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Journal Cover Sri Lankan Journal of Infectious Diseases
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  This is an Open Access Journal Open Access journal
   ISSN (Print) 2012-8169
   Published by Sri Lanka Journals Online Homepage  [49 journals]
  • Editorial

    • Abstract: None Published on 2016-10-27 05:58:38
  • Consumption of human rabies immunoglobulin (HRIG) for major animal bites
           in government hospitals of Sri Lanka.

    • Abstract:
      Introduction:Rabies still remains as a significant public health problem in Sri Lanka. Published data related to the usage of human rabies immunoglobulins (HRIG) which is an expensive biological used for post exposure prophylaxis and the types of animal bites are limited. This study was designed to analyze the consumption of HRIG for major animal bites in government hospitals of Sri Lanka. Methods: A audit was carried out at the rabies unit in the Medical Research Institute (MRI) on the use of HRIG from 1st of January to 31st of December 2012 . Data was extracted from scrutinizing the forms sent to the Rabies Unit following the administration of HRIG by the government hospitals which administer HRIG. Results:1896, 2160, 2186 patients have received HRIG during 2010, 2011and 2012 respectively. The number of patients treated without adhering to the rabies treatment protocol issued by the ministry of health also has inreased over the same period of time. Each year around 60% of total HRIG has been used for stray dog and cat bites, 24% for domestic animal and 17% for wild animal bites.  Conclusions and recommendations:Annual consumption as well as the misuse of HRIG has increased from 2010 to 2012. Effective methods to control stray dogs and cats and the concept of responsible pet ownership should be encouraged. Medical officers in rabies treatment units should be trained on adherence to government protocol for anti rabies post exposure therapy.   Published on 2016-10-27 04:18:27
  • Validation of rapid tests to detect urinary tract infection

    • Abstract: There are several rapid dip stick tests currently in use to detect urinary tract infection (UTI). This study was carried out to validate three different dip sticks that are widely used with urine culture which is the gold standard to diagnose UTI. The findings of the current study suggest that the sensitivity, specificity and predictive value of the three dipsticks are not statistically different from each other and are comparable to sedimentary microscopy. These these three dipsticks can therefore be used instead of urinary sedimentation method. However low positive predictive value (PPV) of all three dipsticks is a major limitation. Further studies with large sample size are needed to evaluate their value in clinical practice. Published on 2016-10-27 04:17:49
  • A descriptive analysis of clinico-demographic features and microbiological
           results of typhoid fever suspected patients in four large hospitals of

    • Abstract: Introduction: Bhutan reports about 2000 typhoid fever cases annually. We aimed at understanding the clinico-demographic features and microbiological results of patients with suspected typhoid fever. Methods: A yearlong (2012) study of typhoid fever suspects was conducted to describe and analyse associations of demographic and clinical features with laboratory findings. Results: A total of 457 patients were enrolled. Most patients were from Phuntsholing General Hospital (n=181; 39.6%) followed by Jigme Dorji Wangchuck National Referral Hospital (n=170; 37.2%), Eastern Regional Referral Hospital (n=56; 12.3%) and Central Regional Referral Hospital (n=50; 10.9%). Fever (n=420; 91.9 %) and headache (n=397; 86.9 %) were the commonest symptoms reported by the patients. Only 30% (n=137) and 11.2% (n=51) had diarrhoea and constipation respectively. Mean duration of illness was 11.2 days. Among the 457 Widal tests performed, 76.1% (n=348) were negative, 12.3 % (n=56) positive for O antigen, 8.5% (n=39) for H antigen and 3.1% (n=14) for both. Only 2 of the 109 (1.8%) patients with a positive Widal test had a positive blood culture. Widal test showed a sensitivity of 33.3% and specificity of 76.3%. There was no association of any symptoms to antibody titres. There were three peaks when suspected cases reported to hospitals. More than 97% (n=447) of blood were sterile and Salmonella Typhi was isolated only in 1.3% (n=6). Only one isolate showed resistance to amoxicillin and nalidixic acid. Conclusion: Typhoid fever was not being diagnosed satisfactorily but over-diagnosed and treated clinically. Widal test should be replaced by more sensitive and specific tests or used cautiously with well-defined cut-off titres.  Published on 2016-10-27 03:35:38
  • Treatment of Autoimmune Haemolytic Anaemia with Hepatitis C Virus-A Real

    • Abstract: Hepatitis C virus (HCV) infection is a potentially curable disease. The first line of treatment is pegylated interferon and ribavirin, both of which cause haemolysis. HCV itself causes autoimmune haemolytic anaemia (AIHA). Treatment of AIHA with steroid is contraindicated in patients on interferon. We report the successful treatment of a patient with AIHA infected with HCV whose treatment was a real challenge due to the risk of exacerbation of haemolysis by antiviral treatment. We describe the successful treatment of this patient initially with corticosteroids followed by pegylated interferon and gradual increase of the dose of ribavirin Published on 2016-10-26 12:35:17
  • Molecular diagnostics in a tuberculous patient with clinical non response
           to standard treatment

    • Abstract: Rapid distinguishing of mycobacterial species and knowledge about their susceptibility is vital for the management of patients with pulmonary disease who are not responding to initial treatment as the mycobacteria have a spectrum of virulence and different susceptibilities to antibiotics. Most biochemical techniques used for species differentiation are laborious and time consuming. Hence molecular techniques are becoming an alternative to existing conventional testing. This study demonstrates the utility of molecular diagnostics for patients with mycobacterial infections who are not responding to initial anti TB therapy. Published on 2016-10-26 12:34:41
  • Community acquired pneumonia due to Legionella pneumophila in a tertiary
           care hospital

    • Abstract: Introduction: Legionella pneumophila can cause severe community acquired pneumonia which may be life threatening. This organism is found in aquatic environments and infection is acquired through inhalation of aerosols. Few studies conducted in Sri Lanka have confirmed the presence of this organism in cooling tower water in Sri Lanka. Published data regarding human cases of legionellosis in Sri Lanka is not available. Objective: To determine the prevalence of community acquired pneumonia due to L. pneumophila among patients who required hospital admission and assess the risk factors associated with this infection. Methods: The study was carried out from July 2014 to June 2015 at the Teaching Hospital, Peradeniya. Expectorated sputum or endotracheal secretions and urine specimen were collected within 24 hours of admission after obtaining consent from all adult patients admitted during the study period with community acquired pneumonia. Respiratory specimens, if obtained, were inoculated onto Buffered Charcoal Yeast Extract (BCYE) agar and were inoculated at 35 ºC – 37 ºC for 7 days and observed for typical colonies. Urine specimens were stored at -20 ºC and ELISA test was performed for the detection of L. pneumophila serogroup 1a antigen. Results: Eighty urine specimens and 27 respiratory specimens were obtained form 80 patients. None of the respiratory specimens grew suspected colonies of L. pneumophila and all urine specimens were negative for L. pneumophila serogroup 1a antigen. Conclusion: L. pneumophila serogroup 1a was not identified as the pathogen responsible for community acquired pneumonia in this study sample.  Published on 2016-10-26 12:08:33
  • Clinical manifestations and microbiology of Shigella diarrhoea in children
           admitted to Teaching Hospital, Jaffna, Sri Lanka

    • Abstract: Introduction: Diarrhoeal diseases are an important public health problem in Sri Lanka. Objectives: To determine the organisms that caused diarrhoea, the clinical profile, socio-demographic details including living conditions, microbiological analysis and response to treatment. Method: A retrospective study was done from October 2014 to January 2015.  Hospital records were used to analyse living conditions, water supply and general wellbeing of the children in addition to clinical and microbiological data. Results: A total of 346 (4% of total admissions) cases were admitted with diarrhoeal illness to the paediatric wards during the study period.  One hundred and twenty one (35%) children had blood and mucous diarrhoea of whom Shigella sp. was isolated from the stools of 15. The mean age of children with proven shigellosis was 2.3±1.1years. Seven of the patients with proven shigellosis had poor growth indicated by the low weight for height i.e. between the -2SD and -3SD.  Shigella flexneri II was identified in 14 patients and Shigella sonnei from one patient. Eight (53%) patients with S. flexneri were treated with IV gentamicin to which there was a clinical response. Majority (12) of the households did not have a proper water supply and 10 families had to travel >5 km to get clean drinking water facilities. All 15 cases demonstrated poor hygienic practices.Conclusions: Blood and mucus diarrhoea accounted for 121 of 346 admissions for diarrhoea during a one year period in Jaffna Hospital. A positive aetiological diagnosis was made in only 15 patients, with S. flexneri isolated from 14 and S. sonnei from one patient Published on 2016-10-25 08:26:52
  • Combating Antimicrobial Resistance

    • Abstract: Antimicrobial Resistance (AMR) is a key global health challenge. While numerous strategies have been put forward by different organizations to combat this problem, identification of locally relevant issues that drive resistance and addressing them would be the key to success. Published on 2016-10-25 05:38:19
  • Spatial and seasonal analysis of human leptospirosis in the District of
           Gampaha, Sri Lanka

    • Abstract: Leptospirosis is a zoonostic infectious disease, caused by a pathogenic species of the Genus Leptospira. In recent years, a markedly increased number of leptospirosis cases have been reported in the District of Gampaha, in the Western Province of Sri Lanka. Typically, the risk of the disease in the district is seasonal with a small spike occurs in March to May and a large spike occurs during October to December. Objectives of this study were to analyze spatial and seasonal patterns of human leptospirosis and to predict the leptospirosis epidemic trend in the District of Gampaha, Sri Lanka. All Divisional Secretariats (DS) of the district of Gampaha were selected for the study. Epidemiological data were obtained from the Regional Epidemiological Unit, Gampaha. The leptospirosis cases were georeferenced according to DS in where these cases were reported. The cumulative incidence and the fatality were calculated for each DS. Of the georeferenced data, highest mean (±S.E.) of number of leptospirosis cases (72.60 ±15.54) were observed from DS of Mirigama. The highest mean cumulative incidence (4.97±1.10) and case fatality rate (3.88±2.42) were observed from DS of Divulapitiya and Katana respectively. According to past 10 years data on leptospirosis, highest mean numbers of leptospirosis cases were reported in March (51.00±12.99) and November (56.80±8.27). A predictive model for clinically confirmed human leptospirosis was designed for the district by using TSA package of the statistical software R. This study provides an evidence base for reducing disease burden by improving the understanding of the dynamic patterns of the disease in the District of Gampaha, Sri Lanka. Published on 2016-10-25 04:09:05
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Heriot-Watt University
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