Conference Papers

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The Prevalence of asthma in Sri Lankan adults
((Wiley Blackwell Scientific Publications, 2016) Amarasiri, D.L.; Undugodage, U.C.M.; Silva, H.K.M.S.; Sadikeen, A.; Gunasinghe, W.; Fernando, A.; Wickremasinghe, A.R.; Gunasekera, K.D.
BACKGROUND AND AIMS: Data on adult asthma is scarce in Sri Lanka. The objective of this study was to estimate the prevalence of asthma and related symptoms amongst adults in the general population. METHODS: A multi-centered, cross-sectional study was conducted using an interviewer-administered translated version of the screening questionnaire of the European Community Respiratory Health Survey from June to December 2013 in 7 provinces of Sri Lanka. Subjects were selected randomly from different regions by stratified sampling. The prevalence of asthma was defined as "wheezing in the past 12 months (current wheeze)", 'self-reported attack of asthma in the past 12 months' or 'current asthma medication use'. RESULTS: The study comprised 1872 subjects (45.1% males, 48.8% aged18-45 years) of which 12.2% were current smokers. In the total population, the prevalence of current wheeze was 23.9% (95% CI: 22.0%-25.9%), of self-reported asthma was 11.8% (95% CI: 10.3%- 13.2%) and of current asthma medication use was 11.1% (95% CI: 9.6%- 12.5%). The prevalence of asthma according to a positive response to either of the above questions was 31.4% (95% CI: 29.3%-33.4%) The prevalence of symptoms was higher in adults aged >45 years. Of those with current wheeze, 60.9% denied a diagnosis of asthma and only 38.2% admitted to use of asthma medication. In those with current wheeze, wheezing was the only symptom in 19.9% whereas 80.1% had at least one other respiratory symptom (tightness of chest, cough or shortness of breath) of which cough was the most common symptom. In those without current wheeze, self-reported asthma and current asthma medication use, 30%, 35.9% and 36.6% respectively had at least one other respiratory symptom. CONCLUSIONS: The prevalence of asthma in Sri Lankan adults is high in comparison with global data. A significant percentage of symptomatic individuals deny having asthma and are not on medication.
Spirometry reference norms for 13-14 year old Sri Lankan children.
(Wiley Blackwell Scientific Publications, 2016) Amarasiri, D.L.; Warnakulasuriya, D.T.; Wickremasinghe, A.R.; Gunasekera, K.D.;
BACKGROUND AND AIMS: Spirometry reference norms have only been reported for Peak Expiratory Flow Rate (PEFR) in Sri Lankan children. The aim of this study was to construct prediction equations for spirometry in Sri Lankan children aged 13-14 years. METHODS: Spirometry was performed in 2078 healthy 13-14 year old Sri Lankan children (1023 boys (49.2%) and 1055 (50.8%) girls) according to American Thoracic Society guidelines. Forced Vital Capacity (FVC), Forced Expiratory Volume in the first second (FEV1), PEFR and Forced Mid-Expiratory Flow Rates (FEF25-75%) were measured. Correlation coefficients were established between each parameter and standing height, weight, and age. The functions were regressed over all possible combinations of variables separately for boys and girls. RESULTS: There were significant correlations between spirometry parameters and height and weight in both genders. There were significant correlations between age and PEFR, FEF25 and FEF50 in males and age and FEV1, PEF and FEF25-75% in females. The prediction equations in males for FVC: 0.047height + 0.0007age- 4.66; for FEV1: 0.041height + 0.016age - 4.22; for PEFR: 0.074height + 0.123age - 7.59 and FEF25- 75%: 0.042height + 0.066 age - 4.36. The equations in females for FVC: 0.028height + 0.031age - 2.36; for FEV1: 0.027height + 0.047age - 2.57; for PEFR: 0.038height + 0.159age - 2.93 and FEF25-75%: 0.02height + 0.136age - 3.18. CONCLUSIONS: Height and age influence ventilatory parameters and could be used to assess lung functions in Sri Lankan children.
Upper respiratory symptoms are common in a cohort of patients with symptomatic gastrooesophageal reflux disease (GORD) in Sri Lanka
(Wiley Blackwell Scientific Publications, 2011) Amarasiri, D.L.; Adikari, D.; Sanjeewa, B.; Jayaratne, A.; Dassanayake, A.S.; de Silva, A.P.; de Silva, H.J.
INTRODUCTION: There is increasing evidence for multiple associations between gastro-oesophageal reflux disease (GORD) and the upper respiratory tract. This study evaluated the presence of upper respiratory symptoms (URS) in a cohort of patients with GORD symptoms from Sri Lanka. METHOD: Seventy adults scoring ≥12.5 on a previously validated GORD symptom score (GORD patients) and 70 healthy controls who had infrequent or no GORD symptoms completed a pre-tested, valid URS questionnaire. They were questioned on frequency of 14 URS in 5 categories (laryngeal, nasal, pharyngeal, sinusal and aural). All GORD patients underwent gastroscopy. An URS score was calculated and correlated against the GORD symptom score and gastroscopy fi ndings. RESULTS : The GORD patients (median age (range) 36 (15–65); 38% males) and controls (median age (range) 38 (15–68); 38% males) were comparable. URS scores were higher in GORD patients (mean ± SE, 4.7 ± 4.0) compared to controls (mean ± SE, 1.9 ± 2.3), as were individual symptom scores. Individuals with higher GORD symptoms scores reported more frequent URS. Nasal symptoms had the highest correlation with the GORD symptom score (r = 0.410; P = 0.001). of the GORD patients, 42 had no evidence of oesophageal or gastric mucosal damage. 28 had evidence of refl ux oesophagitis. In them, the presence of oesophagitis did not seem to influence the frequency of reporting URS. CONCLUSION : URS are common in individuals with GORD symptoms though there appears to be no association with oesophageal mucosal damage

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