Medicine
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This repository contains the published and unpublished research of the Faculty of Medicine by the staff members of the faculty
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Item Larval indices of vector mosquitoes as predictors of dengue epidemics: An approach to manage dengue outbreaks based on entomological parameters in the districts of Colombo and Kandy, Sri Lanka(Hindawi Pub. Co., 2020) Udayanga, L.; Aryaprema, S.; Gunathilaka, N.; Iqbal, M. C. M.; Fernando, T.; Abeyewickreme, W.BACKGROUND: Early detection of dengue epidemics is a vital aspect in control programmes. Predictions based on larval indices of disease vectors are widely used in dengue control, with defined threshold values. However, there is no set threshold in Sri Lanka at the national or regional levels for Aedes larval indices. Therefore, the current study aimed at developing threshold values for vector indices in two dengue high-risk districts in Sri Lanka. METHODS: Monthly vector indices (House Index [HI], Container Index [CI], Breteau Index for Aedes aegypti [BIagp], and Ae. albopictus [BIalb]), of ten selected dengue high-risk Medical Officer of Health (MOH) areas located in Colombo and Kandy districts, were collected from January 2010 to June 2019, along with monthly reported dengue cases. Receiver Operating Characteristic (ROC) curve analysis in SPSS (version 23) was used to assess the discriminative power of the larval indices in identifying dengue epidemics and to develop thresholds for the dengue epidemic management. RESULTS: Only HI and BIagp denoted significant associations with dengue epidemics at lag periods of one and two months. Based on Ae. aegypti, average threshold values were defined for Colombo as Low Risk (2.4 ≤ BIagp < 3.8), Moderate Risk (3.8 ≤ BIagp < 5), High Risk (BIagp ≥ 5), along with BIagp 2.9 ≤ BIagp < 4.2 (Low Risk), 4.2 ≤ BIagp < 5.3 (Moderate Risk), and BIagp ≥ 5.3 (High Risk) for Kandy. Further, 5.5 ≤ HI < 8.9, 8.9 ≤ HI < 11.9, and HI ≥ 11.9 were defined as Low Risk, Moderate Risk, and High Risk average thresholds for HI in Colombo, while 6.9 ≤ HI < 9.1 (Low Risk), 8.9 ≥ HI < 11.8 (Moderate Risk), and HI ≥ 11.8 (High Risk) were defined for Kandy. CONCLUSIONS: The defined threshold values for Ae. aegypti and HI could be recommended as indicators for early detection of dengue epidemics and to drive vector management activities, with the objective of managing dengue epidemics with optimal usage of financial, technical, and human resources in Sri Lanka.Item Climate change induced vulnerability and adaption for dengue incidence in Colombo and Kandy districts: the detailed investigation in Sri Lanka(BioMed Central., 2020) Udayanga, L.; Gunathilaka, N.; Iqbal, M. C. M.; Abeyewickreme, W.BACKGROUND: Assessing the vulnerability of an infectious disease such as dengue among endemic population is an important requirement to design proactive programmes in order to improve resilience capacity of vulnerable communities. The current study aimed to evaluate the climate change induced socio-economic vulnerability of local communities to dengue in Colombo and Kandy districts of Sri Lanka. METHODS: A total of 42 variables (entomological, epidemiological, meteorological parameters, land-use practices and socio-demographic data) of all the 38 Medical Officer of Health (MOH) areas in the districts of Colombo and Kandy were considered as candidate variables for a composite index based vulnerability assessment. The Principal Component Analysis (PCA) was used in selecting and setting the weight for each indicator. Exposure, Sensitivity, Adaptive Capacity and Vulnerability of all MOH areas for dengue were calculated using the composite index approach recommended by the Intergovernmental Panel on Climate Change. RESULTS: Out of 42 candidate variables, only 23 parameters (Exposure Index: six variables; Sensitivity Index: 11 variables; Adaptive Capacity Index: six variables) were selected as indicators to assess climate change vulnerability to dengue. Colombo Municipal Council (CMC) MOH area denoted the highest values for exposure (0.89: exceptionally high exposure), sensitivity (0.86: exceptionally high sensitivity) in Colombo, while Kandy Municipal Council (KMC) area reported the highest exposure (0.79: high exposure) and sensitivity (0.77: high sensitivity) in Kandy. Piliyandala MOH area denoted the highest level of adaptive capacity (0.66) in Colombo followed by Menikhinna (0.68) in Kandy. The highest vulnerability (0.45: moderate vulnerability) to dengue was indicated from CMC and the lowest indicated from Galaha MOH (0.15; very low vulnerability) in Kandy. Interestingly the KMC MOH area had a notable vulnerability of 0.41 (moderate vulnerability), which was the highest within Kandy. CONCLUSIONS: In general, vulnerability for dengue was relatively higher within the MOH areas of Colombo, than in Kandy, suggesting a higher degree of potential susceptibility to dengue within and among local communities of Colombo. Vector Controlling Entities are recommended to consider the spatial variations in vulnerability of local communities to dengue for decision making, especially in allocation of limited financial, human and mechanical resources for dengue epidemic management. KEYWORDS: Climate change; Dengue; Sri Lanka; Vulnerability.Item Predatory efficacy of five locally available copepods on Aedes larvae under laboratory settings: An approach towards bio-control of dengue in Sri Lanka.(San Francisco, CA : Public Library of Science, 2019) Udayanga, L.; Ranathunge, T.; Iqbal, M. C. M.; Abeyewickreme, W.; Hapugoda, M.Many countries are in search of more effective and sustainable methods for controlling dengue vectors, due to undeniable inefficiencies in chemical and mechanical vector control methods. Bio-control of vectors by copepods is an ideal method of using interactions in the natural ecosystem for vector management, with minimum consequences on the environment. Current study determined the predatory efficacy of five locally abundant copepod species on, Aedes larvae under laboratory conditions. Copepods were collected from the pre-identified locations within the districts of Gampaha and Kandy, and identified morphologically. Individual species of copepods were maintained as separate colonies with Paramecium culture and wheat grain as supplementary food. Five adult copepods of each species was introduced into separate containers with 200 larvae (1st instar) of Aedes aegypti. Number of larvae survived in containers were enumerated at 3 hour intervals within a duration of 24 hours. Each experiment was repeated five times. The same procedure was followed for Ae. albopictus. Significance in the variations among predation rates was evaluated with General Linear Modelling (GLM) followed by Tukey's pair-wise comparison in SPSS (version 23). Significant variations in predation rates of studied copepod species were reported (p<0.05), whereby M. leuckarti indicated the highest followed by M. scrassus, while C. languides indicated the lowest predatory efficacy. The effect of different Aedes larval species on the predation rates of copepods remained significant (p<0.05), even though the effect on predatory efficiency was not significant. Based on the findings, both M. leuckarti and M. scrassus, with the highest predatory efficiencies, could be recommended as potential candidates for biological controlling of Aedes vectors in Sri Lanka.