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 Achieving millennium development goal 4 in 2015: are we really on track?(Sri Lanka College of Paediatricians, 2011) Mettananda, S.; Rajindrajith, S.; Warnakulasuriya, T.; Fernando, M.; Devanarayana, N.M.; Gunawardena, N.K.INTRODUCTION: Millennium development goal (MDG) 4 aims to reduce under 5 mortality by two thirds from 1990 (22.2 per 1000 live births) to 2015 (7.4 per 1000 live births). In achieving this, proper and accurate description of the causes of deaths is crucial. OBJECTIVES: To describe the timing, causes and distribution of under 5 child deaths in Sri Lanka and to predict the likelihood of achieving MDG 4. DESIGN, SETTING AND METHOD: Information regarding all under 5 child deaths between 2002-2006 was obtained from the Registrar Generals' Department. Place, sex and age at death were retrieved. Causes of deaths documented accordingly to the ICD-10 classification were reclassified into clinically relevant and user-friendly categories. Mortality rates and predictions for 2015 were calculated using Microsoft Excel. RESULTS: A total of 26,273 deaths have occurred during 2002-2006 [55% neonatal, 21% post-neonatal infant and 24% child (l-5year)]. Tsunami wave in 2004 had caused 2,868 (11%) deaths and they were excluded from further analysis. Prematurity had caused 4,603 (31.8%) neonatal deaths; 2389 (16.5%) were due to infections and 1149 (7.9%) were due to birth asphyxia. Congenital anomalies have contributed to 1830 (12.6%) neonatal deaths, of which, the majority [1389 (9.6%)] were heart diseases. Leading causes for post-neonatal infant deaths include congenital anomalies [1772 (35%)], infections [1516 (29.9%)] and trauma [393 (7.7%)]. in children, 910 (23.4%) deaths were due to infections (10.2% respiratory, 2.0% gastroenteritis and 0.9% dengue). One fifth of deaths were due to congenital anomalies of which half were due to heart defects. Trauma/ accidents and malignancies had contributed to 731 (18.8%) and 279 (7.1%) deaths respectively. Colombo district reported the highest number of deaths (24%). More males (54.7%) have died compared to females. Reduction in mortality rates were observed from 2002-2006; neonatal mortality from 8.3 to 7.6, infant mortality from 11.4 to 10.4 and under 5 mortality from 13.7 to 12.3. Projections of data showed that the neonatal, infant and under 5 mortality rates in 2015 would be 4.6, 6.7 and 7.7 per 1000 live births respectively. CONCLUSIONS: Prematurity was the leading cause of neonatal mortality. Congenital heart diseases are an important cause of death throughout childhood. Trauma and accidents contribute to a significant proportion of child deaths. Predictions from data suggest that Sri Lanka may fall marginally short of achieving MDG 4.Item Knowledge of mothers regarding helminth infections and patterns of anthelminthic usage in children(Sri Lanka Medical Association, 2012) Perera, P.; Dissanayaka, D.; Fernando, M.; Ranathanga, N.INTRODUCTION: Intestinal helminth infections are a global problem. There are lot of misbelieves among people regarding helminth infections, which often leads to inappropriate use of anthelmintics. AIMS: To assess the knowledge of mothers regarding helminth infections and to describe the patterns of anthelmintic usage in children. METHODS: A descriptive cross sectional study was carried out at University Paediatric unit. Teaching hospital Ragama, during September 2011 to November 2011. Two Hundred children and their mothers admitted to the Paediatrics university unit with at least one child above 18 months were recruited with informed written consent. Socio-demographic data, availability of sanitary facilities and safe drinking water, knowledge on intestinal infections and practices related to anthelmintic treatment were collected using a pretested Interviewer administered questionnaire. RESULTS: Nearly all families had access to a safe toilet and 62% had safe drinking water. 84% of children had regular anthelmintic treatment and out of them 39.3% had 3 monthly, 55.3% six monthly and 5.3% annually. Out of them only 81.4% had risk factors to get helminth infections, while 36,9% had no evidence in the past of worm infection. There was no statistically significant association between regular anthelmintics usage and presence of risk factors (odds ratio 1.799, CI 0.849-3.815). Knowledge of mothers regarding transmission of worm infections and clinical features was poor. CONCLUSIONS: Considering the high literacy rate among Sri Lankan mothers knowledge about worm infections was surprisingly poor. A lot of children are receiving unnecessary anthelmintic treatment. Health education programs addressing these issues are indicated.Item Feeding practices of children attending well baby clinics in Ragama MOH area: a descriptive cross sectional study(Sri Lanka Medical Association, 2011) Perera, K.P.J.; Fernando, M.; Warnakulasuria, T.; Ranathunga, N.INTRODUCTION AND OBJECTIVES: Feeding during early childhood is important for growth and health. Objectives of this study were to evaluate the current feeding practices during first few years of life among Sri Lankan children. METHODS: A descriptive cross sectional study conducted in Ragama MOH area during the period of 10th august 2010 and 30th October 2010. 410 children between 2 -5 years of age, attending well baby clinics were included in the study. Interviewer administered questionnaire was used to collect data regarding socio-demographic characteristics and feeding practices. Open ended questions were used. SSPS version 16 was used for data analysis. RESULTS: The study population consisted of 208 boys and 202 girls. 62.2% children were exclusively breastfed for 6 months. 351 have received formula milk. 61 had formula milk started before the age of 6 months and 212 by one year. 330 children had sugar added to formula milk. 144 of them had sugar added within first year. 29 children had complementary food started before 4 months. 294 mothers continued to breastfeed beyond 2 years and 41.6% of them were breast feeding at regular intervals. 82.5% children were receiving overnight feeding either as breast milk or formula beyond 2 years. . CONCLUSIONS: Though high rate of exclusive breast feeding is prevalent in Sri Lanka, there seem to be other issues related to feeding. Too early introduction of complementary food, adding sugar to formula, prolonged breast feeding too frequently and prolonged overnight feeding are among them.Item Analysis of neonatal deaths in Sri Lanka from 2002 to 2006(Sri Lanka Medical Association, 2011) Mettananda, S.; Warnakulasuriya, T.; Fernando, M.; Devanarayana, N.M.; Rajindrajith, S.INTRODUCTION AND OBJECTIVES: To describe the causes, timing and distribution of neonatal deaths in Sri Lanka from 2002 to 2006. METHODS: Information on all neonatal deaths occurred from 2002 to 2006 (5 calendar years) in the entire country was obtained from the Registrar Generals' Department. Place of death and age at death were retrieved. Causes of death documented as 429 different diagnoses according to the ICD-10 classification were reclassified into clinically relevant and meaningful categories. Results: A total of 14,487 neonatal deaths occurred during the 5-year period with a mean of 2897.4 deaths per year; of which 8159 (56.32%) were males. One third of them (4904) died within 24 hours of life and 11,318 (78.12%) were early neonatal deaths. Number of deaths gradually decreased with increasing age. Colombo district reported 3334 (23.0%) deaths. Prematurity and related complications were the cause for 4603 (31.77%) deaths whereas 2389 (16.49%) deaths were due to infections. Proportion of deaths due to infections has gradually decreased from 20.23% in 2002 to 11.84% in 2006. Congenital anomalies contributed to 12.63% (1830) deaths and the majority of those deaths (1389-9.59%) were due to congenital heart diseases. Birth asphyxia had caused 1349 (7.93%) neonatal deaths. Tsunami wave in 2004 has led to 36 (0.25%) neonatal deaths. CONCLUSIONS: Preventable causes such as prematurity, infections and congenital heart diseases are still leading causes of neonatal deaths in Sri Lanka. Targeted healthcare reforms are urgently needed to address these issues.