Conference Papers

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Presenting symptoms/conditions and selected aspects of health care quality at the Outpatient Department (OPD) of the Wickramarachchi Ayurvedic Hospital, yakkala
(College of the Community Physicians of Sri Lanka, 2007) Wanigasekara, C.; Weerasinghe, P.; Weerasinghe, A.; Weerasooriya, S.; Wellagiriya, S.; Wickramarathne, S.; Wijerathne, B.; Abeysena, C.
OBJECTIVE: To describe the presenting symptoms/conditions and selected aspects of health care quality of the Outpatient Department (OPD) of the Wickramarachchi Ayurvedic Hospital. METHODOLOGY: A descriptive cross sectional study was conducted on patients seeking treatment from the CPD oi the Wickramarachchi Ayurvedic Hospital. Yakkala between February to April 2007. A pre-tested interviewer administered questionnaire was used to gather information from 250 patients. RESULTS: Fever, cold and respiratory symptoms (44.2%; n=46), musculoskeletal complaints (28.8%; n=30) and dermatological conditions (14.4%; n=15) were the commonest presentations among persons up to 40 years old. Musculoskeletal complaints (26.8%; n=38). lever, cold and respiratory symptoms (24.6%; n=35) diabetes and hypertension (20.4%; n=29) and eye problems (9.8%; n=14) were the commonest presentations among persons above 40 years. Out of 250 patients, 56(22.4%) had visited the Ayurvedic Hospital as the first preference for the current illness and the balance 194(77.6%) patients had taken treatment from other health care institutions. The majority (86%: =168) sought ayurvedic medicine after taking western medicine. The most common reason for giving up previous treatment methods was treatment failure (69%; n=135). The distance between home and the hospital was <10 km for 52.4%(n=137) patients and >20 km for 11.6%(n=54) patients. Median total expenditure for one visit to the Ayurvedic hospital was Rs.200 (Range Rs. 00500 to 3000.00) and 57.6%(n=144) had spent Rs.100-500 for one visit. Median waiting time for consultation was 90 minutes (Range 5 — 300min). Consultation time was <5 minutes in 52%(n=131) and >10minutes in 24%(n=60) of patients. Two hundred and seven (83%) patients were satisfied with treatment given and 224 (69.6%) on facilities provided by the Ayurvedic hospital. Statistically significant associations were observed between high satisfaction and low educational level (p<0.001) and previous treatment failure from other systems (p<0.001). CONCLUSION: Patients seek ayurvedic treatment for various symptoms/diseases irrespective of their severity. patient's age and the distance to the hospital. The commonest reason for seeking ayurveda treatment was treatment failure at other methods. A majority were satisfied with the treatment provided and facilities available.
High serum total IgE in children in geohelminthic endemic setting
(Sri Lanka Medical Association, 2008) Amarasekera, N.D.D.M.; Gunawardena, N.K.; de Silva, N.R.; Weerasinghe, A.
BACKGROUND: Elevated levels of total IgE (tlgE) in serum are characteristic of atopic diseases. However, the usefulness of tlgE in diagnosing atopic diseases in children living in areas endemic for helminth infections is not well established. OBJECTIVE: To assess the effect of geohelminth infections on serum tlgE levels in children with atopic diseases. DESIGN, SETTING AND METHODS: A total of 640 children in grade 5 were recruited from 17 schools in the Western Province. Data regarding atopic diseases were collected by a standard questionnaire. Screening for helminth infections was done by examining their stool samples by modified Kato-Katz technique. Serum tlgE was measured by fluoroenzymeimmunoassay. RESULTS: The mean age in the study population was 10 years (SD±0.3). The prevalence of geohelminth infection was 15.5%. Trichuris trichiura (14.3%) was the most common, followed by Ascaris lumbricoides (4.2%) and hookworm (0.2%). Mixed infection was detected in 20.3% of infected children. The cumulative prevalence of atopic diseases was 33.7%. Prevalence of asthma, rhinitis and eczema was 17%, 21.4% and 5% respectively. Geometric mean (GM) for tlgE for the geohelminth infected group (1039.9kU/L) was significantly higher than that of the non-infected group (575.4kU/L) (p=0.004). It was also higher in the allergic group (933.3kU/L) than in the non-allergic group (639.7kU/L) but the difference was not statistically significant (p=0.068). CONCLUSION: In the presence of geohelminth infections, raised IgE may be due to geohelminth infection or atopic diseases or both. Therefore, serum tlgE may not be a useful marker for allergic diseases in children living in areas endemic for geohelminth infections.
Prevalence of atopic diseases among school children in Western Province
(University of Kelaniya, 2007) Amarasekera, N.D.D.M.; Gunawardena, N.K.; de Silva, N.R.; Weerasinghe, A.
Background : Atopic diseases such as asthma, rhinitis and eczema in children are major public health problems in developed, industrialized countries as well as in some developing countries. Our objective was to assess the prevalence of atopic diseases in schoolchildren in grade 5 in the Western Province of Sri Lanka. Method : Schoolchildren in grade 5 were selected by stratified - random sampling frbm 17 schools in the Western Province. Internationally validated ISAAC (International Study of Asthma and Allergies in Childhood) questionnaire, filled by the parent or guardian was used to collect details regarding atopic diseases. Results : A total of 640 schoolchildren were recruited. Five hundred ~nd eleven (79.8%) returned the completed questionnaire. The mean age was I 0 years (SD ± 0.3) and 55.9% of the study population was boys. Prevalence of asthma, rhinitis and eczema was 17%, 21.4% and 5% respectively, while 33.7% had one or more diseases, Thirty three (21.4%) of the children with an atopic disease was on long term treatment. Only the prevalence of allergic rhinitis showed a statistically significant difference between the two sexes, being more common in boys. Less than 30% of affected children's parents recognized that their child had either asthma or rhinitis, whereas a higher number of parents (54.2%) recognized that their child had eczema. Among children with asthma, 44.4% had rhinitis and wheezing was severe enough to disturb their sleep in 52.4% of children. Conclusion: One in 3 children in grade 5 had either asthma or rhinitis or eczema, but parental recognition of these conditions was poor. Atopic diseases are a significant health problem among schoolchildren in the Western Province.

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