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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2015 - 20172

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Author: search.filters.author.Dissanayake, D.M.R.Has files: No

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    An islandwide hospital based epidemiological survey of haemoglobinopathies and an assessment of standards of care in 23 centres
    (Sri Lanka Medical Association, 2017) Premawardhena, A.P.; Mudiyanse, R.M.; Jifri, M.N.; Nelumdeniya, U.B.P.; Silva, D.P.S.I.; Nizri, A.H.M.; Rajiyah, M.O.F.; de Silva, T.U.N.; Pushpakumara, K.R.C.; Dissanayake, D.M.R.; Jansz, M.; Rifaya, M.I.; Navarathne, N.M.U.S.B.; Arambepola, W.W.M.M.; Thirukumaran, V.; Mendis, D.; Weerasekara, K.P.; de Silva, N.N.; Vaidyanatha, U.S.de.S.; Mettananda, D.S.G.; Oliveri, N.F.; Weatherall, D.J.
    INTRODUCTION & OBJECTIVES: There is no database for haemoglobinopathy patients in Sri Lanka resulting in imprecise knowledge about the distribution and standards of care among patients managed in different centres in the island. The prevention programme commenced in 2007 is not centrally monitored. METHODS: We carried out centre-wise visitation and data gathering of patients with haemoglobinopathies in 2015. 23 centres were visited by researchers who gathered information from patient records. RESULTS: Data was obtained of 1768 patients. Three centres had over 200 patients each and another three centres had between 50-100 patients. There were 8 centres with less than 10 patients each. Beta thalassaemia major (BTM) accounted for 1207 (68.26%) patients. There were 363 patients (20.53%) with Haemoglobin E-β thalassaemia. Sickle cell-β thalassaemia accounted for 51 patients (2.88%). The mean age of BTM patients was 13 years (range 2-44). Ethnic distribution of the haemoglobinopathies (82.5% Sinhalese, 12% Muslims and 5.2% in Tamils) was discrepant to the national ethnic data. Islandwide mean number of new births of all thalassaemics recorded showed a reduction from 66/year between 2004 - 2009 to 48/year between 2010 to 2015.Clinical record keeping was not systematic in most units thus complication rates were hard to obtain. Death data were available only in two units. CONCLUSION: This study identified significant inconsistencies in haemoglobinopathy care between centres. Existence of small centres needs to be recognized by the Ministry of Health. A reducing trend of new births over the last decade was observed.
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    HCV and HBV infection among a cohort of Sri Lankan thalassaemic patients
    (Sri Lanka Medical Association, 2015) Perera, P.S.; Niriella, M.A.; Peries, M.A.C.; Nelumdeniya, U.B.; Dissanayake, D.M.R.; de Silva, D.S.I.; de Silva, H.J.; Premawardhena, A.P.
    INTRODUCTION AND OBJECTIVES: Previous studies suggest that prevalence of hepatitis C (HCV) and hepatitis B (HBV) virus infections is low in Sri Lanka. Patients with severe thalassaemia are at risk of developing blood borne infections like HBV and HCV. While HBV can be prevented by vaccination, safe blood donor screening practices is the best preventive strategy for HCV. Nationwide HCV blood donor screening was commenced in Sri Lanka in 2009. We studied tne prevalence of HBV and HCV Infections among a Sri Lankan cohort of thaiassaemic patients. Method: All consenting patients with J^JJJfusion dependent thalassaemia in Anuradhapura, Ragama, Baduila, Chilaw centers were screened for HBV and HCV by HBsAg and Anti-HCV antibodies respectively. Those positive during screening for HBV and HCV were confirmed by HBV-DNA and HCV-RNA PCR respectively. Results: A total of 513 patients were tested (Anuradhapura-210, Ragama-184, Badualla-70, Chilaw-49). There were no cases of HBV infection. Anti-HCV antibodies were positive in 97(45.2%), 14(7.6%), 5(7.1%), 0 in the four centres respectively, HCV was confirmed in 32 {15.2%}, 4 (2.2%), 1 (1.4%), 0 patients in the four centres. 2/4 patients from Ragama and the patient from Badualla had blood transfusions from Anuradhapura prior to changing care to present centre. HCV positive patients age ranged from 5-21 years (mean 12.5). Total transfusions ranged from 49-312. CONCLUSION: This is the first report of high HCV prevalence in a specific group to be reported from Sri Lanka, The high prevalence from a single centre (Anuradhapura} is alarming and reasons for this needs urgent investigation.