Breastfeeding practices in a public health field practice area in Sri Lanka: a survival analysis

<p>Abstract</p> <p>Background</p> <p>Exclusive breastfeeding up to the completion of the sixth month of age is the national infant feeding recommendation for Sri Lanka. The objective of the present study was to collect data on exclusive breastfeeding up to six months and to describe the association between exclusive breastfeeding and selected socio-demographic factors.</p> <p>Methods</p> <p>A clinic based cross-sectional study was conducted in the Medical Officer of Health area, Beruwala, Sri Lanka in June 2006. Mothers with infants aged 4 to 12 months, attending the 19 child welfare clinics in the area were included in the study. Infants with specific feeding problems (cleft lip and palate and primary lactose intolerance) were excluded. Cluster sampling technique was used and consecutive infants fulfilling the inclusion criteria were enrolled. A total of 219 mothers participated in the study. The statistical tests used were survival analysis (Kaplan-Meier survival curves and Cox proportional Hazard model).</p> <p>Results</p> <p>All 219 mothers had initiated breastfeeding. The median duration of exclusive breastfeeding was four months (95% CI 3.75, 4.25). The rates of exclusive breastfeeding at 4 and 6 months were 61.6% (135/219) and 15.5% (24/155) respectively. Bivariate analysis showed that the Muslim ethnicity (p = 0.004), lower levels of parental education (p < 0.001) and being an unemployed mother (p = 0.021) were important associations of early cessation of exclusive breastfeeding. At the time of the study, 62% (135/219) of infants were receiving feeds via a bottle and 23% (51/219) were receiving infant formula. Muslim ethnicity was significantly associated with bottle and formula feeding (p < 0.001). Bottle feeding was also significantly higher among mothers with a low level of education and among employed mothers.</p> <p>Conclusion</p> <p>The rate of breastfeeding initiation and exclusive breastfeeding up to the fourth month is very high in Medical Officer of Health area, Beruwala, Sri Lanka. However exclusive breastfeeding up to six months is still low and the prevalence of inappropriate feeding practices is high.</p

Mosquito breeding sites and People’s knowledge of mosquitoes and mosquito borne diseases: A comparison of temporary housing and non-damaged village areas in Sri Lanka after the tsunami strike in 2004

Although it is very important in view of public health to understand the mosquito breeding sites and key reservoirs existing around residential areas, such information is lacking in temporary housing sites constructed after the serious tsunami strikes on 26 December 2004 in Sri Lanka. This study clarified the situation regarding mosquito breeding 14 months after the tsunami in Sri Lanka by surveying temporary housing and non-damaged village areas, and also by examining people‘s knowledge related to mosquito breeding sites and mosquito-borne diseases. The relative frequency of mosquito larvae in wastewater pools was significantly higher in temporary housing than in village areas. The prevalence of storage containers at temporary housing and village areas was not significantly different. It was found that wastewater pools in temporary housing sites were the main breeding site of Culex quinquefasciatus Say, Cx. tritaeniorhynchus Giles, and Aedes albopictus Skuse whereas storage containers in village areas were the main breeding site of Cx. quinquefasciatus and Ae. albopictus. No mosquitoes bred in storage containers in the temporary housing but some Ae. albopictus did so in village areas. The questionnaires indicated a significant difference between residents of temporary housing and villages in response to the question: Do you know where mosquitoes breed? The proportion of the “wastewater pools” response was higher among temporary housing residents than among village residents. This knowledge among temporary housing residents may relate to the fact that wastewater pools are latent breeding sites for mosquitoes in temporary housing sites. Although residents in the temporary housing sites put salt and abluent into storage containers to prevent mosquitoes from breeding, wastewater pools receiving a constant supply of wastewater provided the best breeding site for mosquitoes