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This repository contains the published and unpublished research of the Faculty of Medicine by the staff members of the faculty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 Human health importance zoonotic gastrointestinal helminths and ectoparasites among stray dogs in Galle District, Sri Lanka(Department of Biosystems Engineering of the Faculty of Agriculture & Plantation Management Wayamba University, 2021) Rathnayaka, S.; Gunathilaka, N.; Udayanga, L.BACKGROUND: A notably high stray and semi domesticated dog population exist in close proximity to humans in Sri Lanka. However, the prevalence of gastrointestinal and ecto-parasites among these stray dog population has been limitedly studied. Therefore, the present investigation focused on zoonotic potential among stray dog community in Sri Lanka. METHODS: A total of 110 stray dogs randomly captured from the Galle District of Sri Lanka during May to July 2018 was considered for the study. Freshly voided fecal samples were obtained. Ectoparasites were collected using a lose comb and stored in an alcohol solution. Presence of major gastrointestinal and ectoparasitic species were investigated using standard microscopic methods. The Chi-square test of independence was used for statistical analysis. RESULTS: The highest egg count as Eggs per Gram (EPG) were detected from A. caninum (264.65 + 86.02 EPG), followed by T. canis (58.38 + 7.22 EPG) and E. vermicularis (22.70 + 5.70 EPG). Approximately one third of the stray dog population (29.1%; n= 32) indicated ectoparasitic infestations, dominated by Rhipicephalus sanguineus (40.9%; n=45), Ctenocephalides canis (23.6%; n=26) and Ixodes scapularis (19.1%; n=21). The results of the Chi-square test of independence denoted that there was a significant difference on the prevalence of helminthic parasites, among male and female stray dog populations (χ2= 15.19, df = 7, P = 0.03). CONCLUSIONS: The present study revealed the potential risk on human health by intestinal helminthic and ectoparasites among stray dog populations. Hence, better understanding of such diseases and their control is essential.Item Enteric pathogens of zoonotic concern in non-human primates in Sri Lanka(European Wildlife Disease Association (EWDA, 2016) Tegner, C.; Sunil-Chandra, N.P.; Ingrid, H.; Perera, V.; Wijesooriya, W.R.P.L.I.; Fahlman, A.Zoonotic disease is a two-way street where humans and other animals are interchanging pathogens. We investigated the occurrence of the potentially zoonotic Campylobacter spp., Salmonella spp. and group A rotaviruses in faecal samples from free-ranging toque macaques and tufted gray langurs in Sri Lanka. Samples were opportunistically collected from primate troops with close human contact at five sites. Standardized culturing was used to detect the bacteria and an ELISA-based dipstick test was used for detection of group A rotaviruses antigens. Genotyping was performed using pulse field gel electrophoresis (PFGE) and multi-locus sequence typing (MLST) and the isolates' sensitivity to selected antibiotics was tested with VetMIC TM (National Veterinary Institute, Uppsala, Sweden) panels Camp EU, CLIN GN and GN-mo (version 4). All 98 samples tested negative for rotavirus. The 40 samples from gray langurs were also all negative for Campylobacter spp. and Salmonella spp. Of the 58 samples collected from toque macaques, C. jejuni was isolated from ten, C. coli from four and Salmonella enterica enterica subsp. Virchow from two of the samples. The fact that neither of the bacteria were isolated from tufted gray langur samples could reflect a true difference between the primate species. However, this should be interpreted in the light of a relatively small sample size. Resistance to ampicillin, ciprofloxacin, nalidixic acid and tetracycline was identified in four C. jejuni isolates, of which three were multidrug resistant. In addition, all C. jejuni showed undetectable MIC-values to colistin, while all C. coli were sensitive to the substance. All C. coli were resistant to ampicillin. The S. Virchow isolates were sensitive to all antibiotics tested for. Six strains of C. jejuni were identified using PFGE and MLST clonal complexes were assigned to all isolates. Sequence types were assigned to seven out of ten C. jejuni. The detection of antibiotic resistant zoonotic bacteria in free-ranging toque macaques with close human contact may have implications for both non-human primate conservation and public health in Sri Lanka and beyondItem A Diagnostic scoring model for Leptospirosis in resource limited settings(Public Library of Science, 2016) Rajapakse, S.; Weeratunga, P.; Niloofa, R.; Fernando, N.; de Silva, N.L.; Rodrigo, C.; Maduranga, S.; Nandasiri, N.; Premawansa, S.; Karunanayake, L.; de Silva, H.J.; Handunnetti, S.Leptospirosis is a zoonotic infection with significant morbidity and mortality. The clinical presentation of leptospirosis is known to mimic the clinical profile of other prevalent tropical fevers. Laboratory confirmation of leptospirosis is based on the reference standard microscopic agglutination test (MAT), direct demonstration of the organism, and isolation by culture and DNA detection by polymerase chain reaction (PCR) amplification. However these methods of confirmation are not widely available in resource limited settings where the infection is prevalent, and reliance is placed on clinical features for provisional diagnosis. In this prospective study, we attempted to develop a model for diagnosis of leptospirosis, based on clinical features and standard laboratory test results. METHODS: The diagnostic score was developed based on data from a prospective multicentre study in two hospitals in the Western Province of Sri Lanka. All patients presenting to these hospitals with a suspected diagnosis of leptospirosis, based on the WHO surveillance criteria, were recruited. Confirmed disease was defined as positive genus specific MAT (Leptospira biflexa). A derivation cohort and a validation cohort were randomly selected from available data. Clinical and laboratory manifestations associated with confirmed leptospirosis in the derivation cohort were selected for construction of a multivariate regression model with correlation matrices, and adjusted odds ratios were extracted for significant variables. The odds ratios thus derived were subsequently utilized in the criteria model, and sensitivity and specificity examined with ROC curves. RESULTS: A total of 592 patients were included in the final analysis with 450 (180 confirmed leptospirosis) in the derivation cohort and 142 (52 confirmed leptospirosis) in the validation cohort. The variables in the final model were: history of exposure to a possible source of leptospirosis(adjusted OR = 2.827; 95% CI = 1.517-5.435; p = 0.001) serum creatinine > 150 micromol/l (adjusted OR = 2.735; 95% CI = 1.374-4.901; p = 0.001), neutrophil differential percentage > 80.0% of total white blood cell count (adjusted OR 2.163; 95% CI = 1.309-3.847; p = 0.032), serum bilirubin > 30 micromol/l (adjusted OR = 1.717; 95% CI 0.938-3.456; p = 0.049) and platelet count < 85,000/mm3 (adjusted OR = 2.350; 95% CI = 1.481-4.513; p = 0.006). Hosmer-Lemeshow test for goodness of fit was 0.931. The Nagelkerke R2 was 0.622. The area under the curve (AUC) was noted as 0.762. A score value of 14 reflected a sensitivity of 0.803, specificity of 0.602, a PPV of 0.54, NPV of 0.84, a positive LR of 2.01 and a negative LR of 0.32. CONCLUSIONS: The above diagnostic model for diagnosis of leptospirosis is suggested for use in clinical settings. It should be further validated in clinical practice.Item Soil-transmitted helminth infections: updating the global picture(Elsevier, 2003) de Silva, N.R.; Brooker, S.; Hotez, P.J.; Montresor, A.; Engels, D.; Savioli, L.No Abstract Available