Browsing by Author "Wijeyaratne, P.M."

Filter results by typing the first few letters
Now showing 1 - 2 of 2
  • No Thumbnail Available
    Item
    Importance of active case detection in a malaria elimination programme
    (The Bulletin of the Sri Lanka College of Microbiologists, 2014) Wickremasinghe, R.; Fernando, S.D.; Thiliekaratne, J.; Wijeyaratne, P.M.; Wickremasinghe, A.R.
    INTRODUCTION AND OBJECTIVES: Malaria surveillance methods routinely used in Sri Lanka are passive and active case detection (PCD, ACD) and activated passive case detection (APCD). Active case detection is carried out by mobile malaria clinics. Tropical and Environmental Diseases and Health Associates (TEDHA) an implementation partner of the Anti Malaria Campaign (AMC) carries out APCD and ACD in four districts in Sri Lanka namely Trincomalee, Batticaloa, Ampara and Mannar, complementing the parasitological surveillance activities carried out by the AMC. DESIGN, SETTING AND METHODS: The ACD programme of TEDHA involves screening of populations irrespective of the presence of fever or any other signs or symptoms of malaria to detect infections and residual parasite carriers. TEDHA screens a) high risk populations using ACD through mobile malaria clinics including armed forces personnel and b) pregnant females who visit antenatal clinics for asymptomatic malaria infections during their first trimester. Populations are selected in consultation with the Regional Malaria Officer of the AMC thus avoiding any overlap with the population screened by the government. RESULTS: TEDHA screened 387.309 individuals between January 2010 and December 2012, for malaria by ACD including high risk groups and pregnant women and diagnosed eight malaria positive cases (7 Ptasmodium vivax infections and one mixed infection with P. vivax and Plasmodium falciparum}. All these cases were from the Mannar district amongst resettled populations and army personnel. During this period 125 cases were detected in the Mannar district by the Anti Malaria Campaign by passive case detection. No cases of malaria were detected by ACD by the AMC. CONCLUSIONS: The progress made by Sri Lanka in the malaria elimination drive is largely due to increased surveillance and judicious use of control methods. The country now needs to focus on enhanced surveillance to be malaria free and to prevent re-introduction of malaria into the country. As highlighted here, ACD played a major role in interrupting malaria transmission in the country. ACKNOWLEDGEMENTS: Financial assistance by the Global Fund (Grant, No. PR2 SRL809G11-M) is gratefully acknowledged. The authors would like to acknowledge the support given by the staff of TED HA.
  • No Thumbnail Available
    Item
    Importance of active case detection in a malaria elimination programme
    (BioMed Central, 2014) Wickremasinghe, R.; Fernando, S.D.; Thillekaratne, J.; Wijeyaratne, P.M.; Wickremasinghe, A.R.
    Introduction of human immunization reduced Japanese Encephalitis (JE) cases dramatically in Sri Lanka. However, the increased reporting ofadverse events following immunization (AEFI) affected vaccine acceptance by the community. Against this background, we describe the incidence of overall AEFI and incidence and profile of AEFI, thought to be causally related to the mouse-brain derived JE vaccine. A follow-up of 9798 vaccine recipients was performed for a period of two weeks post-vaccination. Parents self-recorded observed signs and symptoms. The self-records were collected by trained supervisors. All monitored children who manifested symptom/s were investigated in details by medical officers experienced in AEFI investigations within two weeks after ending the follow-up period. Using the results of the investigation, the causality assessment was performed. The estimated cumulative incidence rate of overall AEFI was 8.6 children per 100 immunizations. The same for observed AEFI consistent with causal association to the inactivated JE vaccine was 4.3 children (95% CI-3.9-4.7%) per 100 immunizations. The most frequent AEFI was fever (81%). The frequency of high fever (>102 °F) was 26%. Other major AEFI were body ache (22%) vomiting (21%), urticaria (19%), pruritus (5%), and headache (5%). Though 83% of children with AEFI thought to be causally related to the vaccine sought medical care, only 6.6% required hospitalizations. The incidence rate of AEFI in the cohort event monitoring was several-fold higher than that reported through the national AEFI surveillance system. The incidence rate of allergic manifestations among Sri-Lankan children approached what was reported for non-endemic settings and was higher than in other JE endemic populations elsewhere. Contrary to the belief of medical practitioners and the general public, incidence of seizures was low and vaccine related other neurological manifestations were absent.