Journal/Magazine Articles
Permanent URI for this collectionhttp://repository.kln.ac.lk/handle/123456789/13
This collection contains original research articles, review articles and case reports published in local and international peer reviewed journals by the staff members of the Faculty of Medicine
Browse
5 results
Search Results
Item Effects of indoor air pollution on the development of children under five years of age in Sri Lanka(MDPI, 2022) Ranathunga, N.; Perera, P.; Nandasena, S.; Sathiakumar, N.; Kasturiratne, A.; Wickremasinghe, R.Air pollution is a multifaceted environmental toxin affecting the Central Nervous System (CNS) through diverse pathways. The CNS of young children is particularly susceptible to the detrimental effects of toxins, as brain development continues postnatally with the formation of interneuronal connections, glial cell proliferation and myelination of axons. Indoor air pollution (IAP) from solid fuel combustion is more harmful than outdoor air pollution. Numerous air pollutants hazardous to health are released during the burning of unprocessed biomass. The primary source of fuel in Sri Lanka for cooking is biomass, mainly wood. In this study, we evaluated the influence of IAP resulting from biomass combustion on the neurodevelopment of children. In a cohort of children under five years living in a semi-urban area of Sri Lanka, neurodevelopment was assessed using Denver II developmental screening test. Air quality levels were measured (Carbon Monoxide (CO) and Particulate Matter 2.5 (PM2.5)) in a subsample. There were significantly high levels of CO and PM2.5 in the ambient air of households using biomass as the primary fuel for cooking. Children living in these households had a significantly higher number of children with ‘suspect’ developmental assessment scores in the language, social behavior and play and gross motor development domains.Item Effects of indoor air pollution due to solid fuel combustion on physical growth of children under 5 in Sri Lanka: A descriptive cross sectional study(Public Library of Science, 2021) Ranathunga, N.; Perera, P.; Nandasena, S.; Sathiakumar, N.; Kasturiratne, A.; Wickremasinghe, A.R.ABSTRACT: Solid fuel combustion is an important risk factor of morbidity. This study was conducted to determine the effect of indoor air pollution (IAP) due to solid fuel combustion on physical growth in 262 Sri Lankan children under five. Exposure was defined by the type of fuel used for cooking. Pollutant levels were measured in a subsample of households. "High" exposure group (households using biomass fuel/kerosene oil for cooking) comprised 60% of the study population; the prevalence of wasting was 19.7% and underweight was 20.4% in the entire population where 68% were from the high exposure group. Children from the "high" exposure group had significantly lower mean z-scores for weight-for-height (p = 0.047), height-for-age (p = 0.004) and weight-for-age (p = 0.001) as compared to the "low" exposure group (children of households using liquefied petroleum gas and/or electricity) after adjusting for confounders. Z-scores of weight-for-age, height-for-age and weight-for-height were negatively correlated with CO (p = 0.001, 0.018, 0.020, respectively) and PM2.5 concentrations (p<0.001,p = 0.024 p = 0.008, respectively). IAP due to combustion of biomass fuel leads to poor physical growth.Item Effect of household air pollution due to solid fuel combustion on childhood respiratory diseases in a semi urban population in Sri Lanka.(BioMed Central, 2019) Ranathunga, N.; Perera, P.; Nandasena, S.; Sathiakumar, N.; Kasturiratne, A.; Wickremasinghe, R.BACKGROUND:Household air pollution from combustion of solid fuels for cooking and space heating is one of the most important risk factors of the global burden of disease. This study was aimed to determine the association between household air pollution due to combustion of biomass fuel in Sri Lankan households and self-reported respiratory symptoms in children under 5 years. METHODS: A prospective study was conducted in the Ragama Medical Officer of Health area in Sri Lanka. Children under 5 years were followed up for 12 months. Data on respiratory symptoms were extracted from a symptom diary. Socioeconomic data and the main fuel type used for cooking were recorded. Air quality measurements were taken during the preparation of the lunch meal over a 2-h period in a subsample of households. RESULTS: Two hundred and sixty two children were followed up. The incidence of infection induced asthma (RR = 1.77, 95%CI;1.098-2.949) was significantly higher among children resident in households using biomass fuel and kerosene (considered as the high exposure group) as compared to children resident in households using Liquefied Petroleum Gas (LPG) or electricity for cooking (considered as the low exposure group), after adjusting for confounders. Maternal education was significantly associated with the incidence of infection induced asthma after controlling for other factors including exposure status. The incidence of asthma among male children was significantly higher than in female children (RR = 1.17; 95% CI 1.01-1.37). Having an industry causing air pollution near the home and cooking inside the living area were significant risk factors of rhinitis (RR = 1.39 and 2.67, respectively) while spending less time on cooking was a protective factor (RR = 0.81). Houses which used biomass fuel had significantly higher concentrations of carbon monoxide (CO) (mean 2.77 ppm vs 1.44 ppm) and particulate matter2.5 (PM2.5) (mean 1.09 mg/m3 vs 0.30 mg/m3) as compared to houses using LPG or electricity for cooking. CONCLUSION: The CO and PM2.5 concentrations were significantly higher in households using biomass fuel for cooking. There was a 1.6 times higher risk of infection induced asthma (IIA) among children of the high exposure group as compared to children of the low exposure group, after controlling for other factors. Maternal education was significantly associated with the incidence of IIA after controlling for exposure status and other variables.Item Epidemiology of goitres in Sri Lanka with Geographic Information System Mapping: a population based cross sectional study(Jaypee Publishers, 2015) Fernando, R.; Chandrasinghe, P.C.; Nandasena, S.; Pathmeswaran, A.BACKGROUND: Sri Lanka is considered an endemic region for goiter. Early researchers have suggested the existence of a goiter belt based on rainfall pattern. Subsequent studies done in school children have challenged this theory. Current study is a community-based cross-sectional study done to assess the epidemiology of goiters. Geographic information system (GIS) mapping of the goiter prevalence is developed for the first time in Sri Lanka. METHODS: Study subjects were selected using a multi-staged cluster sampling with probability proportionate to size (PPS) method. Examination for the presence of goiters was done by two trained investigators and graded. ArcGIS 10 software was used for geostatistical analysis and developing a map by interpolating the data collected for the first time in Sri Lanka. RESULTS: A total of 5200 individuals (female-66%, median age-38 years; range 10-92 years) were assessed and 426 goiters were detected. The adjusted prevalence rate of goiters was 6.8%. Kriging interpolation method was used to develop the most appropriate epidemiological map clustering of high prevalence areas with scattered pockets of high prevalence was observed. Current map does not show a prevalence pattern in relation to the rainfall or elevation above sea level as proposed in the past. CONCLUSION: Goiter prevalence in Sri Lanka appears to be different from earlier proposed patterns. Use of GIS has contributed to develop a comprehensive epidemiological map of goiters demonstrating the absence of an endemic goiter belt in the wet zone as proposed earlier.Item Indoor air pollution and respiratory health of children in the developing world(Hong Kong, China : Baishideng Publishing Group Co., Limited, 2013) Nandasena, S.; Wickremasinghe, A.R.; Sathiakumar, N.Indoor air pollution (IAP) is a key contributor to the global burden of disease mainly in developing countries. The use of solid fuel for cooking and heating is the main source of IAP in developing countries, accounting for an estimated 3.5 million deaths and 4.5% of Disability-Adjusted Life Years in 2010. Other sources of IAP include indoor smoking, infiltration of pollutants from outdoor sources and substances emitted from an array of human utilities and biological materials. Children are among the most vulnerable groups for adverse effects of IAP. The respiratory system is a primary target of air pollutants resulting in a wide range of acute and chronic effects. The spectrum of respiratory adverse effects ranges from mild subclinical changes and mild symptoms to life threatening conditions and even death. However, IAP is a modifiable risk factor having potential mitigating interventions. Possible interventions range from simple behavior change to structural changes and from shifting of unclean cooking fuel to clean cooking fuel. Shifting from use of solid fuel to clean fuel invariably reduces household air pollution in developing countries, but such a change is challenging. This review aims to summarize the available information on IAP exposure during childhood and its effects on respiratory health in developing countries. It specifically discusses the common sources of IAP, susceptibility of children to air pollution, mechanisms of action, common respiratory conditions, preventive and mitigating strategies.