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 Importance of private health sector in malaria surveillance: a case study in Nuwara-Eliya district, Sri Lanka(Sri Lanka College of Microbiologists, 2002) Kusumawathie, P.H.D.; Wickremasinghe, A.R.; Karunaweera, N.OBJECTIVE: To determine the Utilization of public and private health facilities by suspected malaria cases in Divisional Director of Health Services (DDHS) area Hanguranketha in Nuwara-eliya district (from July 2000 to June 2001). DESIGN, SETTING AND METHODS: Two state hospitals, DH Rikillagaskada and RH Gonagantenna were selected as public health facilities. Seven clinics at Rikillagaskada and Gonagantenna in which government medical officers engaged in private practice after duty hours were selected as private health facilities. The number of cases blood filmed for malaria at public facilities was obtained from hospital records. Data for the private sector was obtained using a pre designed form. Reporting from the private sector was done on a monthly basis. RESULTS: Among 572 cases blood filmed at government hospitals, 22 were positive for P.vfvax. In the private sector. 634 cases of suspected malaria were reported and treated on clinical grounds. During the study period, 40 P.vivax and 65 P.falciparum cases were detected by examining 1270 blood films collected by Active Case Detection and Special Malaria Clinics, conducted in the villages with risk of malaria transmission within the study area. Of the microscopically confirmed malaria cases, 15.4% of P.falciparum infections were resistant to chloroquine. Investigation of malaria cases revealed 66.7% of cases were indigenous while 33.3% were imported. If the Slide Positive Rate (SPR) of the government facilities is applied to the data of the private sector, 610 cases would have been given chloroquine without actually having malaria. CONCLUSIONS: According to this study, 52.57% of suspected malaria cases had sought treatment at private health facilities. Incorporating the private health sector in malaria surveillance would be helpful in correct treatment and control of malaria in malarious areas. Unnecessary anti malarial therapy should be reduced by provision of laboratory facilities at private health centers. ACKNOWLEDGEMENTS: Assistance provided by the Provincial Director Health Services, Central Province and Deputy Provincial Director Health Services, Kandy, and the Director Anti-Malaria Campaign is acknowledged.Item Evaluation of the spatial and temporal trends of dengue outbreaks in Akurana, Central Province, Sri Lanka(Sri Lanka Association for the Advancement of Science, 2015) Udayanga, N.W.B.A.L.; Gunathilaka, P.A.D.H.N.; Iqbal, M.C.M.; Kusumawathie, P.H.D.; Najim, M.M.M.; Amerasinghe, U.S.; Abeyewickreme, W.Renowned as the world's fastest growing vector borne disease, dengue has become one of the major health issues in Sri Lanka leading to an alarming concern due to recent outbreaks throughout the country. Despite the immense efforts taken by the relevant authorities to reduce the rate of mortality, the average number of dengue cases recorded in each year remains around 30,000-35,000 without being changed significantly over time in Sri Lanka. Investigation of the trends in spatial and temporal distribution patterns of dengue is often treasured in the drafting and implementation of management/action plans to ensure effective management of dengue epidemics at regional scale. Thus, a statistical and geo informatics based analysis of the recent trends in dengue distribution was carried out to identify spatial and temporal trends in distribution patterns of Dengue in the Akurana Medical Officer of Health (MOH) area. Monthly records of reported dengue cases from 2010 to 2014 of the Akurana MOH area were obtained and were subjected to a scatter plot analysis in MINITAB (version 14.12.0) to identify the temporal patterns in the recorded dengue cases. Spatial maps of the recorded dengue case distribution in each GND for each month and for the whole study period were prepared by using Arc GIS 10.1. The spatial and temporal variations of dengue outbreak distribution within the Akurana MOH (at GND level) were analyzed to identify the recent trends in dengue incidence. Akurana, Bulugahathenna, Dippitiya, Dunuwila, Konakalagala and Neeralla localities could be identified as areas with relatively high risk to dengue outbreaks throughout the study period, while localities such as Balakanduwa, Delgasgoda, Delgasthenna, Malgamandeniya, Marahela, Palleweliketiya and Udawelikatiya emerged as areas with low risk. As suggested by the results of the paired-Chi square test [>Χ2 (30, 0.95) = 43.773], the emergence of dengue outbreaks indicated a significantly declining trend of recorded dengue cases in most of the GNDs (Aswadduma, Delgasgoda, Kurugoda, Malgamandeniya, Palleweliketiya and Walahena etc.) during the recent years. The evaluation of the trends in temporal and spatial distribution of dengue outbreaks at the localized level, could be recommended as a useful tool in the planning and implementation of action plans to control the rise of dengue, while evaluating the efficacy of already implemented control measures at regional scale.Item Geographical Information System (GIS)-based maps for monitoring of entomological risk factors affecting transmission of Chikungunya in Sri Lanka(Faculty of Tropical Medicine, Mahidol University, 2008) Hapugoda, M.D.; Gunawardena, N.K.; Kusumawathie, P.H.D.; Jayasooriya, G.A.J.S.K.; Hapuarachchi, H.A.C.; Abeyewickreme, W.INTRODUCTION: Chikungunya is an important mosquito-born viral infection in Sri Lanka at present. OBJECTIVE: To prepare OUS-based maps Tor monitoring of entomological risk Factors affecting transmission of chikungunya. RESEARCH DESIGN: Entomological risk factors affecting transmission of chikungunya were examined in a chikungunya hot-spot in the District of Kandy, Sri Lanka from April to July in 2008. Hundred house-holds in 33 clusters were recruited. The distant between clusters was at least 200m which is beyond the maximum flight range of Aedes mosquitoes, the vectors of chikungunya. Monthly surveillance was conducted using standard entomological surveillance methods followed by obtaining information through a pre-tested questionnaire. G1S was used to map the selected house¬holds and display entomological data. RESULTS: GIS-based maps were developed to highlight the spatial and temporal distribution of vectors, their density and the presence of key breeding sites. Maps showed the presence of high density of Aedes albopictus mosquitoes in more than 90% of the key (artificial) breeding habitats in all clusters throughout the study period. DISCUSSION: Generalized high density of Ae. albopictus suggests that this species may play a major role in transmitting chikungunya in the study area. GIS-based 'maps may be used as an important tool to find out spatial and temporal distribution of vectors, their density and key breading sites in a selected hotspot, which would enable cost effective and efficient interventions for vector control in disease endemic areas.Item Cost analysis of application of Poecilia reticulata (guppy) and temephos in anopheline mosquito control in river bed pools below the major dams in Sri Lanka(Sri Lanka Association for the Advancement of Science, 2004) Kusumawathie, P.H.D.; Wickremasinghe, A.R.; Karunaweera, N.D.; Wijeyaratne, M.J.S.Item Occurrence of a dengue epidemic in Minipe valley of the Kandy district: evidence for Aedes albopictus being an epidemic vector of dengue in Sri Lanka(Sri Lanka Association for the Advancement of Science, 2011) Kusumawathie, P.H.D.; Jayasooriya, G.A.J.S.K.; Abeyewickreme, W.; Hapugoda, M.D.Item Nocturnal human biting behavior of Anopheles culicifacies in a hydro electric power project area situated in a sylvatic environment in the Central Province of Sri Lanka(Sri Lanka Association for the Advancement of Science, 2007) Kusumawathie, P.H.D.; Jayasooriya, G.A.J.S.K.; Abeyasinghe, R.R.; Wickremasinghe, A.R.Nocturnal human biting behavior of Anopheles culicifacies was studied from January 2006 - March 2007 at the Victoria hydro electric power generation project area in the Central Province of Sri Lanka. Monthly collections of indoor and outdoor, landing and biting, mosquitoes were made from 1700 - 0600 hours (13 hours) using 3 - 4 indoor and 4 -8 outdoor human baits. In each collection, human baits were seated with exposed hands and legs below the knees. Hourly collections of landing and biting mosquitoes on the exposed surfaces of the body using torches and aspirators were made and mosquitoes were identified to species. Data was summarised as the number of An. culicifacies collected indoors and outdoors each hour/bait separately. The majority (97.83%) of An. culicifacies bit outdoors as compared to indoors. There were monthly variations in the biting habits with the highest densities being observed from February to April. An. culicifacies bit throughout the night with peak biting hours from 2200 - 2400 hours. Previous studies indicated that the peak biting hours were earlier in the evening and the morning. Further studies are required to study the nocturnal human biting behavior of An. culicifacies in other areas of Sri Lanka since this information is very important in planning malaria control activities. However, preventive measures directed to protect the outdoor workforce in the Victoria project should be a priority. If space spraying is planned, it should be carried out between 2200 - 2400 hours to cover the peak biting period of An. culicifacies in the project area.Item Most productive and prevalent breeding habitats of Aedes aegypti and Ae. albopictus (pupae) in the Kandy and Nuwara Eliya districts of Sri Lanka(Sri Lanka Association for the Advancement of Science, 2007) Kusumawathie, P.H.D.; Jayasooriya, G.A.J.S.K.; Wickremasinghe, A.R.Breeding habitats of Aedes aegypti and Ae. albopictus in the Kandy and Nuwara Eliya districts were studied from April 2006 to April 2007. Surveys of Aedes aegypti and Ae. albopictus immatures were carried out in 101 localities in the Divisional Director of Health Services (DDHS) areas of Akurana, Doluwa, Gampola, Gangawatakorale, Hanguranketha, Kundasale, Medadumbara, Nawalapitiya, Pathadumbara, Pathahewaheta, Poojapitiya, Tumpane, Udunuwara, Werallagama, Yatinuwara and in the Kandy Municipal Council area. During each survey, all potential indoor and outdoor breeding habitats of Ae. aegypti and Ae. albopictus were examined. Aedes larvae and pupae, 10 of each, were randomly collected from each mosquito immature positive habitat by dipping, pipetting or straining (if a particular habitat had < 10 larvae/ pupae, all larvae/ pupae were collected). Larvae and emerged adults from pupae were identified using larval and adult identification guides. Twenty two (22) types of container habitats were positive for Ae. aegypti and Ae. albopictus larvae. Of these 14, were positive for Ae. aegypti and or Ae. albopictus pupae. Pupal container index (percentage of containers positive for Ae. aegypti and / or Ae. albopictus pupae) of different types of container habitats were: metal ware (11.59%), unprotected plastic tanks (8.33%), roof gutters (7.14%), tyres (5.69%), polythene bags/sheets (3.85%), ornamental ponds (2.97%), coconut shells (2.67%), refrigerator trays (1.87%), water storage barrels (1.73%), clay pots (1.48%), water storage cement tanks (1.41%), tins (0.75%), leaf axils (0.72%) and discarded plastic containers (0.60%). However, water storage cement tanks (35.09%), water storage barrels (18.45%), discarded plastic containers (15.43%), refrigerator trays (7.13%), clay pots (5.40%) and tyres (4.91%) constituted the majority (86.41%) of potential breeding sites of Ae. aegypti and Ae. albopictus. Management of mostly prevalent and pupae positive containers would reduce the adult Ae. aegypti and Ae. albopictus density and consequently the dengue and dengue haemorrhagic fever incidence in the Kandy and Nuwara Eliya districts.Item Factors affecting transmission of chikungunya using Geographical Information System (GIS)(Sri Lanka Association for the Advancement of Science, 2009) Hapugoda, M.D.; Gunawardena, N.K.; Kusumawathie, P.H.D.; Jayasooriya, G.A.J.S.K.; Abeyewickreme, W.Transmission of chikungunya has been observed in many parts of Sri Lanka during the past few years. The objective of this study was to identify possible factors affecting transmission of chikungunya in a high risk area and to intervene and monitor those using GIS. Entomological, environmental, socio-economic and other possible factors were examined with regard to a chikungunya hot-spot in Kandy municipality for 12 months starting from April 2008. Hundred house-holds from 33 clusters were recruited. The distant between each cluster was maintained at a minimum of 200 m. Micro level approaches for collection of position, population, environmental, socio-economic and other related information were performed at each house-hold through a pre-tested questionnaire. Monthly entomological and epidemiological surveillance were conducted for 12 months. Digital topographical maps and meteorological information were obtained. GIS was used to map the selected households and to highlight the spatial and temporal distribution of factors under study. Selected risk area was an urban area where homesteads were the major land use pattern. The weather pattern of the study area was typical that of the Wet Zone. Entomological surveillance conducted showed the presence of high density of Aedes albopictus mosquitoes in more than 90% of the key (artificial) breeding habitats. Socio-economic data revealed although all house-holds have a sound knowledge on transmission on dengue including preventive measures, they were less concerned about the key mosquito breeding sites. GIS maps generated during the study showed distribution of these identified factors in all clusters. House index and man hour density of Ae. albopictus showed a positive correlation with rainfall, with a lag period of 2 and 3 months. The generalized high density of Ae. Albopictus suggest that this species may play a major role in transmitting chikungunya in the study area. In conclusion, the presence of high density of Ae. albopictus and lack of concern about key mosquito breeding sites in all clusters may be important risk factors. GIS-based maps can be used as an important tool to find out spatial and temporal distribution of possible risk factors in a selected hotspot, which would enable health authorities to prioritize implementation of control activities in a cost effective mannerItem Disease transmitting mosquito species breeding in water storage tanks in Kandy, Sri Lanka(Sri Lanka Association for the Advancement of Science, 2005) Kusumawathie, P.H.D.; Wickremasinghe, A.R.; Wickremasinghe, D.R.; Jayasooriya, G.A.J.S.K.Item Sensitivity of different larval collection methods in dengue vector surveillance in the Kandy and Nuwara Eliya districts(Sri Lanka Association for the Advancement of Science, 2006) Kusumawathie, P.H.D.; Jayasooriya, G.A.J.S.K.; Wickremasinghe, A.R.