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Risk factors for viral hepatitis A infection in Gampaha District, Sri Lanka: an unmatched case control study.

ABSTRACT: BACKGROUND:Hepatitis A virus (HAV) is one of the commonest food and water borne infectious diseases. The objective of the study was to determine the risk factors of HAV infection in the Gampha District in Sri Lanka. METHODS:This was an unmatched case control study conducted between January 2015 and November 2016 comprising of 504 participants with a case control ratio of 1:1. The study population included individuals of age 1 year and above who were permanent residents of the district. Cases included participants admitted to four secondary care state hospitals with an acute HAV diagnosed by detecting serum anti-HAV IgM antibodies. Controls were randomly selected individuals from the community with serum negative for Anti-HAV IgM and IgG. An interviewer administered questionnaire was used for the data collection and multiple logistic regression was applied to determine the independent risk factors. The results are expressed as adjusted odds ratios (AOR) and 95% confidence intervals (CI). RESULTS:Risk factors for HAV infection were poor knowledge regarding hepatitis (AOR;3.98, 95% CI?=?1.97-8.05), unhygienic sanitary practices (OR?=?2.73; 95% CI?=?1.42-5.23), unhygienic practices related to drinking water (OR?=?2.67; 95% CI?=?1.37-5.21), residing in urban areas (OR?=?5.94; 95% CI?=?2.98-11.86) and lower family income (OR?=?2.83; 95% CI?=?1.30-6.13). CONCLUSIONS:The independent modifiable risk factors for HAV infection were poor knowledge regarding hepatitis, unhygienic sanitary practices, and unhygienic practices related to drinking water. Community awareness must be raised on hygienic practices and safe water drinking practices. Inequities of social determinates of health must be addressed.

SUBMITTER: Ariyarathna N

PROVIDER: S-EPMC7079469 | biostudies-literature | 2020 Mar

REPOSITORIES: biostudies-literature

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Risk factors for viral hepatitis A infection in Gampaha District, Sri Lanka: an unmatched case control study.

Ariyarathna Nalin N Abeysena Chrishantha C

BMC public health 20200318 1

<h4>Background</h4>Hepatitis A virus (HAV) is one of the commonest food and water borne infectious diseases. The objective of the study was to determine the risk factors of HAV infection in the Gampha District in Sri Lanka.<h4>Methods</h4>This was an unmatched case control study conducted between January 2015 and November 2016 comprising of 504 participants with a case control ratio of 1:1. The study population included individuals of age 1 year and above who were permanent residents of the dist ...[more]

PMID: 32188427

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Project description:Dengue is the most important mosquito-borne viral infection in Sri Lanka causing an enormous social and economic burden in the country. In the absence of therapeutic drugs and the developed vaccines are under investigation, vector control is the best strategy to reduce the disease transmission. Therefore, the development of novel tools to control dengue vector mosquitoes has become the need of the hour. Novaluron is a recently developed Insect Growth Regulator (IGR) which inhibits chitin synthesis in immature stages of insects. The aim of the study was to identify the efficacy of a simple and cost-effective Autocidal Gravid Ovitrap (AGO) developed using Novaluron to control dengue outbreaks in the District of Gampaha, Sri Lanka. Laboratory and semifield experiments were performed to identify the activity range, optimum field dosage, and residual effects of Novaluron following the World Health Organization guidelines, and field experiments were performed in the Ragama Medical Officer of Health (MOH) area. Two study areas 800?m apart were selected and assigned as treated and control areas randomly. In each study area, 30 households were selected randomly. Each household was given two ovitraps, one placed indoors and the other placed outdoors. Mortality and survival counts were recorded separately for one-year time period and data were analyzed using a two-way repeated measures analysis of variance model. During the laboratory experiments, the adult emerging inhibition was 100% in all tested concentrations. The optimum field dosage was 2?ppm and the residual effect was 28 days. In the field experiments, significantly higher mortality counts were recorded in treated areas both indoor- and outdoor-placed AGOs. Two-factor repeated measures ANOVA followed by Tukey's test confirmed that the mean mortality count is high for the developed AGOs both indoor and outdoor settings. The developed AGO can be deployed to control both indoor and outdoor dengue vector mosquito populations, and in dengue-risk areas, the ovitrap will be supportive to local health authorities to enhance the efficiency of future vector control programs.

Project description:BackgroundThe midgut microbiota of mosquitoes maintain basal immune activity and immune priming. In recent years, scientists have focused on the use of microbial communities for vector control interventions. In the present study, the midgut bacteria of larvae and adults of Aedes aegypti and Ae. albopictus were assessed using both field-collected and laboratory-reared mosquitoes from Sri Lanka.MethodsAdults and larvae of Ae. aegypti and Ae. albopictus were collected from three selected areas in Gampaha Medical Officer of Health area, Gampaha District, Western Province, Sri Lanka. Bacterial colonies isolated from mosquito midgut dissections were identified by PCR amplification and sequencing of partial 16S rRNA gene fragments.ResultsAdults and larvae of Ae. aegypti and Ae. albopictus harbored 25 bacterial species. Bacillus endophyticus and Pantoea dispersa were found more frequently in field-collected Ae. aegypti and Ae. albopictus adults, respectively. The midgut bacteria of Ae. aegypti and Ae. albopictus adults (X2 = 556.167, df = 72, P < 0.001) and larvae (X2 = 633.11, df = 66, P < 0.001) were significantly different. There was a significant difference among the bacterial communities between field-collected adults (X2 = 48.974, df = 10, P < 0.001) and larvae (X2 = 84.981, df = 10, P < 0.001). Lysinibacillus sphaericus was a common species in adults and larvae of laboratory-reared Ae. aegypti. Only P. dispersa occurred in the field-collected adults of Ae. aegypti and Ae. albopictus. Species belonging to genera Terribacillus, Lysinibacillus, Agromyces and Kocuria were recorded from Aedes mosquitoes, in accordance with previously reported results.ConclusionsThis study generated a comprehensive database on the culturable bacterial community found in the midgut of field-collected (Ae. aegypti and Ae. albopictus) and laboratory-reared (Ae. aegypti) mosquito larvae and adults from Sri Lanka. Data confirm that the midgut bacterial diversity in the studied mosquitoes varies according to species, developmental stage and strain (field vs laboratory).

Project description:BackgroundOrthohantaviruses and leptospira are emerging zoonotic pathogens of high public health significance. The epidemiology of orthohantavirus infections and leptospirosis is similar and presents related clinical pictures in humans. However, a paucity of data on actual reservoir hosts for orthohantaviruses and leptospira exists. Therefore, this study aimed at determining the occurrence of orthohantaviruses and leptospira in small mammals captured in an endemic region of Sri Lanka.MethodsRodents and shrews were morphologically and/or genetically identified using morphological keys and DNA barcoding techniques targeting the cytochrome oxidase b subunit gene (Cytb). Lung tissues and sera were subsequently analyzed for the presence of orthohantavirus RNA using qRT-PCR. Sera of rats were tested for IgG antibodies against orthohantaviruses and leptospira.ResultsForty-three (43) small mammals representing: Rattus (R.) rattus (black rat) or R. tanezumi (Asian rat), Suncus murinus (Asian house shrew), R. norvegicus (brown rat) and Mus musculus (house mouse) were investigated. No orthohantavirus RNA was detected from the lung tissue or serum samples of these animals. Elevated levels of IgG antibodies against Puumala orthohantavirus (PUUV) and/or Seoul orthohantavirus (SEOV) antigens were detected in sera of 28 (72%) out of the 39 rats analysed. Interestingly, 36 (92%) of the 39 rats also showed presence of anti leptospira-IgG antibodies in their serum, representing dual infection or dual exposure in 26/39 (66.7%) of examined rats.ConclusionsThis project targets important public health questions concerning the occupational risk of orthohantavirus infections and/or leptospirosis in an endemic region of Sri Lanka. Most rats (72%) in our study displayed antibodies reacting to orthohantavirus NP antigens, related to PUUV and/or SEOV. No correlation between the orthohantavirus and leptospira IgG antibody levels were noticed. Finally, a combination of both morphological and DNA barcoding approaches revealed that several species of rats may play a role in the maintenance and transmission of orthohantavirus and leptospira in Sri Lanka.

Project description:A mosquito species has its own favourable requirements of abiotic and biotic characteristics including microbiota, in a breeding habitat. Some of the microbiota may cause parasitic or pathogenic effects to mosquito larvae such as species of viruses, parasitic bacteria, fungi, protists, entomopathogenic nematodes, and filamentous fungi. In Sri Lanka, there is a scarcity of information on microbiota associated with mosquito breeding habitats and their effect on mosquito larvae. Hence, the present study was conducted to determine microbiota species/taxa associated with a variety of mosquito breeding habitats in selected areas of the Gampaha District in Sri Lanka and the relationship, if any, the microbiota has with mosquito larva survival and breeding. Forty-five microbiota species belonging to 11 phyla were found from different mosquito breeding habitats with the highest percentage belonging to phylum Euglenozoa (27.89%). Species that belonged to the phylum Amoebozoa (1.22%) and Sarcodina (1.17%) had the lowest abundance, and each of its species richness was recorded as one. Philodina citrina followed by Monostyla bulla comprised 30.8% and 16.59%, respectively, of the total rotifer population. From the total microbiota, 25-50% existed as accidental while less than 25% rare, in the habitat type according to their abundance. Paddy fields had the highest species richness (17), evenness (23.52), Shannon-Weiner (66.64), and beta diversity (0.65) over 50% indicating high heterogeneity in microbiota composition among the habitats. Ciliated protists, namely, Vorticella microstoma, Zoothamnium spp., and Chilodinella sp., were identified as naturally occurring microbiota associated with Culex mosquito larvae that inhabited in paddy fields and associated irrigation canals. Only Vorticella microstoma caused a significant lethal effect on mosquito larvae. This study revealed that species of Cx. gelidus, Cx. pseudovishnui, Cx. tritaeniorhynchus, Cx. quinquefasciatus, and Cx. whitmorei served as hosts for V. microstoma where infectivity rate in Cx. tritaeniorhynchus reached 73.22. Chilodinella sp. selectively served as endoparasitic to Cx. gelidus larvae causing only 4.58% mortality, and invasive cysts of the pathogen were observed in the subcuticular layer of the host body. Even though Zoothamnium spp. were found on Cx. tritaeniorhynchus larvae, there was no lethal effect due to the attachment of the parasitic agent. The potential of these microbiotas in integrated vector controlling approaches in future perspectives is recommended.

Project description:BACKGROUND:Oesophageal carcinoma (OC) is one of the leading cancers in Sri Lanka. Its increasing incidence despite the implementation of various preventive activities addressing the conventional risk factors indicates the possibility of the existence of novel, country-specific risk factors. Thus, the identification of novel risk factors of OC specific to Sri Lanka is crucial for implementation of primary prevention activities. METHODS:A case-control study was conducted among 49 incident cases of OC recruited from the National Cancer Institute, Maharagama using a non-probability sampling method, and unmatched hospital controls (n?=?196) excluded of having OC recruited from the endoscopy unit of the National Hospital of Sri Lanka. Data were collected using an interviewer administered questionnaire. Risk factors for OC were assessed by odds ratio (OR) with 95% confidence interval (CI). The risk factors were adjusted for possible confounding by logistic regression analysis. RESULTS:Of the study population, OC was common among males (69%) and the majority presented with squamous cell carcinoma (65%) at late stages (Stage IV: 45%; Stage III: 37%). Following adjusting for confounders, the risk factor profile for OC included; age?>?65 years (OR?=?4.0; 95% CI: 1.2-14.2); family history of cancer (OR?=?5.04; 95% CI: 1.3-19.0); sub-optimal consumption of dietary fibre (OR?=?3.58; 95% CI: 1.1-12.3); sub-optimal consumption of anti-oxidants (OR?=?7.0; 95% CI: 2.2-22.5); over-consumption of deep fried food (OR?=?6.68; 95% CI:2.0-22.6); 'high risk' alcohol drinking (OR?=?11.7; 95% CI: 2.8-49.4); betel quid chewing (OR?=?6.1; 95% CI: 2.0, 20.0); 'low' lifetime total sports and exercise activities (MET hours/week/year) (OR?=?5.83; 95% CI: 1.5-23.0); agrochemicals exposure (OR?=?6.57; 95% CI: 1.4-30.3); pipe-borne drinking water (OR?=?5.62; 95% CI:1.7-18.9) and radiation exposure (OR?=?4.64; 95% CI: 1.4-15.5). Significant effect modifications were seen between betel quid chewing and male sex (p?=?0.01) and between ever exposure to radiation and age over 65 years (p?=?0.04). CONCLUSIONS:Risk profile for OC includes novel yet modifiable risk factors in relation to diet, occupation, environment and health. Primary prevention should target these to combat OC in Sri Lanka.

Project description:BackgroundLeishmaniasis is a notifiable disease in Sri Lanka since 2008. Previous studies show a gap in the notification of leishmaniasis. The purpose of the present study was to determine the Knowledge, attitudes and practice of medical officers regarding leishmaniasis.MethodsA cross-sectional study was conducted in the Anuradhapura district which reported the highest case load of leishmaniasis. Medical officers from public and private health care institutes in the area filled a self-administered questionnaire in the presence of the investigators.ResultsOne hundred and eighty-eight (188) medical officers completed the questionnaire. Of them, 95.7% were aware of leishmaniasis as a parasitic infection and 84.7% correctly identified Leishmania donovani as the causative organism in Sri Lanka. From the respondents, 181 (96.8%) knew that the vector of leishmaniasis is sand fly. Cutaneous leishmaniasis was reported as the most prevalent form of leishmaniasis in the country by 176 (94.1%). Nearly half of the respondents (98, 54.1%) were aware of the fact that the Anuradhapura district has the highest disease burden. Many of them had the idea that leishmaniasis is an emerging disease (155, 84.3%,) and early diagnosis is important in controlling the disease (163, 89.1%). Although about three fourth (123, 73.7%,) of the participants mentioned that leishmaniasis should be notified at first clinical suspicion, only 74 (42.5%) were aware that it is a legal requirement. Some medical officers (39, 22%) believed that the current notification system in the country is not effective. Unavailability of notification forms (60, 36.8%) heavy workload (85, 50.3%) and inadequate supportive staff (55, 35.1%) were reported as barriers for timely notification. Even though 105 (58.0%) of medical officers had suspected leishmaniasis during the last 8 years period only 35 (19.4%) had notified.ConclusionsEven though more than 90% of the participants had good theoretical knowledge about leishmaniasis; notification of leishmaniasis is considerably inadequate. This study emphasizes the need for greater efforts to improve the notification of leishmaniasis in Sri Lanka.

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Risk factors for viral hepatitis A infection in Gampaha District, Sri Lanka: an unmatched case control study.

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Risk factors for viral hepatitis A infection in Gampaha District, Sri Lanka: an unmatched case control study.

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