Medicine

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Author: search.filters.author.Sunil-Chandra, N.P.Subject: search.filters.subject.Sri Lanka-epidemiology

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    Association of Hantavirus infections and Leptospirosis with the occurrence of Chronic Kidney Disease of Uncertain Etiology in the North Central Province of Sri Lanka: A prospective study with patients and healthy persons
    (Frontiers Media SA, 2020) Sunil-Chandra, N.P.; Jayaweera, J.A.A.S.; Kumbukgolla, W.; Jayasundara, M.V.M.L.
    ABSTRACT: Chronic Kidney disease of uncertain etiology (CKDu) has become a significant disease burden, affecting farming community of Sri Lanka and the exact etiology, which could be multifactorial, is not hitherto established. This study is aimed to determine the association of past hantavirus infection and leptospirosis with the occurrence of CKDu. A cohort (n = 179) of known CKDu patients living in high-CKDu prevalent areas of Anuradhapura district of Sri Lanka was compared with a group of 49 healthy, sex-matched younger blood relatives of CKDu patients (control-1) and another 48 healthy, age, and sex-matched individuals living in low-CKDu prevalent area (control-2) of the same district where same life style and climate conditions prevail. Fifty out of 179 (27.9%) CKDu patients, 16/49 (32.7%) of control-1 and 7/48 (14.6%) of control-2 were found positive for IgG antibodies to Puumala, Hantaan or both strains of hantaviruses. Hantaan strain specificity was found to be predominant in all study groups. Hantavirus IgG sero-prevalence of healthy individuals living in low-CKDu prevalent area was significantly lower compared to CKDu patients and healthy younger blood relatives living in high-CKDu prevalent areas (p = 0.03). Past hantavirus infection possesses a significant risk for the occurrence of CKDu (OR = 4.5; 95% CI-3.1-5.4, p = 0.02). In contrast, IgG seroprevalence to hantaviruses was not significantly different in CKDu patients and healthy younger blood relatives living in high-CKDu prevalent areas indicating past hantavirus infection has no association with the occurrence of CKDu or possibly, younger relatives may develop CKDu in subsequent years. Seroprevalence to leptospirosis showed no significant difference between CKDu patients and healthy controls. KEYWORDS: CKDu; chronic kidney disease; hantaviruses; leptospira; sero-prevalence. Erratum in: Front Cell Infect Microbiol. 2020;10:631515
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    Epidemiology of multidrug-resistant Enterobacteriaceae in Sri Lanka: First evidence of bla KPC harboring Klebsiella pneumoniae.
    (Elsevier., 2020) Kumudunie, W.G.M.; Wijesooriya, L.I.; Namalie, K.D.; Sunil-Chandra, N.P.; Wijayasinghe, Y.S.
    BACKGROUND: Extended-spectrum β-lactamase producing Enterobacteriaceae (ESBL-PE) and carbapenem-resistant Enterobacteriaceae (CRE) are disseminated worldwide posing a serious public health concern. Although, the presence of ESBL-PE and CRE in Sri Lanka has been reported, the prevalence is unknown. This study aimed to provide up-to-date epidemiological data on multidrug-resistant Enterobacteriaceae and to characterize the molecular determinants of carbapenemase-producing Enterobacteriaceae (CPE) in Sri Lanka.METHODS: A prospective cross-sectional study was conducted at a tertiary care hospital in Sri Lanka between December 2017 and February 2018. ESBL-PE and CRE were identified by disc diffusion method. Carbapenemase production was determined by carbapenem inactivation method and the presence of selected carbapenemase genes were detected by PCR. RESULTS: Five hundred and ninety-three Enterobacteriaceae were isolated from variety of clinical samples. Overall prevalence of ESBL-PE and CRE were 26.0% (n = 154) and 9.6% (n = 57), respectively. The highest rate of ESBL-PE (30.8%) was found in urine samples, while the highest occurrence of CRE (20.8%) was seen in respiratory specimens. The most common CRE species identified was K. pneumoniae (n = 46, 80.7%), followed by C. freundii (n = 4, 7.0%), E. coli (n = 3, 5.3%), P. rettgeri (n = 2, 3.5%), E. cloacae (n = 1, 1.7%), and K. aerogenes (n = 1, 1.7%). Carbapenemase production was observed in 54 (94.7%) of CRE isolates. Fifty eight carbapenemase encoding genes were identified in 54 CPE. The most prevalent carbapenemase gene was blaOXA-48-like (n = 48, 88.9%), followed by blaNDM (n = 8, 14.8%), and blaKPC (n = 2, 3.7%). CONCLUSIONS: This study reports an alarming rate of CRE and the emergence of blaKPC harboring K. pneumoniae in Sri Lanka. The need for preventive measures is highlighted to limit the spread of these difficult-to-treat bacteria in the country. KEYWORDS: Carbapenem resistance; Carbapenemase; ESBL; Enterobacteriaceae; KPC; Sri Lanka.
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    Rotavirus-associated diarrhoea in buffalo calves in Sri Lanka
    (British Veterinary Association, Elseveir, 1994) Sunil-Chandra, N.P.; Mahalingam, S.
    Faecal samples from 150 buffalo calves, one to 150 days old, located in various districts of Sri Lanka, were examined for group A rotavirus antigen by a screening enzyme linked immunosorbent assay (ELISA). Positive samples were confirmed by the blocking ELISA. In the calves studied 27.3 per cent were diarrhoeic, and the rest were non-diarrhoeic but were in contact with the animals showing diarrhoea. Antigen was detected in 36.6 per cent of the diarrhoeic animals and in 11.9 per cent of the non-diarrhoeic animals. There was a strong association between the presence of antigen in faeces and diarrhoea in these animals (chi 2 = 46.98; P < 0.001). Of the 146 serum samples examined for antirotaviral antibodies, by the blocking ELISA at a single serum dilution (1:20) against a constant dose of antigen (8 units), 68.5 per cent were positive indicating a widespread infection with the virus in the population studied. This is the first record of the detection of rotavirus and its association with diarrhoea in buffalo calves in Sri Lanka.
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    Study of natural rotavirus infection in buffalo calves in Sri Lanka
    (Springer, 1995) Sunil-Chandra, N.P.; Mahalingam, S.
    No Abstract Available
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    Concomitant leptospirosis-hantavirus co-infection in acute patients hospitalized in Sri Lanka: implications for a potentially worldwide underestimated problem
    (Cambridge University Press, 2015) Sunil-Chandra, N.P.; Clement, J.; Maes, P.; de Silva, H.J.; Van Esbroeck, M.; Van Ranst, M.
    Two global (re-)emerging zoonoses, leptospirosis and hantavirus infections, are clinically indistinguishable. Thirty-one patients, hospitalized in Sri Lanka for acute severe leptospirosis, were after exclusion of other potentially involved pathogens, prospectively screened with IgM ELISA for both pathogens. Of these, nine (29·0%) were positive for leptospirosis only, one (3·2%) for hantavirus only, seven (22·5%) for both pathogens concomitantly, whereas 13 (41·9%) remained negative for both. Moreover, in a retrospective study of 23 former patients, serologically confirmed for past leptospirosis, six (26·0%) were also positive in two different IgG ELISA hantavirus formats. Surprisingly, European Puumala hantavirus (PUUV) results were constantly higher, although statistically not significantly different, than Asian Hantaan virus (HTNV), suggesting an unexplained cross-reaction, since PUUV is considered absent throughout Asia. Moreover, RT-PCR on all hantavirus IgM ELISA positives was negative. Concomitant leptospirosis-hantavirus infections are probably heavily underestimated worldwide, compromising epidemiological data, therapeutical decisions, and clinical outcome.
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    Seroepidemiological study of herpes simplex virus type 1 and 2 in Brazil, Estonia, India, Morocco and Sri Lanka
    (BMJ Publishing Group, 2003) Cowan, F.M.; French, R.S.; Mayaud, P.; Gopal, R.; Robinson, N.J.; de Oliveira, S.A.; Faillace, T.; Uuskula, A.; Nygard-Kibur, M.; Ramalingam, S.; Sridharan, G.; El Aouad, R.; Alami, K.; Rabi, M.; Sunil-Chandra, N.P.
    BACKGROUND: The association between herpes simplex virus type 2 (HSV-2) and human immunodeficiency virus (HIV) and the development of HSV vaccines have increased interest in the study of HSV epidemiology. OBJECTIVES: To estimate the age and sex specific seroprevalence of HSV-1 and HSV-2 infections in selected populations in Brazil, Estonia, India,Morocco, and Sri Lanka. METHODS: Serum samples were collected from various populations including children, antenatal clinic attenders, blood donors, hospital inpatients, and HIV sentinel surveillance groups. STD clinic attenders were enrolled in Sri Lanka, male military personnel in Morocco. Sera were tested using a common algorithm by type specific HSV-1 and HSV-2 antibody assay. RESULTS: 13,986 samples were tested, 45.0% from adult females, 32.7% from adult males, and 22.3% from children. The prevalence of HSV-1 varied by site ranging from 78.5%-93.6% in adult males and from 75.5%-97.8% in adult females. In all countries HSV-1 seroprevalence increased significantly with age (p<0.001) in both men and women. The prevalence of HSV-2 infection varied between sites. Brazil had the highest age specific rates of infection for both men and women, followed by Sri Lanka for men and Estonia for women, the lowest rates being found in Estonia for men andIndia for women. In all countries, HSV-2 seroprevalence increased significantly with age (p<0.01) and adult females had higher rates of infection than adult males by age of infection. CONCLUSIONS: HSV-1 and HSV-2 seroprevalence was consistently higher in women than men, particularly for HSV-2. Population based data on HSV-1 and HSV-2 will be useful for designing potential HSV-2 vaccination strategies and for focusing prevention efforts for HSV-1 and HSV-2 infection
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    Low community seroprevalence of hepatitis C virus infection in the Gampaha district
    (Sri Lanka Medical Association, 2002) Gunasekera, H.A.K.M.; Sunil-Chandra, N.P.; de Silva, H.J.
    No Abstract available
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