Exploration for analysis of medicinal foods used to manage dyslipidaemia in Sri Lankan traditional medicine

The medicinal foods used to manage non-communicable diseases in Sri Lankan traditional medicine are slowly but steadily disappearing from the country due to many reasons. This study is the first stage of the research project aimed to explore and analyze the medicinal foods used to manage dyslipidaemia in traditional medical practices of Sri Lanka. A qualitative study covering the whole island was conducted cross-sectionally, supplemented by a document review including ancient textbooks and talipot palm (Corypha umbraculifera) leaf manuscripts. The study included all the registered traditional medical practitioners of the country, more than 55 years of age. Practitioners with poor memory and feeble health and those who were not in current practice were excluded. The first participant was selected purposively and the rest by using the snowball sampling technique. The investigator administered, validated, open-ended, semistructured questionnaire was the tool used, and the interviews were conducted face to face or using either telephone, zoom, or WhatsApp technology. The saturation was achieved by the 25th participant and data were analysed using the framework analysis technique. Nine medicinal foods including three herbal congees, one herbal beverage, one green leaf salad, and four curry preparations with antidyslipidaemic effects were explored. Sri Lankan native medicine possesses many medicinal foods with antidyslipidaemic effects and they should be explored, scientifically studied, and used as evidence-based management for the smooth control of diabetes mellitus

Risk factors for upper limb fractures due to unintentional injuries among adolescents : a case control study from Sri Lanka

Background: Injuries are the number one cause for morbidity and mortality among adolescents. Adolescent fractures are a hidden public health problem in Sri Lanka. Upper limb fractures are common in adolescents due to various risk factors. Many injuries are predictable and can be prevented by identifying the risk factors. The aim of the study was to determine the risk factors for upper limb fractures among adolescents in Sri Lanka. Methods: A case control study was undertaken with 450 cases and 450 controls. Cases were recruited consecutively from all major hospitals among the adolescent victims who had admitted with newly diagnosed upper limb fractures in the district of Colombo. Controls were apparently healthy adolescents from the same district and excluded who had previous upper limb fractures. The age and gender were not matched in selecting controls since these two factors were potential risk factors for adolescent fractures according to previous literature. Risk factors for upper limb fractures were assessed by odds ratio (OR) with 95% confidence interval (CI) and adjusted for possible confounding by performing logistic regression analysis. Results: The mean age of the cases was 13.62 years with a Standard Deviation (SD) of 2.8 and controls was 12.75 years (SD = 2.7) respectively. Having a high standard of living index (OR = 3.52; 95%CI: 2.3–5.2, p < 0.001), being in a high social class category (social class I & II) (OR = 2.58, 95%CI: 1.7–3.92, p < 0.001), engage in physical or sports activity (OR = 9.36; 95%CI: 3.31–26.47, p < 0.001), watching television (OR = 1.95; 95%CI: 1.18 -3.22, p = 0.009), playing video or computer games (OR = 2.35; 95%CI: 1.7–3.24, p < 0.001), and attending extra classes (OR = 1.82; 95%CI: 1.2–2.7, p = 0.007) were risk factors for having a upper limb fracture. Risk factors for upper limb fractures following adjusted for confounders were siblings in the family (aOR = 11.62, 95% CI: 6.95–41.29, p = 0.03) and attend extra classes after school hours (aOR = 2.51, 95%CI: 0.68–0.93, p = 0.04). Two significant effect modifications between being a Buddhist and low standard of living index (p < 0.001) and having one sibling in the family and attend extra classes after school hours (p = 0.01) were observed. Conclusions: Modifiable risk factors in relation to lifestyle factors and socioeconomic position were important determinants of upper limb fracture risk in adolescents. Many fractures can be prevented by strengthening awareness programmes in the community

Assessment of knowledge and perceptions on leishmaniasis: An island-wide study in Sri Lanka.

Cutaneous leishmaniasis (CL) is a notifiable disease in Sri Lanka with increasing case numbers reported from every part of the country. In addition to disease treatment and vector control measures, knowledge and perceptions in a community are key contributors to a successful intervention program. An island-wide survey was carried out to assess the knowledge and perceptions regarding CL across the island, with 252 confirmed CL cases and 2,608 controls. Data was collected by trained personnel, using a pre-tested Case Reporting Form (CRF). Although the percentage who referred to CL by its correct name was low (1.4%), majority stated that it is a fly induced skin disease (79.1%). Knowledge on the symptoms, curability and the name of the vector was high in these communities, but specific knowledge on vector breeding places, biting times and preventive methods were poor. The patients were more knowledgeable when compared to the controls. Differences in the level of knowledge could be identified according to the level of education of the participants as well as across the different areas of the country. The main source of information was through the healthcare system, but the involvement of media in educating the communities on the disease was minimal. While this study population was unaccustomed to the use of repellants or sprays, the use of bed nets was high (77.7% of the participants) in this study population. Although misconceptions and incorrect practices are rare in Sri Lankan communities, promoting health education programs which may improve disease awareness and knowledge on vector and its control will further strengthen the control and prevention strategies

A legacy of 75 years in advancing health and wellbeing

No abstract availabl

Health related quality of life of preterm born children at three years in a sub urban district in Sri Lanka: a retrospective cohort study

Abstract Background Preterm birth leads to multiple morbidities affecting the health of a child. Lack of information on the health impact of prematurity hinders the possibility of any effective public health interventions in this regard. Our aim was to determine the association between preterm birth and Health-Related Quality of Life (HRQOL) among 3 years old children in the Gampaha district, Sri Lanka. Methods A community-based retrospective cohort study was conducted among 790 preterm and term born children who were 03 years old. Multi-stage cluster sampling technique was used to identify children. The exposure status, a preterm birth, was established using the maternal pregnancy records. Outcome status was measured using a validated health related quality of life questionnaire (prepared in Sinhala) for preschool-aged children. Mothers of the children responded to an interviewer-administered questionnaire which had variables on the exposure status, outcome and additional variables such as child development status and birth related information. Quality of life was measured in twelve different domains of health (subscales). The impact was analyzed using the multiple linear regression. Results Response rate was 95.5% (n = 379) for preterm group and 95.2% (n = 378) for term-born group. Health-Related Quality of Life scores obtained by preterm children were lower than the term born children in eight subscales. Preterm birth showed statistically significant association with subscales on sleep wellbeing, general wellbeing and abdominal symptoms in the adjusted analysis (p < 0.05). Among preterm children prolonged illness, delayed development status, socio economic status and maternal perception on the health status of the child were common predictors of quality of life. Conclusion Preterm birth affected health related quality of life of preschool aged children

Breast-feeding Performance Index : a composite index to describe overall breast-feeding performance among infants under 6 months of age

Objectives: To develop a composite index to describe the overall breast-feeding performance of infants ,6 months of age; and, using this index, to identify the factors associated with poor breast-feeding practices and the association between breastfeeding and infant morbidity. Design, setting and subjects: The 2003 Demographic and Health Survey was a multistage cluster sample survey of 4320 households in Timor-Leste which covered 573 infants aged ,6 months. Breast-feeding Performance Index (BPI) was constructed by allocating one point for each of seven infant feeding practices: first suckling within an hour of birth; absence of prelacteals; non-use of feeding bottles; current breastfeeding; not receiving liquids; not receiving formula or other milk; and not receiving solids in the last 24 hours. BPI was treated as the dependent variable in univariate and multivariate analyses to identify the factors associated with poor breast-feeding. Results: Exclusive breast-feeding rate was 29.9%. The BPI (mean 4.4, standard deviation 1.77) was categorised as low, average and high according to tertiles. Multivariate analysis indicated that infants from the richest households were 1.70 (95% confidence interval (CI) 1.04–2.77) times more likely to have ‘low BPI’ than the poorest. Maternal BMI ,18.5 kgm22 was predictive of poor breast-feeding (odds ratio ¼ 1.79; 95% CI 1.27–2.52). In the ‘low’ BPI group, the incidence of diarrhoea (13.4%) and acute respiratory infections (20.7%) during the previous two weeks was significantly higher than in ‘average’ (4.3 and 9.3%) and ‘high’ BPI groups (4.6 and 5.5%). Conclusions: Creating a composite index to assess the overall breast-feeding performance among infants ,6 months of age is feasible. BPI can be effectively used to identify target groups for breast-feeding promotion interventions

Infant and young child feeding indicators across nine East and Southeast Asian countries : an analysis of National Survey Data 2000–2005

Objective: To compare infant and young child feeding practices in children aged 0–23 months across nine East and Southeast Asian countries. Design: Secondary analyses of cross-sectional data from available Demographic and Health Surveys (DHS; Indonesia, Philippines, Timor-Leste, Cambodia and Vietnam), Multiple Indicator Country Surveys (Lao People’s Democratic Republic (Lao PDR) and Myanmar) and national nutrition surveys (Democratic People’s Republic of Korea (DPR Korea) and Mongolia) conducted between 2000 and 2005. Setting: Seven countries from Southeast Asia and two from East Asia. Subjects: Children aged 0–23 months with samples ranging from 826 to 5610 for DHS, and from 477 to 5860 for non-DHS data. Results: More than 93% of infants were ever breast-fed, and over 75% were currently breast-fed except in the Philippines. Timely initiation of breast-feeding varied from 32% in Indonesia to 46% in Timor-Leste. Exclusive breast-feeding (EBF) rate in infants under 6 months of age ranged from 11% in Myanmar to 60% in Cambodia. EBF rates were also low in Vietnam (15?5%) and Lao PDR (23 %), and varied between 30% and 40% in Indonesia, Philippines and Timor-Leste. The proportion of infants under 6 months of age who were given breast milk with non-milk liquids was high except in Indonesia and Timor-Leste. Bottle-feeding rates were lower in DPR Korea (3 %), Lao PDR (6 %) and Myanmar (6 %) and higher in the Philippines (49 %) and Mongolia (31 %). Timely complementaryfeeding rate varied widely across countries (6–99 %). Conclusions: All the countries studied should make greater efforts to improve timely initiation of breast-feeding and EBF for 6 months. Measures should be taken to reduce high bottle-feeding rate in the Philippines, Mongolia, Indonesia and Vietnam, and improve complementary-feeding rate in Lao PDR, Myanmar, DPR Korea and Philippines

Factors associated with nonexclusive breastfeeding in 5 East and Southeast Asian countries : a multilevel analysis

This study aimed to examine individual-, household-, and community-level characteristics associated with nonexclusive breastfeeding (non-EBF) in infants younger than 6 months of age using Demographic and Health Surveys data collected between 2002 and 2005 in East and Southeast Asia. Multilevel logistic regression was used to estimate the odds ratios for factors associated with non-EBF. Exclusive breastfeeding rates in infants younger than 6 months were as follows: Vietnam, 15.5%; Timor-Leste, 30.7%; the Philippines, 33.7%; Indonesia, 38.9%; and Cambodia, 60.1%. The significant individual factors associated with non-EBF included first-born infants, working mothers, and higher maternal age. Communities with a higher proportion of wealthier households in Indonesia, trained delivery assistance in the Philippines, and poor maternal education in Vietnam and Cambodia were at greater risk for non-EBF. All countries need effort to improve EBF, specifically targeting working moth¬ers, less educated women, rich households, and first-time mothers. Health institutions and care providers should be appropriately guided to support EBF

Determinants of infant and young child feeding practices in Nepal : secondary data analysis of Demographic and Health Survey 2006

Childhood undernutrition and mortality are high in Nepal, and therefore interventions on infant and young child feeding practices deserve high priority. To estimate infant and young child feeding indicators and the determinants of selected feeding practices. The sample consisted of 1,906 children aged 0 to 23 months from the Demographic and Health Survey 2006. Selected indicators were examined against a set of variables using univariate and multivariate analyses. Breastfeeding was initiated within the first hour after birth in 35.4% of children, 99.5% were ever breastfed, 98.1% were currently breastfed, and 3.5% were bottle-fed. The rate of exclusive breastfeeding among infants under 6 months of age was 53.1%, and the rate of timely complementary feeding among those 6 to 9 months of age was 74.7%. Mothers who made antenatal clinic visits were at a higher risk for no exclusive breastfeeding than those who made no visits. Mothers who lived in the mountains were more likely to initiate breastfeeding within 1 hour after birth and to introduce complementary feeding at 6 to 9 months of age, but less likely to exclusively breastfeed. Cesarean deliveries were associated with delay in timely initiation of breastfeeding. Higher rates of complementary feeding at 6 to 9 months were also associated with mothers with better education and those above 35 years of age. Risk factors for bottle-feeding included living in urban areas and births attended by trained health personnel. Most breastfeeding indicators in Nepal are below the expected levels to achieve a substantial reduction in child mortality. Breastfeeding promotion strategies should specifically target mothers who have more contact with the health care delivery system, while programs targeting the entire community should be continued