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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Item Prevalence and severity of abusive experiences during childhood among a group of young adults from Gampaha District(Sri Lanka Medical Association, 2016) Chandraratne, N.K.; Fernando, A.D.; Gunawardena, N.S.INTRODUCTION: Abuse during childhood is a public health problem leading to adverse health, social and economic consequences. OBJECTIVES: The study aims to determine the prevalence and severity of physical, sexual and emotional abuse during childhood among young adults aged 18-20 years schooling in the Gampaha District. METHOD: A descriptive cross-sectional study was conducted among 1500 schooling young adults selected by multistage cluster sampling. The prevalence of physical, sexual and emotional abuse was ascertained using the validated version of ICAST-R (ISPCAN Child Abuse Screening Tool-Retrospective Version). The severity of abusive experiences was assessed using a tool developed by the researchers based on modified Delphi technique. RESULTS: Prevalence of physical abusive experiences during childhood was 45.4% (95%CI = 42.9–47.9) (males- 54.8%, 95%CI = 51.1–58.8, females- 38.3%, 95%CI = 35.0–41.3), prevalence of severe physical abuse was 0.1%.. Being 'beaten by an object' was the commonest experience among both males (45.9%, 95% CI = 42.8–49.8) and females (32.0%, 95% CI = 28.7-35.6). Prevalence of sexual abuse during childhood was 9.1% (95% CI=7.6-10.5) (males: 6.4%, 95%CI=4.6–8.3, females: 11.5%,95%CI = 9.4–13.7), prevalence of severe sexual abuse was 0.2%. ‘Someone exposing their genitals’ was the commonest act (9.1%, 95%CI = 7.1-11.1) experienced by females and ‘Someone touching the genitals’ was the commonest act (4.0%, 95%CI = 2.5-5.7) experienced by males. Prevalence of emotional abuse during childhood was 27.9% (95%CI = 25.7–30.2) (males: 33.9%, 95%CI = 30.4–37.3, females: 23.2%,95% CI = 20.3–26.1) severe emotional abuse was seen among 2.4%. Insulting or criticizing was the most common abusive act among both males (29.5%, 95%CI = 26.2-33.1) and females (20.1%, 95%CI = 17.2-22.9). CONCLUSIONS: Prevalence of physical, sexual and emotional abusive experiences during childhood were high among schooling young adults in the Gampaha District. This calls for targeted interventions.Item Association of attachment with parents and abusive experiences during childhood(Sri Lanka Medical Association, 2016) Chandraratne, N.K.; Fernando, A.D.; Gunawardena, N.S.INTRODUCTION: Improving parent-child attachment is considered to be an effective intervention in preventing child abuse. OBJECTIVES: This study is aimed at determining the association between parent-child attachment and experience of abuse during childhood. METHOD: A cross sectional analytical study was conducted among a representative sample of 1479 schooling young adults aged 18-20 years in Gampaha District, selected using a multi-stage cluster sampling method. Experience of abuse during childhood were determined using the self-administered locally validated tool SICAST-R. Parent-child attachment was determined using Inventory of Parent and Peer Attachment (IPPA), a self-administered tool, which measures the attachment to parents during childhood in the dimensions of communication, trust and alienation. RESULTS: The prevalence rates for abusive experience during childhood were 45.4% (95% CI=42.9–47.9), 9.1% (95% CI=7.6-10.5) and 27.9% (95% CI=25.7–30.2) for physical, sexual and emotional abuse respectively. All three dimensions that describe the attachment with the mother were significantly associated with being physically (poor trust:OR=3.71, 95% CI=1.52-9.05; poor communication: OR=1.72, 95%CI=0.89-3.35; presence of alienation: OR=2.63, 95%CI=1.72-4.00), sexually (poor trust: OR=3.62, 95%CI=1.07-12.25; poor communication :OR=2.44, 95% CI=1.01-5.92; presence of alienation: OR=3.89, 95% CI=2.22-6.81) and emotionally (poor trust: OR=6.56, 95% CI=2.88-14.91; poor communication: OR=3.19, 95% CI=1.78-5.71; presence of alienation: OR=3.32, 95% CI=2.21-4.98) abused during childhood. Similarly, aall three dimensions that describe the attachment with the father were significantly associated with being physically (poor trust: OR =3.16, 95%CI = 1.92-5.19; poor communication: OR=2.72, 95%CI=1.57-4.72; presence of alienation: OR=2.53, 95%CI=1.80-3.56), sexually (poor trust: OR=2.49, 95%CI = 1.18-5.29; poor communication: OR = 3.28, 95%CI = 2.27-4.74; presence of alienation: OR = 2.55, 95%CI = 1.54-4.22) and emotionally (poor trust: OR = 3.29, 95%C I= 2.00-5.39; poor communication:OR = 4.47, 95%CI = 2.05-9.73; presence of alienation: OR=3.21, 95%CI = 2.30-4.48) abused during childhood. CONCLUSIONS: Poor attachment with parents is associated with abusive experience during childhood. Public Health Programmes should focus on improving parent-child attachment.Item Profile of paediatric respiratory diseases requiring hospital admission(Sri Lanka Medical Association, 2012) Subasinghe, V.; Karunasekera, W.; Fernando, A.D.; Lakmini, C.; Weerasooriya, L.; Hathagoda, W.INTRODUCTION: Respiratory tract disorders cause significant mortality and morbidity in children worldwide. OBJECTIVES: To study the pattern of respiratory diseases and its seasonal variation among children. METHODS: A descriptive study was conducted at University Paediatric Unit, Colombo North Teaching Hospital in 2010 and 2011. All children below 12 years admitted with respiratory tract diseases (ICD-10 classification) were recruited into the study. Data collection forms were filled by medical officers using patient records. RESULTS: Total of 2651 (1370 in 2010; 1281 in 2011) were admitted with respiratory diseases. In respective years, 53% (2010) and 55%(2011) were males. Highest number of admissions was during infancy (27.2%). During consecutive years 2010 and 2011, 43.0% and 45.2% had unspecified lower respiratory tract infections (LRT1); 29.9% and 29.4% had upper respiratory tract infections (URTI); 10.7% and 12.4% had bronchial asthma; 1.8% and 2.2% had pneumonia; 5.9% and 8.9% had bronchiolitis. Stabilization at ETU was needed in 8.5%. Median duration of hospital stay was 3 (range 1-60) days. No follow-up was required in a majority (82.5%). Admissions due to respiratory diseases peaked in June (2010-20.1% and 2011-16.0%) and were mainly due to LRTI-52.0%, URTI-28.4%. Admissions with bronchial asthma were higher during the first half of the year (2010-86.3% and 2011-80.5%). Deaths were 18 (1.3%) in 2010 and 6 (0.5%) in 2011. CONCLUSIONS: Respiratory tract infections peak in June whereas asthma is precipitated in early months of the year. Over one-fourth of patients had URTI and was unnecessarily admitted.Item Child abuse and neglect; who gets abused and who abuses them?(Sri Lanka Medical Association, 2005) Fernando, A.D.; Karunasekera, K.A.W.; Fernando, L.; Samarasekera, A.OBJECTIVES: To study the socio-demographic characteristics of victims of child abuse and characteristics of the perpetrators. Study Design: A descriptive study. METHOD: A prospective study of 112 victims of child abuse presenting to the University Paediatric Unit, Ragama from January 2000 to August 2004. The study evaluated characteristics of victims and perpetrators. Ethical approval was obtained. Data Analysis: Epi info version 6. RESULTS: Mean age of the victims was 9.7 years. 79% were females. Ethnicity-91% Singhalese, 5%Muslims and 4%Tamils. 82% resided in Gampaha District. Education of father and mother respectively - 5% and 11%-not attended school, 32% and 34%-primary education, 52% and 50%-ordinary level and 11% and 9%-advanced level. Social class -46%-unskilled, 26%-poorly skilled, 18%-skilled and 10%-lesser professionals. Monthly income (Rs.) -6% <2000, 37% 2000-5000, 33% 5000-10,000 and 24% >10,000. Marital status- 64%-married, 27%-divorced, 6%-unmarried and living together, 3%-single. Amongst married parents, 20% of mothers and 6% of fathers were abroad. Caregiver to the victim- 47%-both parents, 15%-mother, 15%-father, 14%-relatives and 9%-others. Consumption of alcohol by father -59%. Characteristics of perpetrators- 98% were known to the victims and in 24% the perpetrator was the father. Number of perpetrator/s- 86%-one, 5%-two, 5%-three, 4%-more than 3. Perpetrator being drunk at the tine of abuse in 31%. Amongst sexually abused, 26% were acts of incest. Of those 70% by father. CONCLUSIONS: The most vulnerable victims of abuse are shown to be 10-year-old females. Majority came from low social and educational backgrounds, In <5Q%, both parents cared for the child. 98% of perpetrators were trusted persons and in nearly a quarter it was the father.Item A profile of child abuse and neglect in a tertiary care hospital(Sri Lanka Medical Association, 2005) Fernando, A.D.; Karunasekera, K.A.W.; Fernando, L.; Samarasekera, A.OBJECTIVES: To study the pattern of child abuse and neglect. To evaluate the management and the Outcome of such victims STUDY DESIGN: A descriptive study METHOD: The sample consists of 112 victims of child abuse referred to the University Paediatric Unit, Ragama Hospital, from January 2000 to August 2004. The study prospectively evaluated types of abuse, their characteristics, management of victims and outcome. Ethical approval was obtained. RESULTS: 24% had more than one type of abuse. Categories of abuse were: 70% -sexual, 33% -physical, 16% -neglect, 14% -emotional and 6% -child labour. Amongst sexually abused, 62% had penetrative sex, 8% became pregnant, 4% had sexually transmitted diseases, 5% had severe degree perineal/peri-anal tears, and 37% had psychological disturbances at the time of presentation. 39% came for follow up assessment after 6 months. Amongst them, 60% had psychological disturbances, amongst physically abused, 19% had fractures. Amongst all victims, the mean duration of hospital stay was 29 days. Management outcome: 46% sent back to parents, 11% to extended family member/s, 38% to Children's Homes and 5% to others. CONCLUSIONS: 24% had more than one type of abuse. The commonest type was sexual abuse. The majority of them had penetrative sex and 8% became pregnant. Psychological disturbances were found in the majority of victims of sexual abuse on follow up. 57% of victims were able to continue to live with their parents/extended family.