Severe Dengue Epidemics in Sri Lanka, 2003–2006

One-sentence summary for table of contents: Changes in transmission dynamics and virus genes are likely increasing emergence of severe epidemics in this country.Recent emergence of dengue hemorrhagic fever in the Indian subcontinent has been well documented in Sri Lanka. We compare recent (2003–2006) and past (1980–1997) dengue surveillance data for Sri Lanka. The 4 dengue virus (DENV) serotypes have been cocirculating in Sri Lanka for >30 years. Over this period, a new genotype of DENV-1 has replaced an old genotype. Moreover, new clades of DENV-3 genotype III viruses have replaced older clades. Emergence of new clades of DENV-3 in 1989 and 2000 coincided with abrupt increases in the number of reported dengue cases, implicating this serotype in severe epidemics. In 1980–1997, most reported dengue cases were in children. Recent epidemics have been characterized by many cases in children and adults. Changes in local transmission dynamics and genetic changes in DENV-3 are likely increasing emergence of severe dengue epidemics in Sri Lanka

The impact of national culture and industry structure on grocery retail customer loyalty: a comparative study of the United Kingdom and Sri Lanka.

Despite the pivotal influence of customer loyalty on retailer performance and profitability, the effect of national culture and industry structure on customer loyalty in grocery retailing has been thinly researched. This PhD is the first to investigate the influence of these factors by examining two culturally and structurally disparate markets; the UK and Sri Lanka. A sequential mixed methods research design was used where a qualitative phase (three focus groups in each country) preceded a large scale survey (n= 550). The preliminary inductive phase generated new knowledge in the absence of adequate existing theory and guided the development of the survey instrument which was used to further investigate the preliminary findings. This study finds that national culture has an indirect influence on customer loyalty via customer service and loyalty programmes. These findings make a significant contribution to theory by challenging the limited existing literature that suggests a direct influence. A direct influence of industry structure is identified in both countries; UK customers are more ‘truly’ loyal to their main retailer and this is influenced by a common focus on quality by retailers. Similarly, greater spurious and latent loyalty is evident in Sri Lanka where customers prefer retailers offering higher standards of customer service and product quality. An indirect influence is also highlighted by the aversion to tracking in the UK and openness in Sri Lanka which reflects the level of loyalty programme maturity and customer familiarity in the two countries. These findings provide the first focused insight of the influence of industry structure on customer loyalty. Findings further highlight that national culture influences customer perceptions of loyalty programme attributes where Sri Lankan customers are more open to tracking and tiered schemes whilst expecting preferential treatment and soft benefits. Whilst supporting the limited existing literature, these findings provide novel insights that will guide future research on the influence of national culture on loyalty programmes. The theoretical framework provided in this study is the first detailed depiction of customer loyalty in relation to national culture and industry structure. This framework will act as a valuable theoretical base when future research is undertaken in this area. From a practical perspective, this research will enable domestic grocery retailers in Western markets to understand how national culture influences customer loyalty, thereby, allowing them to cater to culturally disparate customer segments more efficiently. Similarly, international retailers can obtain a greater understanding of cultural and structural influences when developing their strategies by focusing on key elements such as customer service, product quality and loyalty programmes

The Mindful Consumer: Balancing egoistic and altruistic motivations to purchase local food

Today’s more “mindful” consumers’ food consumption decisions are changing as they attempt to balance egoistic and altruistic motivations. This study explores the relative importance of these types of motivations in influencing Australian consumers’ attitudes towards, and purchase frequency of, local food. Factors examined include ethical self-identity, environmental consciousness, health consciousness and food safety. Results indicate egoistic motivations may influence local food consumption decisions more strongly than altruistic motivations. Recommendations for producers and retailers of local food in appealing to more “mindful” consumers suggest more focused marketing and communication strategies, clearer branding and labelling of produce, and training of service staff

The Influence of National Culture and Industry Structure on Grocery Retail Customer Loyalty

This study examines, for the first time, the influence of national culture and industry structure on customer loyalty in grocery retailing. Grocery retailers have a long and continued history of international expansion and it is vital to understand how loyalty can be nurtured in different contexts. Thematic analysis of focus groups conducted in the culturally and structurally disparate countries of the United Kingdom and Sri Lanka provide unique insights. Key differences have been identified around consumer preferences and perceptions of loyalty programmes and the key drivers of different loyalty types. Theoretical and managerial implications are discussed

Severe dengue epidemics in Sri Lanka, 2003-2006

Recent emergence of dengue hemorrhagic fever in the Indian subcontinent has been well documented in Sri Lanka. We compare recent (2003-2006) and past (1980-1997) dengue surveillance data for Sri Lanka. The 4 dengue virus (DENV) serotypes have been cocirculating in Sri Lanka for >30 years. Over this period, a new genotype of DENV-1 has replaced an old genotype. Moreover, new clades of DENV-3 genotype III viruses have replaced older clades. Emergence of new clades of DENV-3 in 1989 and 2000 coincided with abrupt increases in the number of reported dengue cases, implicating this serotype in severe epidemics. In 1980-1997, most reported dengue cases were in children. Recent epidemics have been characterized by many cases in children and adults. Changes in local transmission dynamics and genetic changes in DENV-3 are likely increasing emergence of severe dengue epidemics in Sri Lanka

Severe Dengue Epidemics in Sri Lanka, 2003–2006

One-sentence summary for table of contents: Changes in transmission dynamics and virus genes are likely increasing emergence of severe epidemics in this country

Histopathological diagnosis of myocarditis in a dengue outbreak in Sri Lanka, 2009

<p>Abstract</p> <p>Background</p> <p>In 2009, an outbreak of dengue caused high fatality in Sri Lanka. We conducted 5 autopsies of clinically suspected myocarditis cases at the General Hospital, Peradeniya to describe the histopathology of the heart and other organs.</p> <p>Methods</p> <p>The diagnosis of dengue was confirmed with specific IgM and IgG ELISA, HAI and RT-PCR techniques. The histology was done in tissue sections stained with hematoxylin and eosin.</p> <p>Results</p> <p>Of the 319 cases of dengue fever, 166(52%) had severe infection. Of them, 149 patients (90%) had secondary dengue infection and in 5 patients, DEN-1 was identified as the causative serotype. The clinical diagnosis of myocarditis was considered in 45(27%) patients. The autopsies were done in 5 patients who succumbed to shock (3 females and 2 males) aged 13- 31 years. All had pleural effusions, ascites, bleeding patches in tissue planes and histological evidence of myocarditis. The main histological findings of the heart were interstitial oedema with inflammatory cell infiltration and necrosis of myocardial fibers. One patient had pericarditis. The concurrent pulmonary abnormalities were septal congestion, pulmonary haemorrhage and diffuse alveolar damage; one case showed massive necrosis of liver.</p> <p>Conclusions</p> <p>The histology supports occurrence of myocarditis in dengue infection.</p

Identification of Conserved and HLA Promiscuous DENV3 T-Cell Epitopes

Anti-dengue T-cell responses have been implicated in both protection and immunopathology. However, most of the T-cell studies for dengue include few epitopes, with limited knowledge of their inter-serotype variation and the breadth of their human leukocyte antigen (HLA) affinity. In order to expand our knowledge of HLA-restricted dengue epitopes, we screened T-cell responses against 477 overlapping peptides derived from structural and non-structural proteins of the dengue virus serotype 3 (DENV3) by use of HLA class I and II transgenic mice (TgM): A2, A24, B7, DR2, DR3 and DR4. TgM were inoculated with peptides pools and the T-cell immunogenic peptides were identified by ELISPOT. Nine HLA class I and 97 HLA class II novel DENV3 epitopes were identified based on immunogenicity in TgM and their HLA affinity was further confirmed by binding assays analysis. A subset of these epitopes activated memory T-cells from DENV3 immune volunteers and was also capable of priming naïve T-cells, ex vivo, from dengue IgG negative individuals. Analysis of inter- and intra-serotype variation of such an epitope (A02-restricted) allowed us to identify altered peptide ligands not only in DENV3 but also in other DENV serotypes. These studies also characterized the HLA promiscuity of 23 HLA class II epitopes bearing highly conserved sequences, six of which could bind to more than 10 different HLA molecules representing a large percentage of the global population. These epitope data are invaluable to investigate the role of T-cells in dengue immunity/pathogenesis and vaccine design. © 2013 Nascimento et al

Analysis of Effects of Meteorological Factors on Dengue Incidence in Sri Lanka Using Time Series Data

In tropical and subtropical regions of eastern and South-eastern Asia, dengue fever (DF) and dengue hemorrhagic fever (DHF) outbreaks occur frequently. Previous studies indicate an association between meteorological variables and dengue incidence using time series analyses. The impacts of meteorological changes can affect dengue outbreak. However, difficulties in collecting detailed time series data in developing countries have led to common use of monthly data in most previous studies. In addition, time series analyses are often limited to one area because of the difficulty in collecting meteorological and dengue incidence data in multiple areas. To gain better understanding, we examined the effects of meteorological factors on dengue incidence in three geographically distinct areas (Ratnapura, Colombo, and Anuradhapura) of Sri Lanka by time series analysis of weekly data. The weekly average maximum temperature and total rainfall and the total number of dengue cases from 2005 to 2011 (7 years) were used as time series data in this study. Subsequently, time series analyses were performed on the basis of ordinary least squares regression analysis followed by the vector autoregressive model (VAR). In conclusion, weekly average maximum temperatures and the weekly total rainfall did not significantly affect dengue incidence in three geographically different areas of Sri Lanka. However, the weekly total rainfall slightly influenced dengue incidence in the cities of Colombo and Anuradhapura