Rajitha Wickremasinghe - Academia.edu (original) (raw)

Papers by Rajitha Wickremasinghe

Oral Presentation Abstract (OP31), 120th Annual Scientific Sessions, Sri Lanka Medical Associatio... more Oral Presentation Abstract (OP31), 120th Annual Scientific Sessions, Sri Lanka Medical Association, 2007 Colombo, Sri Lanka

Parasitology International, Feb 1, 2023

BMC Nephrology, Jul 5, 2011

Parasitology International, Apr 1, 2023

Oral Presentation Abstract (OP30), 128th Annual Scientific Sessions, Sri Lanka Medical Associatio... more Oral Presentation Abstract (OP30), 128th Annual Scientific Sessions, Sri Lanka Medical Association, 6th-8th July 2015 Colombo, Sri Lanka

Ceylon Medical Journal, Dec 29, 2017

Introduction Chronic kidney disease of unknown etiology (CKDu) has emerged as a significant publi... more Introduction Chronic kidney disease of unknown etiology (CKDu) has emerged as a significant public health problem in Sri Lanka. The role of environmental exposure to cadmium and arsenic in the aetiology of CKDu is still unclear. Identification of a panel of novel urinary biomarkers would be invaluable in the study of toxin mediated damage postulated to be the aetiology of CKDu. Objectives The aims of this study were to evaluate the profile of novel urinary biomarkers in CKDu patients and identify any association with environmental exposure to heavy metals. Methods Thirty seven randomly selected CKDu patients attending a renal clinic in the North Central Province and two control groups namely a farmer group (n=39) and a non-farmer group (n=40) from a non-endemic area were included in this comparative cross sectional study. Urine samples were analyzed for heavy metals and five urinary biomarkers. Results CKDu patients had significantly elevated urinary levels of fibrinogen (198.2 ng/mg creatinine p<0.001), clusterin (3479 ng/mg creatinine p<0.001), cystatin-C (5124.8 ng/mg creatinine p<0.001) and β2-microglobulin (9913.4 ng/mg creatinine p<0.001) compared to the control groups. Fibrinogen and β2-microglobulin were the best to discriminate CKDu patients from normal individuals with the receiver operator areas under the curve being 0.867 and 0.853, respectively. Urinary fibrinogen and KIM-1 levels correlated positively with urinary arsenic levels. KIM-1 levels correlated positively with urinary mercury and lead levels but no correlation was seen with urinary cadmium levels. Conclusions Fibrinogen and β2-microglobulin have the potential of being a screening tool for detection of CKDu and may aid the early diagnosis of toxin mediated tubular injury in CKDu. Their usefulness need to be further validated in a larger epidemiological study of patients with early stages of CKDu.

Journal of Hypertension, Sep 1, 2016

for the COBRA-BPS Study Group Background: High blood pressure (BP) is the leading attributable ri... more for the COBRA-BPS Study Group Background: High blood pressure (BP) is the leading attributable risk for cardiovascular disease globally. There is little information on effective and sustainable public health system strategies for managing hypertension in South Asian countries. We conducted a feasibility study to gather preliminary data to optimize BP-lowering strategies for a public health intervention in rural communities in Bangladesh, Pakistan, and Sri Lanka. Methods: A mixed method feasibility study comprised a 3-month pre and postevaluation of a multicomponent intervention (MCI), including BP screening and home health education by trained government community health worker (CHW); providers trained in hypertension management, and compensation of CHW for additional services. Checklists were used to document care. Stakeholder interviews were also conducted. Individuals aged 40 years and above with high BP (systolic !140 mmHg or diastolic !90 mmHg based on two readings from 2 separate days, or receiving antihypertensive medications) were enrolled from rural communities in Bangladesh, Pakistan, and Sri Lanka. BP was measured at baseline and 3 months postintervention. Results: A total of 412 (90%) of the 454 eligible individuals were recruited. Of those recruited, 90% received home health education session by trained CHWs, 80% were referred to trained providers, of whom 83% completed the management checklist. A follow-up rate of 95.6% was achieved. The mean SBP declined significantly by 4.5 mmHg 95% confidence interval (2.3, 6.7) mmHg (P < 0.001) in the overall pooled analysis in three countries; however, it varied among countries. BP decline was 10.5 mmHg (8.1, 13.0 mmHg) (P < 0.001) in the pooled analysis of individuals with uncontrolled hypertension at baseline, and was also significant each of the three countries. All 98 stakeholders strongly supported upscaling the proposed MCI strategies. Conclusion: The proposed MCI is feasible for implementation and requires long-term, large-scale evaluation in the rural public health infrastructure in South Asian countries to determine sustainability of health system changes and BP control. If these long-term effects are confirmed, MCI may be a long-term strategy for tackling rising rates of cardiovascular disease in low-resourced countries. Clintrial.gov NCT02341651

UN chronicle, Apr 17, 2012

Climate change is defined as a statistically significant variation in either the mean state of th... more Climate change is defined as a statistically significant variation in either the mean state of the climate or in its variability, persisting for an extended periodtypically decades or longerthat may be attributed to natural internal processes, external forcing, or persistent anthropogenic changes in the composition of the atmosphere or in land use. Malaria, the world’s most important and deadly tropical mosquito-borne parasitic disease, kills approximately 1 million people and afflicts as many as 1 billion people in 109 countries throughout Africa, Asia, and Latin America. Reducing the impact of malaria will significantly enhance the efforts to achieve the Millennium Development Goals, agreed upon by every United Nations Member State. Variation in climatic conditions, such as temperature, rainfall patterns, and humidity, has a profound effect on the longevity of the mosquito and on the development of malaria parasites in the mosquito and, subsequently, on malaria transmission.

Communications biology, May 5, 2022

In the Discussion sentence beginning 'Indeed, it has been recently shown…' in this article, the t... more In the Discussion sentence beginning 'Indeed, it has been recently shown…' in this article, the text 'LRIG' should read 'LRIG1'. These have now been corrected in the PDF and HTML versions of the Article.

Malaria Journal, Mar 27, 2022

Background: Sri Lanka eliminated malaria in November 2012 and was certified malaria-free by the W... more Background: Sri Lanka eliminated malaria in November 2012 and was certified malaria-free by the World Health Organization (WHO) in September 2016 but is facing a challenge to prevent re-establishment of malaria. Influx of travellers from malarious countries and the presence of malaria vectors in formerly endemic areas make the country both receptive and vulnerable. Susceptibility to malaria, the predisposition of populations to be infected by malaria parasites, is influenced by biologic and generic factors such as the age-sex composition, socio economic status, and the migration history of the population. The aim of this study was to assess susceptibility to malaria during the prevention of re-establishment phase in Sri Lanka. Methods: A national survey was conducted among 3454 households. A multistage cluster sampling technique was used to select the households. Susceptibility was assessed based on pre-defined variables by interviewing heads of households using an interviewer-administered questionnaire. Basic socio-demographic information, travel history, history of fever and past malaria infections in the preceding three years were collected. Data were analysed using SPSS version 20 package. Results: The percentage of the population who had been overseas within the last 3 years in the urban sector (4.5%, n = 99) was higher than that of the rural (2.8%, n = 288) and estate sectors (0.2%, n = 2) (p < 0.001); it also declined with the wealth index up to the 4th quintile with a slight rise in the 5th quintile (p < 0.001). The likelihood of travel overseas was 1.75 times (95% CI: 1.38-2.22) higher for urban residents as compared rural estate residents; it was 1.46 times (95% CI: 1.16-1.92) higher for persons from the upper wealth index quintile as compared to persons from the 1st and 2nd quintiles after controlling for sex, age and area of residence. 177 persons had fever within the past 2 weeks of the survey. There was no association between presence of fever within the last 2 weeks and sector or travel abroad. Conclusions: Urban residents, upper socioeconomic class persons and males are more likely to travel overseas and bring the parasite into the country. Social vulnerability and risk of re-establishment of malaria can be assessed by combining susceptibility with resilience and receptivity.

Oral Presentation Abstract (OP1), 124th Annual Scientific Sessions, Sri Lanka Medical Association... more Oral Presentation Abstract (OP1), 124th Annual Scientific Sessions, Sri Lanka Medical Association, 2011 Colombo, Sri Lanka

Eisei Dobutsu, 2015

Previous records of Sri Lankan Anopheles were most imperfect, and even the number and names of th... more Previous records of Sri Lankan Anopheles were most imperfect, and even the number and names of the species present were very doubtful. There was no systematic study conducted for Sri Lankan adult anophelines since 1990. Therefore, the objective of this study was to explore the species abundance and morphological variations of anopheline mosquitoes in Sri Lanka. Entomological surveys were conducted on a monthly basis from June 2010 to December 2013 in Trincomalee District, using five entomological techniques. Entomological surveys identified a total of 131,804 mosquito specimens belong to 18 anopheline species. One of which was An. jeyporiensis, a species that was not in the checklist in Sri Lanka. Its basic morphological features are similar to the members in Myzomyia series under the subgenus Cellia. Following characteristics were used to confirm the species as An. jeyporiensis; Centre of the scutum covered with short oblong white scales extending back to scutellum; Vein R 1 usually with accessory pale spot on preapical dark (PD) area; Foretarsomere 1 with apical pale band nearly 2.0 width of tarsomere diameter.

Access to affordable essential medicines for noncommunicable, chronic diseases is critical in man... more Access to affordable essential medicines for noncommunicable, chronic diseases is critical in management of the diseases. This study aims to assess the availability, prices, and affordability of medicines for common chronic diseases in the Asia Pacific Region (APR). A secondary analysis of medicines price and availability data from the Health Action International's (HAI) database was undertaken using the standardized WHO/HAI methodology. The median availability of any medicine in the public sector was 35.5% compared with 56.7% in the private sector. Countries paid 1.4 times the International Reference Price to procure lowest-priced generics (LPGs) and 9.1 times for innovator brands (IBs). Patients would have to spend 2.3 and 0.4 day's wages to purchase one month's treatment of a chronic disease for IBs and LPGs, respectively in the private sector. These findings highlight the need to increase availability, reduce prices, and improve affordability of the medicines.

Liver International, Jul 10, 2014

BMJ Open, Apr 1, 2023

Objectives To describe the rehabilitation services available for communication disorders in Sri L... more Objectives To describe the rehabilitation services available for communication disorders in Sri Lanka and to estimate the adequacy of the services in provinces and districts of the country. Setting The study considered government and private institutions, which provide rehabilitation services for communication disorders in Sri Lanka. Participants Institutions providing services of speechlanguage pathologists, audiologists and audiology technicians in Sri Lanka. Primary and secondary outcome measures We investigated the number of government hospitals and private institutions, which provide speech-language pathology and audiology services in Sri Lanka as the primary outcome measure. A number of speech-language pathologists, audiologists and audiology technicians working in the institutions were obtained from records and institution-based inquiries to identify the adequacy of the services in the country as the secondary outcome measure. Results Of the 647 government hospitals that provide free healthcare services in the country, 45 and 33 hospitals had speech and language therapy and audiology units, respectively. Government hospitals do not have audiologists but only have audiology technicians. The number of speech and language therapists and audiology technicians in the government sector per 100 000 population in the country was 0.44 and 0.18, respectively. There were wide variations in specialist to population ratio between districts. 77 private centres provide speech therapy services in 15 out of the 25 districts; 36 private centres provide audiological evaluations in 9 districts. Conclusions The number of specialist speech and language therapists and audiologists is not sufficient to provide adequate rehabilitation services for communications disorder for the Sri Lankan population. Not recruiting audiologists to the government sector affects the management of hearing impairment in the affected.

Ceylon Medical Journal, May 4, 2022

Vilniaus universiteto Vidaus ligų, šeimos medicinos, gerontologijos ir onkologijos klinika, 1 Reu... more Vilniaus universiteto Vidaus ligų, šeimos medicinos, gerontologijos ir onkologijos klinika, 1 Reumatologijos, traumatologijos ir ortopedijos bei rekonstrukcinės chirurgijos klinika, 2 Eksperimentinės ir klinikinės medicinos institutas Raktažodžiai: Bath'o ankilozinio spondilito funkcinis indeksas, Bath'o ankilozinio spondilito bendrosios savijautos įvertinimo skalė, Bath'o ankilozinio spondilito ligos aktyvumo indeksas, klausimynų lietuvių kalba pritaikymas, patikimumas, pagrįstumas. Santrauka. Originalūs angliški Bath'o ankilozinio spondilito funkcinio indekso, bendrosios savijautos vertinimo skalės, ligos aktyvumo indekso klausimynai skirti spondiloartropatijomis sergančiųjų sveikatai, fizinei ir psichinei būklei bei gydymo veiksmingumui įvertinti. Tyrimo tikslas. Pritaikyti Bath'o ankilozinio spondilito funkcinio indekso, bendrosios savijautos vertinimo skalės, ligos aktyvumo indekso klausimynus Lietuvoje, ištirti jų psichometrines savybes: patikimumą ir pagrįstumą. Metodai ir medžiaga. Tiriamų lietuvių kalba klausimynų pritaikymas atliktas pagal tarptautinių klausimynų adaptacijoms keliamus reikalavimus. Psichometrinės klausimynų lietuvių kalba savybės ištirtos 139 spondiloartropatijomis sergantiems pacientams, 2006-2008 m. gydytiems Vilniaus universiteto ligoninės Santariškių klinikų Reumatologijos skyriuje. Pagrįstumas tirtas lyginant tiriamus klausimynus su spondiloartropatijoms pritaikytu sveikatos vertinimo klausimynu, stuburo paslankumo metrologiniais rodikliais, paciento skausmo intensyvumo ir bendrosios sveikatos būklės įvertinimu, ligos aktyvumo įvertinimu bei spaudimui ir (ar) lietimui skausmingų vietų skaičiumi. Ištirtas klausimynų vidinis suderinamumas ir stabilumas. Rezultatai. Atliktas Bath'o ankilozinio spondilito funkcinio, ligos aktyvumo indekso ir bendrosios savijautos įvertinimo skalės pritaikymas. Nustatytas geras (Cronbacho a³0,80) funkcinio ir ligos aktyvumo indeksų bei pakankamas (Cronbacho a=0,58) bendrosios savijautos įvertinimo skalės vidinis suderinamumas. Šiems trims klausimynams būdingas aukštas stabilumas laiko atžvilgiu (vidinis klasės koreliacijos koeficientas >0,95). Nustatytas reikšmingas ryšys tarp tiriamųjų instrumentų atskirų klausimų, jų rezultatų ir kitų sveikatos būklės rodiklių. Išvados. Bath'o ankilozinio spondilito funkcinio ligos aktyvumo indeksai ir bendrosios savijautos vertinimo skalė atitinka jiems keliamus psichometrinius reikalavimus ir yra tinkami spondiloartropatijų poveikiui vertinti lietuviškai kalbančių ligonių sveikatai.