Sri Lanka

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Browsing Sri Lanka by Author "ABEYASINGHE, RR"

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    Glucose 6-phosphate dehydrogenase deficiency and Malaria in Anuradhapura district
    (Post Graduate Institute of Medicine, Colombo: PGIM., 1998) ABEYASINGHE, RR
    The effects of glucose 6-phosphate dehydrogenase deficiency on the severity of intravascular haemolysis was assessed.In addition,the hypothesis 'glucose 6 -phosphate dehydrogenase deficiency offers protection from malaria' was tested.The usefulness of some of the tests used to identify glucose 6 -phosphate dehydrogenase status was also assessed.The severity of haemolysis was also assessed by the degree of anaemia and the need for blood transfusions.The follow up of glucose 6 -phosphate dehydrogenase deficient subjects and non-deficient controls indicated the incidence density of malaria to be 0.33 cases/100 person-months among subjects and 0.41 cases/100 person-months among controls.The relative risk (95 per cent CI) for malaria was 0.8 (0.51-1.27).Glucose 6 -phosphate dehydrogenase deficiency appears to have a protective effect on malaria,though not significant.The preventive fraction was 19.5 per cent.
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    Treatment seeking for malaria at general hospital Anuradhapura
    (Post Graduate Institute of Medicine, Colombo: PGIM ., 1995) ABEYASINGHE, RR
    Malaria remains a major public health problem in Sri Lanka. The control of malaria has received considerable attention over the years. The implementation of the "NEW GLOBAL MALARIA CONTROL STRATEGY" in Sri Lanka was also undertaken to improve control in the island. One of the main elements of this strategy, is to provide early diagnosis and prompt treatment to malaria patients. The aim of implementing this particular element is to reduce transmission of the diasease and to minimise complications in malaria patients. The extensive health facilities available in the country, have together with the field malaria control measures already implemented ensured that mortality due to malaria remained very low. However, morbidity due to malaria in the island continues to remain rather high. Observations have also revealed a change in the clinical patterns of malaria, due to various reasons. This has led to some malaria patients not being diagnosed early, leading to various complications in them. In view of these facts, this descriptive study of malaria patients seeking treatment at General Hospital Anuradhapura was conducted to analyse the frequency of occurrence of some commonly occurring presenting symptoms in malaria patients and to estimate the approximate duration of parasitaemia in malaria patients resident within the Anuradhapura district, who sought treatment from General Hospital Anuradhapura. The majority of patients who sought treatment were males and the majority of infections were caused by plasmodium vivax. Among the patients, those with a long duration of continuous residence in the district (10 years and over) were more than those with a short duration of continuous residence in the district (0-9 years). Fever was found to be the commonest presenting symptom reported by patients. Headache, muscle and/or joint pains were also reported to occur in a large number of patients. Among the "initial symptoms" identified by patients, which according to them was the first symptom they felt during the present episode of malaria, fever was the commonest. Headache was also identified by a large number of patients to be the "initial symptom". Fever was identified as the "initial symptom", more often by patiens with a short duration of continuous residence in the district, in comparison to patients with a long duration of continuous residence in the district. However, both vivax and falciparum infected patients idetified fever to be the "initial symptom" in the majority of instances. The duration of the disease as from the day of onset of the "initial symptom" to the day of seeking treatment ranged from 1-14 days, and it was found that upto 89.67 percent of patients had sought treatment within one week of the onset of the "initial symptom". Fever was identified the "prime symptom" (the single symptom which prompted patients to seek treatment, out of all the existing symptoms) by 84.51 percent of patients. Headache was identified as the "prime symptom" by only 7.04 percent of patients. Patients with a short duration of continuous residence in the districtm claimed fever to be the "prime symptom" more often than patients with a long duration of continuous residence in the district. The duration of the "prime symptom" in patients ranged from 1-11 days and 92.96 of the patients had sought treatmen within7 days from the day of onset of the "prime symptom" Considering the period of continuous residence in the district, when studying presenting symptoms and immune levels of the population to malaria appears more important, than considering the age of the patients. This is especially more so in areas where large scale movement of the population takes place Also worthy of consideration, is the fact that over 10 percent of the patients had not received treatment, even one week after the onset of the "initial symptoms" which was identified by them to be the beginning of the present episode of malaria. This is most important, if the "NEW GLOBAL MALARIA CONTROL STRATEGY" now being implemented is to succeed in Sri Lanka