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.Nishizono, A.

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    Surveillance of rotavirus in three hospital settings of Sri Lanka 2007 - 2010
    (Sri Lanka College of Microbiologists, 2014) Chandrasena, T.G.A.N.; Rajindrajith, S.; Gunawardena, N.K.; Liyanarachchi, N.; Abeysekera, C.K.; Matsomoto, T.; Yahiro, T.; Nishizono, A.; Ahmed, K.
    INTRODUCTION: Rotavirus is an important aetiological agent of childhood diarrhoeas in Sri Lanka. OBJECTIVES: To study the rotavirus epidemiology and genotypic diversity of cases hospitalized in three geographical locations of Sri Lanka, Ragama, Galle and Kandy. MATERIALS AND METHODS: The study was approved by the ethical review board of the Sri Lanka College of Paediatricians. Stool samples were collected from children < 5 years, hospitalized at the Teaching Hospitals at Ragama (RTH) (November 2007 - October 2010) Galle (GTH) and Kandy (KTH) (mid and late 2008) respectively for acute gastroenteritis. Rotavirus was detected using EIA kit, Rotaclone®. A subset of rotavirus positive samples was genotyped by reverse-transcription(Rt)-PCR and polyacrylamide-gel-electrophoresis (PAGE). RESULTS: Stool samples of 1245 children (69.2%, 23.3% and 7.3% from RTH, GTH and KTH respectively) were screened for rotavirus. Of them, 476 were positive by EIA. The overall rate of prevalence of rotavirus infection was 38.2%. The median age of infection ranged from 13-20 months. Rotavirus genotyping was done on 375 (78.8 %) samples. G1 [P8] was the overall dominant strain (44.8%) followed by G9[P8] (10.1%), G2[P4] (5.3%), G3[P8] (3.2%), G1[P6] (2.1%), G12[P6] (1.3%), G2[P8] (1.06%) and 0.26% of G4[P6], G4[P4] and G4[P8]. The G or P serotype was untypable in 25.6% of samples and 5.6% were of mixed-G and P type. PAGE yeilded 25 electropherotypes (E1-E12 and E16-E29), with E5 and E20 causing 19 and 14 percent of infections respectively. The electropherotype could not be determined in 26%. CONCLUSIONS: Rotavirus continues to be an important cause of childhood diarrhoreas in Sri Lanka. Strain G1P8 predominated in all areas during the surveillance period with a notable percentage of mixed-G and P infections. Multiple E types identified indicate increasing strain diversity
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    Spatial epidemiology and hotspots of Rotavirus In children: an analysis and mapping using Geographic Information System
    (Sri Lanka College of Paediatricians, 2010) Gunawardena, N.K.; Rajindrajith, S.; Chandrasena, T.G.A.N.; Nishizono, A.; Moji, K.; Ahmed, K.
    INTRODUCTION: Rotavirus is a leading cause of acute gastroenteritis in Sri Lanka. Studies from the western world have assessed the seasonal variations of this infection and its association with environmental factors such as rainfall and temperature. However, little is known of its seasonal variation and geographical distribution in Sri Lanka. Areliable and updated distribution map of rotavirus infection is essential for target control strategies and policy making processes. Geographical Information. System (GIS) has previously been used to monitor spatial distribution of diseases and their transmission dynamics. For the first time we describe the spatial epidemiological patterns of rotavirus diarrhoea in Sri Lanka. OBJECTIVE: To study the spatial epidemiological distribution of rotaviral infection among children with diarrhoeal diseases admitted to the North Colombo Teaching Hospital, Ragama. DESIGN, SETTING AND METHOD: This study was carried out in two phases. Phase I, a prospective hospital-based study, was conducted in the North Colombo Teaching Hospital from January 2008 to October 2009 to detect the incidence of rotavirus infection in children with diarrhoea. Stool samples were analyzed for Group A rotavirus antigen by enzyme linked immunosorbent assay (EL1SA) (Rotaclone). During Phase II of the study, patients with rotavirus infection were mapped using geographic coordinates obtained from a hand-held GIS receiver (Trimble Juno SB). Rainfall and temperature data for the years 2008 and 2009 in the Gampaha District were obtained from the Department of Meteorology, Sri Lanka and correlated with the spatial distribution data. RESULTS: In 2008 and 2009, 71 (60.6% males) and 99 (63.6% males) had rotavirus infection respectively. Spatial distribution data showed that most rotavirus infections (78%) presenting to the Teaching Hospital, Ragama were coming from a 10 km radius of catchment area. The hot spots were clustered in and around the marshy land areas of the Gampaha District and 67% use water from their own well or from the well of a neighbour. The peak incidence in both years was between May and July which coincided with the highest rainfall to the area. There was no correlation between environmental temperature and rotavirus infection rates. CONCLUSION: Incidence of rotavirus infection is highest in children living around marshy lands and using water from private sources such as a well.
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    Rotavirus surveillance at the North Colombo Teaching Hospital, Sri Lanka, 2007-2008
    (Sri Lanka College of Paediatricians, 2010) Chandrasena, T.G.A.N.; Rajindrajith, S.; Gunawardena, N.K.; Abayawardana, U.A.T.M.; Ranasinghe, S.L.; Nishizono, A.; Moji, K.; Ahmed, K.
    INTRODUCTION: Rotavirus disease is a common paediatric problem and accounts for severe dehydrating diarrhoea, a large number of hospital admissions and an annually estimated 600,000 deaths across the world. Prospective Rotavirus surveillance was initiated at the North Colombo Teaching Hospital (NCTH), Sri Lanka from April 2005. The serorype distribution in our previous study was; G9P[S] 35.2%, G12P[8] 14.7%, G3P[4] 17.2%, G2P[8/4/6] 14%, GlP[8/4] 6.5% and G4P[8/4] 3.3%. OBJECTIVE: To describe the serotype distribution of rotavirus responsible for hospitalization at the NCTH. DESIGN, SETTING AND METHOD: A prospective hospital-based study was conducted in the paediatric units of the NCTH from November 2007-October 2008. Stool samples of children admitted with diarrhoea were analyzed for Group A rotavirus antigen by enzyme linked immunosorbent assay (ELISA) (Rotaclone). Stool samples positive for rotavirus were characterized by electropherotyping (PAGE) and serotyping (reverse transcription polymasase chain reaction - RT PCR). RESULTS: Group A rotavirus was detected in 78 (33%) of 231 children less than 5 years of age admitted with diarrhoea. G9, Gl, G2, G3 and G non-typable infections were seen in 33(42%), 31 (40%) 7 (9%), 1 (1.3%) and 4 (5%) respectively. A predominance of G9 serotype (84%) was seen during the initial seven months. Dramatic transition of genotypic predominance to Gl (70%) occurred in the latter half of the year. All Gl, G3 and G9 strains assayed for P genotype contained P8 except two mixed G9 infections which were associated with P4 and PS. In contrast to the previous report, all G2 strains identified were associated with P4 and serotypes G12P [8] and G4P [8/4] were not detected. Polyacrylamide-gel-electrophoresis revealed the presence of El, E2, E3, E4 and E5 electropherotypes with a co-dominance of Eland E5 (30.7%). CONCLUSIONS: During the study period a rising trend in prevalence with a fluctuating genotypic distribution was observed at CNTH, Sri Lanka. The diversity of rotavirus serotypes requires a vaccine that confers adequate homotypic and heterorypic protection against these strains.