance and the need for a highly coordinated multi-sectoral approach in dealing with emerging new infections. It also suggests that synergies between the COVID-19 epidemic control programme and other health programmes may be found and developed to the advantage of both. KEYWORDS: Contact tracing; Malaria and COVID-19; Multi-sectoral health collaboration; Prevention of re-establishment of malaria; Quarantine.
Pub Med and Google Scholar perspectives of the Ceylon Medical Journal: Analysis from 2002 - 2016
(Sri Lanka Medical Association, 2018) Mendis, K.; Solangaarachchi, D. I. K.; Weerabaddana, C.
INTRODUCTION: Revisiting our analysis published in 2002, a bibliometric analysis of the Ceylon Medical Journal(CMJ) was done. METHOD: CMJ citations from 2002-2016 were downloaded in PubMed/MEDLINE format and written to a MS• Access database using 'PubMed Grabber' software from Kelaniya. For analysis, advanced PubMed queries and Google Scholar (for H-Index and cross-check author publication details) were used. RESULTS: 87~ citations were authored by 1666 authors. However, only 441 had more than one citation. Annual citations decreased from 71 (2002) to 61 (2016). Range 51-71, mean 58.6 and mode 51. Publications types: Journal Articles 685 (75%), Case Reports 281 (32%), Letters 210 (24%), Reviews 19 (2%), Clinical Trials 25(3%). Classification of citations by ICD-10 main chapters using Medical Subject Headings [MeSH]: infections and parasitic 156 (17.7%), endocrine, nutritional and metabolic 119 (13.5%), neoplasms 111 (12.6%), nervous system 101 (11.5%), digestive system 90 (10.2%). Authors with the highest number of articles were: [CMJ articles in PubMed, All articles in PubMed, H-Index] de Silva HJ [30,150,41] Lamabadusuriya SP [22,26,4] Pathmesweran A [22,64, 17] Senanayake MP [18,28, 9] de Silva NR (17,45,26] Kuruppuarachchi KA [16,24,7] Jayasinghe-_S_ [ 16, 189, 19] . CONCLUSION: The number of annual citations in CMJ is decreasing. For 1225 (73%) authors, publishing in the CMJ was a one-time affair. Case reports (32%) and letters (24%) totalled 56%. The vast majority of the top ranked CMJ authors had more citations in journals with a higher 'journal impact-factor' than CMJ. This may be one reason that CMJ is yet to have an impact-factor. Our method depends on the accuracy and consistency of author name, affiliation, and the key words submitted by authors.