Conference Papers

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This collection contains abstracts of conference papers, presented at local and international conferences by the staff of the Faculty of Medicine

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Author: search.filters.author.Chandrasena, T.G.A.N.

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    A preliminary survey for filarial parasites among dogs and cats in mahawewa, puttalam and their vector identification
    (Elsevier, 2022) Nimalrathna, S.; Mallwarachchi, C.; Chandrasena, T.G.A.N.; de Silva, N.; Kimber, M.; de Silva, N.R.; Harischandra, H.
    PURPOSE This study investigated the prevalence of zoonotic filarial parasites within the canine and feline population in Mahawewa, Puttalam, and their vectors based on a brugian filariasis positive human case reported to the Anti-filariasis Campaign in January 2021.METHODS & MATERIALS All reachable dogs and cats, both stray and domestic, within a 500m radius of the index human case of brugian filariasis were screened for microfilaria using Giemsa stained thick blood smears prepared from capillary blood, obtained from an ear-lobe prick. Mosquito collection was done using a dog-baited trap, two window traps and a B.G. Sentinel trap from the same study site and identified using morphological keys. The head and the thorax regions of randomly selected mosquito specimens were dissected for morphological identification of larval filaria parasites via microscopy. RESULTS A total of nine dogs and three cats were surveyed, of which seven dogs and one cat had filarial infections. All the infected animals harbored B.malayi microfilariae, while four dogs and one cat were co-infected with Dirofilaria repens and two dogs with an unidentified species. A total of 119 mosquitoes were caught and identified by taxonomic keys using a dog-baited trap, two window traps and a B.G. Sentinel trap from the study site. Dissection of heads and thoraces of randomly selected 12 Mansonia annulifera, 18 Mansonia indiana 20 Mansonia uniformis and 8 Culex spp. revealed filarial larvae in M.annulifera (n=4, 33.33%), M. indiana (n=14, 77.78%), M. uniformis (n=10, 50.00%) and Culex spp.(n=5, 62.5%) via microscopy. CONCLUSION M.indiana was incriminated as a potential vector of filarial parasites for the first time in Sri Lanka. Preliminary evidence generated indicate a high prevalence of B.malayi and D.repens among dogs and cats in Mahawewa, Puttalam with an abundance of mosquito vectors mostly of Mansonia and Culex spp. This warrants further studies with a larger sample size and molecular identification of the filarial larvae within mosquito and animal samples, especially as re-emergence of brugian filariasis in humans is being reported after four decades of quiescence, and a zoonotic brugian parasite has been detected over the recent past, raising a concern from a one health perspective.
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    Detection of a case of Brugian Filariasis from Anuradhapura, a non-endemic district of Sri Lanka
    (Sri Lanka Medical Association, 2018) Mallawarachchi, C.H.; Gunaratne, I.E.; Ekanayaka, G.M.G.A.C.; Mallawarachchi, S.M.N.S.M.; Chandrasena, T.G.A.N.; Mendis, D.; de Silva, N.R.
    INTRODUCTION AND OBJECTIVES: In 2016, the WHO declared that lymphatic filariasis was no longer a public health problem in Sri Lanka. However low-grade persistence of bancroftian filariasis continues in all three endemic provinces, while brugian filariasis has re-emerged. The periodicity pattern of the re-emerged Brugia spp. suggests zoonotic origin. A canine survey done in the district of Anuradhapura found a moderately high prevalence (28.2%) of B. malayi infections in the Thirappane MOH area. Objective of the study was to investigate the threat of zoonotic B.malayi infections to humans in the Thirappane MOH area. METHODS: A cross sectional survey was done among all consenting residents of three randomly selected areas representing the three PHI areas of the Thirappane MOH. Residents were screened between 8.00 pm and 12.00 pm using night blood smears (NBS) and Brugia rapid test (BRT) for presence of anti-Brugia IgG4 antibodies. BRT was done selectively. Ethical and administrative clearance was obtained prior to the survey. RESULTS: A total of 752 individuals were screened by NBS; 176 of them were also screened by BRT. 193, 208 and 351 NBSs were done respectively in Thirappane, Galkulama and Mooriyankadawala PHI areas. One individual, a 25-year-old long-term resident of Mooriyankadawala PHI area was positive for Brugia spp. microfilariae by NBS and by BRT. The microfilariae exhibited nocturnal sub-periodicity. CONCLUSION: Transmission of brugian filariasis appears to occur even outside the traditional endemic belt. The presence of canine reservoirs of infection and water bodies with aquatic vegetation probably favour transmission by Mansonia spp. vector mosquitoes in the study area.
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    Clinical Charasteristics of paediatric rickettsioses
    (Sri Lanka Medical Association, 2013) Premaratna, R.; Karunasekara, K.A.W.; Fernando, M.A.M.; de Silva, L.; Chandrasena, T.G.A.N.; de Silva, H.J.
    INTRODUCTION AND OBJECTIVES: Rickettsioses are re-emerging in Sri Lanka. Both children and adults are vulnerable to these infections. Data on paediatric rickettsioses in the country are sparse. Objectives were to study the clinical characteristics of paediatric rickettsioses based on data received by the Rickettsail Disease Diagnostic and Research Laboratory (RDDRL), Faculty of Medicine, University of Kelaniya, over the last two years. METHODS: All clinical and laboratory data of confirmed rickettsioses were analyzed. RESULTS: Out of 46 requests received by the RDDRL, 22 were positive for acute rickettsioses in diagnostic titres IFA-IgD>1:128 (all>256). Of the positives, 16 were positive for spotted fever group rickettsioses (SFG), 5 for scrub thypus (ST) and 1 for both. 4/5 ST had eschars. The mean age was 56.59 months. (43.9); the youngest affected was aged 5 months. Of the sample 12 (54.5%) were male. Fever was present in all; mean duration was 9.81 (4.5) days; fever intensity was 102.80F (1.03); frequency of spikers per day was 2.33 (0.67). clinical features were headache 12 (54.5%), body aches 9 (40.9%), joint pains 6 (27.3%), cough 14 (63.6%), shortness of breath 5 (22.7%), rash 14 (63.6%); macular popular rash 13, diarrhea 4 (18.2%), lymphadenopathy 7 (31.8%), palpable liver 4, palpable spleen 1. Total WBC 11.1x109/L (SD-4.8); neurophils-84.8% (SD-13.8) lymphocytes 40.5% (17.2). ESR 1st Hr 46.3mm (SD-26.7) CRP 42.1mg/dl (40.6) SGOT 51.2iu/L (32.1) SGPT 50.2iu/L (51.4). ECG was normal in all, Chest x-ray showed patchy shadows in 4. CONCLUSIONS: SFG rickettsioses were commoner than ST, among children living in the Gampaha and Kurunegale districts. Clinical features were similar to adults. Diagnostic investigations were requested late in the febrile illness.
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    Occurence of tick bits and serological evidence of exposure to rickettsioses among Sri Lankan military personnel
    (International Society for Infectious Diseases, 2009) Premaratna, R.; Chandrasena, T.G.A.N.; Nawasiwatte, B.M.T.P.; Kulasiry, K.I.R.; Rajeev, S.; Bandara, K.B.K.R.G.W.; Rajapakse, R.P.V.J.; Kularatna, S.A.M.; de Silva, H.J.
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    Predicted cost benifits of establishment of Ricckettsial didease diagnostics in Sri Lanka
    (American Society of Rickettsiology, 2008) Premaratna, R.; Dissanayake, I.; Chandrasena, T.G.A.N.; Attanayake, N.; de Silva, H.J.
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    Rickettsial infections and their clinical presentations in the Western Province of Sri Lanka: A hospital based study
    (American Society of Rickettsiology, 2007) Premaratna, R.; Loftis, A.D.; Chandrasena, T.G.A.N.; Dasch, G.A.; de Silva, H.J.
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    The role of antioxidants in filarial infection
    (Royal Society of tropical medicine and Higiene (RSTMH), American Society of tropical medicine and Higiene(ASTMH), British Society for Parasitology, 2000) Premaratna, R.; Chandrasena, T.G.A.N.; Senarath, S.; Chandrasena, L.G.; de Silva, N.R.; de Silva, H.J.
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    Effect of genotyping on the severity of rotavirus Gastroenteritis
    (Sri Lanka College of Paediatricians, 2011) Chandrasena, T.G.A.N.; Rajindrajith, S.; Gunawardena, N.K.; Silva, G.M.K.S.; Pathmeswaran, A.; Kazuhiko, M.; Kamruddin, A.
    INTRODUCTION: Rotavirus is the commonest cause of paediatric gastroenteritis. There remains a controversy regarding disease severity being related to rotavirus genotype G9. OBJECTIVE: Study the genotype related severity of rotavirus gastroenteritis. DESIGN, SETTING AND METHOD: All children under 5 years of age who were admitted with acute diarrhoea to North Colombo Teaching Hospital and submitted a sample of stool for analysis from April 2005 to October 2008 were selected for the study. Clinical information was collected regarding the study group. Acute diarrhoea was defined as passage of 3 times or more stools over a period of 24 hours. Stools were collected from cases with blood and mucus diarrhoea as well. The stool compliance rate was around 75-80%. Faecal specimens were tested and genotyped for rotavirus using the ELISA kit, Rotaclone® (Meridian Diagnostics, Cincinnati) and reverse transcription (RT) PCR respectively. Severity of gastroenteritis was assessed using the 20 point scoring system ofVesikariand Ruuska. RESULTS: The total number of stool specimens collected during the study period was 813 and of this 178 were positive for group A rotavirus; all the rotavirus positive stool specimens were genotyped. The two predominant VP7 genotypes were G9 (76; 42.7%) and Gl (35; 19.7%) followed by G2 (22; 12.4%), G3 (22; 12.4%), G12 (18; 10.1%) and G4 (4; 2.2%) respectively. The mean severity scores of, Gl, G2, G3, G4, G9 and G12 were 12,12,12,14,13 and 13, respectively. Comparison of clinical features between the two common G types, G9 and Gl revealed the following: duration of diarrhoea was longer among G9 (mean 4±2 days) than Gl (mean 2±1 day) and a higher percentage of cases were febrile and had vomiting in G9 (84.9 and 86.3 respectively) than Gl (76.7 and 65.5 respectively) infections (p>0.05). The rest of the clinical features were similar. The percentage with severe disease (score >14) was higher among the G9 (38.4) than among Gl (26.7) infections (p>0.05). CONCLUSION: Although rotavirus G9 genotype was associated with a more severe gastroenteritis than the common Gl genotype, this association was not significant (p>0.05).
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    Etiology of fever of unknown origin in a selected group of Sri Lankan patients with prompt responses to Doxycycline
    (Centers for disease control and Prevention, 2008) Dasch, G.A.; Premaratna, R.; Rajapakse, R.P.; Chandrasena, T.G.A.N.; Eremeeva, M.E.; de Silva, H.J.
    BACKGROUND: Most patients with long duration of fever go undiagnosed in settings where diagnostic facilities are inadequate. Untreated rickettsial infections cause extended fevers; while both scrub typhus and tick typhus are re-emerging diseases in Sri Lanka, laboratory facilities to specifically diagnose rickettsial infections in Sri Lanka are not available. METHODS: We collected 2 ml venous blood from febrile patients who had no etiological diagnosis after 7 days of hospital admission, but who showed rapid clinical response to doxycycline, to verify whether they had experienced a rickettsial infection. Acute serum samples were analysed using IFA for rickettsial infections caused by Orientia tsutsugamushi, Rickettsia conorii and Rickettsia typhi. A positive IgG IFA titer >1:128 was used to define a probable case of rickettsial infection. RESULTS: 28 patients [15 males, mean age 32.5 (SD 9.2 yrs)] were studied. Mean duration of fever at admission was 6.1 days (SD 3.1). Two patients had features suggestive of encephalitis and two had erythema nodosum. Others had no specific clinical features. Routine investigations were inconclusive and blood cultures were negative. IgG-IFA titer of >128 was found in 10 for R. conorii, 6 for O. tsutsugamushi and 6 for both R. conorii and O. tsutsugamushi. None were positive for R. typhi. Six were negative for all tests. One patient with encephalitis and one with erythema nodosum had high titers for R. conorii. CONCLUSIONS: The majority of Sri Lankan patients with undiagnosed fever responding promptly to doxycycline had a rickettsial etiology. Patients with rickettsioses exhibit varied clinical presentations so greater use of doxycycline for patients with extended fevers in rickettsial-endemic settings with inadequate diagnostic facilities appears warranted. The high proportion of patients with tick typhus and antibodies against both spotted fever and scrub typhus rickettsiae was unexpected based on previous studies of patients from the same region who were confirmed to have scrub typhus by serology and by the presence of the classic eschar. It is unknown whether the etiology of tick typhus and vector(s) transmitting this agent on the Western lowland region of Sri Lanka are the same as those responsible for spotted fevers in the central hill country of Sri Lanka.
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    Clearance of microfilaraemia and red blood cell glutathione peroxidase(GPX) levels in asymptomatic microfilaraemics after single dose and 14 days’ treatment with diethyl carbamazine citrate(DEC) 
    (Sri Lanka Medical Association, 2001) Premaratna, R.; Chandrasena, T.G.A.N.; Abeyewickreme, W.; de Silva, N.R.; Chandrasena, L.G.; de Silva, H.J.
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