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This repository contains the published and unpublished research of the Faculty of Medicine by the staff members of the faculty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 Analysis of nutritional status and factors associated with undernutrition in children aged 6-59 months in a rural area of Sri Lanka(Sri Lanka College of Paediatricians, 2019) Samarasekara, G.S.; Mettananda, S.; Punchihewa, P.OBJECTIVE: To describe the prevalence and factors associated with undernutrition in children aged 6-59 months in a rural area of Sri Lanka. METHOD: A community-based, cross-sectional study was carried out among children aged 6-59 months attending well baby clinics in Dehiattakandiya Medical Officer of Health area from November 2016 to January 2017. Data collection was done using an interviewer-administered questionnaire. Weight and height measurements were taken with calibrated instruments. Data analysis was done using logistic regression by SPSS 16.0. RESULTS: Four hundred and sixty four children were recruited having a mean age of 29.3 ±14.6 months; 53% were females. Prevalence of stunting, underweight and wasting was 36.4%, 42.9% and 19.0% respectively. The following independent associations were identified: for stunting- low birth weight, breastfeeding beyond 2 years, lower maternal education and paternal smoking; for underweight- birth order more than 2, low birth weight, breastfeeding beyond 2 years, lower maternal education and paternal smoking and alcohol use; for wasting- male sex, low birth weight and paternal smoking. CONCLUSIONS: Low birth weight, prolonged breastfeeding, lower maternal education level and paternal smoking had a significant association with stunting and underweight whilst male sex, low birth weight, and paternal smoking had a significant association with wasting in children aged 6-59 months.Item A Review and meta-analysis of the impact of intestinal worms on child growth and nutrition(Wiley-Blackwell, 2008) Hall, A.; Hewitt, G.; Tuffrey, V.; de Silva, N.More than a half of the world's population are infected with one or more species of intestinal worms of which the nematodes Ascaris lumbricoides, Trichuris trichiura and the hookworms are the most common and important in terms of child health. This paper: (1) introduces the main species of intestinal worms with particular attention to intestinal nematodes; (2) examines how such worms may affect child growth and nutrition; (3) reviews the biological and epidemiological factors that influence the effects that worms can have on the growth and nutrition of children; (4) considers the many factors that can affect the impact of treatment with anthelmintic drugs; (5) presents the results of a meta-analysis of studies of the effect of treating worm infections on child growth and nutrition; (6) discusses the results in terms of what is reasonable to expect that deworming alone can achieve; (7) describes some important characteristics of an ideal study of the effects of deworming; and (8) comments on the implications for programmes of recommendations concerning mass deworming.Item Nutritional status and productivity of Sri Lankan tea pluckers(Sri Lanka Medical Association, 2003) Selvaratnam, R.R.; de Silva, L.D.R.; Pathmeswaran, A.; de Silva, N.R.OBJECTIVE: To assess the impact of nutritional status on productivity of tea pluckers. DESIGN: Cross-sectional, analytical. SETTING AND PARTICIPANTS OF STUDY: All tea pluckers in five divisions of a tea estate in Hatton. MEASUREMENTS: A dietary survey was conducted using the 24 h dietary recall method. Nutritional status was assessed by measurement of body mass index (BMI) and haemoglobin (Hb) levels, and faeces were examined for helminth ova. The daily weight of tea leaves plucked and the number of days worked by each woman during the preceding month were noted from production records. RESULTS: Three hundred and four women (mean age 37.8 years, SD 8.4) were examined. The majority (59.9%) had evidence of chronic energy deficiency (BMI < 18.5). Almost all (94.4%) were anaemic (Hb < 13.3 g/dl, altitude adjusted cutoff). Mean daily iron intake was 8.7 mg (SD 2.3 mg), 45.9% of the national recommended dietary allowance. Only 10.1% had hookworm infection, all of light intensity. Multivariate regression analysis showed that dietary iron intake, the number of children and the number of children below 5 years, but not hookworm infection, were independently associated with Hb (p < 0.05). There was a strong positive correlation between monthly productivity and Hb, but not with BMI. Variation in Hb levels accounted for 65% of variation in productivity (adjusted R2 = 0.651). CONCLUSIONS: Most of the study population had chronic energy deficiency and anaemia. Dietary inadequacy of iron is a much more important causative factor than hookworm infection. Productivity was strongly associated with the degree of anaemia but not with BMI.Item The Health and nutritional status of school children in two rural communities in Sri Lanka(Blackwell Scientific Publications, 2000) Fernando, S.D.; Paranavitane, S.R.; Rajakaruna, J.; Weerasinghe, S.; Silva, D.; Wickremasinghe, A.R.There is growing evidence of considerable burden of morbidity and mortality due to infectious diseases and undernutrition in school children. This study describes the nutritional status and parasitic infections of school children in two areas of rural Sri Lanka. All children in four primary schools in the Moneragala district of Sri Lanka were included in the study. The height and weight of children were measured and anthropometric indices calculated. Stool and blood samples were examined for evidence of intestinal helminthiasis, malaria and anaemia. A greater proportion of boys than girls were underweight, wasted and stunted. Over 80 percent of the children were anaemic but did not apparently have iron deficiency anaemia according to their blood picture. The prevalence of parasitic infections such as hookworm and Plasmodium spp that may contribute to anaemia was low.Item Micronutrient status of plantation workers in Sri Lanka during pregnancy and post partum(Wiley-Blackwell Pub. Asia, 1996) de Silva, L.D.R.; Athukorala, T.M.S.Iron, zinc and vitamin A status was assessed in 309 plantation workers during pregnancy and in a sub-sample of 108 subjects at 20 to 36 weeks postpartum and the birth weights of their newborn were noted. A significant positive correlation was noted between haemoglobin concentration at 10-26 weeks of gestation of anaemic mothers (n = 180) and birth weights of their new born. Depleted iron stores (serum ferritin < 12 micrograms/l) were noted in 33.3% of subjects at 10-26 weeks of gestation. There was no significant change in serum ferritin concentration at > 32 weeks of gestation. Iron deficiency persisted at 20-36 weeks postpartum. Marginal vitamin A deficiency was also noted, as, 46.2% and 15.6% of the subjects respectively, had low serum vitamin A levels in pregnancy and postpartum. Low serum zinc levels were noted only in pregnancy. Iron supplementation during pregnancy was only effective in preventing further deterioration in iron status and it should be continued for about 12 weeks after deliveryItem Evaluation of effectiveness of iron-folate supplementation and anthelmintic therapy against aneamia in pregnancy - a study in the plantation sector of Sri Lanka(American Society of Clinical Nutrition, 1994) Athukorala, T.M.S.; de Silva, L.D.R.; Dechering, W.H.J.C.; Dissanayake, T.S.Intervention measures against anemia available to plantation workers during pregnancy include fortified food supplements (thriposha) and iron-folate supplements containing 60 mg elemental Fe. The effectiveness of these intervention measures was studied in 195 subjects whose iron and nutritional status were assessed at < 24 and > 32 wk of gestation. Taking thriposha conferred no significant benefit on maternal nutritional status, probably because sufficient amounts were not consumed. An increase in the duration of iron-folate supplementation to > 17 wk caused a significant positive change (P < 0.01) in hemoglobin, whereas an increase in the dose frequency had no significant benefit. Anthelminthic therapy in addition to iron-folate supplements caused a significant positive change in hemoglobin (P < 0.001) and serum ferritin (P < 0.005) compared with no supplementation. Thus, anthelminthic therapy significantly increased the beneficial effects of iron supplementation on hemoglobin concentration and iron status.Item Adolescent pregnancy: zinc supplementation and iron effects(Wiley-Blackwell, 1993) Cherry, F.F.; Sandstead, H.H.; Wickremasinghe, A.R.No Abstract Available