Browsing by Author "Gunawardena, S"

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    The pattern of hypogammaglobulinaemia in Sri Lankan children.
    (2000-06-29) de Silva, N R; Gunawardena, S; Ratnayake, H; Weerasinghe, A
    OBJECTIVE: To evaluate the prevalence of hypogammaglobulinaemia in Sri Lankan children who present with recurrent or severe bacterial infections. DESIGN: A descriptive study. SETTING: Medical Research Institute (MRI), Colombo. SUBJECTS: 100 children between the ages of four months to twelve years referred to the Department of Immunology, MRI, for evaluation of immune status during four years from 1993 to 1997. MEASUREMENTS: Immunoglobulin G, A and M levels were measured using radial immunodiffusion technique. RESULTS: 22 out of 100 children had an underlying antibody deficiency, of whom IgA deficiency was the commonest (18 patients). Two patients had low IgG and A and elevated IgM levels, and they were diagnosed as having X linked-hyper-IgM syndrome. One patient had deficient IgA and IgM, and all three immunoglobulins were deficient in another. CONCLUSIONS: Results indicate that IgA deficiency is the commonest immunodeficiency in Sri Lanka, which is comparable with studies done in the West. This study also shows the need to improve the standard of care in patients with immunodeficiency.
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    Primary immune deficiency among patients with recurrent infections.
    (2007-09-21) De Silva, Rajiva; Gunawardena, S; Wickremesinghe, G; Ranasinghe, B; Namasivayam, Y
    OBJECTIVES: Primary immune deficiency is relatively rare. Patients present with recurrent or persistent infections or infections with opportunistic pathogens. We investigated patients who presented during the years 2005-7 with recurrent or persistent infections or infections with opportunistic organisms, for underlying immune deficiency. DESIGN: Descriptive study. SETTING: Department of Immunology, Medical Research Institute, Colombo. STUDY POPULATION: 257 patients referred to the Department of Immunology, Medical Research Institute, Colombo, with a history of recurrent infections, for evaluation of possible immune deficiency. MEASUREMENTS: Appropriate evaluation of immunological competence of the humoral and cell mediated immune systems. RESULTS: There were 8 patients with agammaglobulinaemia (X linked agammaglobulinaemia and autosomal recessive agammaglobulinaemia), 2 patients each with ataxia telangiectasia, IgA deficiency and hyper-IgE syndrome, 3 patients with common variable immune deficiency (CVID), and 1 patient each with Griscelli syndrome, hyper-IgM syndrome and X linked severe combined immune deficiency (SCID). CONCLUSIONS: Primary immune deficiency must be included in the evaluation of patients with recurrent infections, and timely intervention can prevent morbidity and mortality.
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    Seroconversion rate following measles vaccination.
    (2000-09-24) Gunawardena, S; Bandaranayake, V
    OBJECTIVE: To assess the seroconversion rate following measles vaccination in Sri Lankan children. DESIGN: A descriptive study. SETTING: Immunisation clinic, Lady Ridgeway Hospital, Colombo (LRHC). SUBJECTS: 134 infants who attended the LRHC for measles vaccination. MEASUREMENTS: Pre- and post-vaccination blood samples were collected and serum was tested for the presence of anti-measles 1gG antibodies using the ELISA technique. RESULTS: Of the 134 infants only 102 were brought for the post-vaccination sample. Of these 102 samples, 101 were negative for anti-measles antibodies before vaccination. Of the 101 sero-negative samples 94 became sero-positive 6 to 8 weeks after vaccination. These results indicate that the seroconversion rate is 93.06%, which is similar to the results of studies done in other countries. CONCLUSION: Most infants are susceptible to measles infection by the age of 9 months, and it is appropriate to vaccinate infants at this age, as is the practice at present. However, further studies are needed to assess the duration of protection with a single dose of measles vaccine.