Levels of Cytokines in Leptospirosis Patients with Different Serovars and Locus.

Leptospirosis has a wide spectrum of clinical manifestations ranging from mild to severe disease. The cytokine response is considered one of the key drivers for this varying manifestation. The different cytokine response observed in patients with leptospirosis could be due to the variation of infecting serovars.

Whole genome sequencing data of and isolated from human subjects of Sri Lanka.

Leptospirosis is a re-emerging zoonotic disease. This article reports the complete genome sequences of three novel strains of Genus : two from the species (FMAS_RT1, FMAS_PD2) and one from (FMAS_PN5). These isolates were recovered from the blood samples of acute febrile patients in different geographical and climatic zones of Sri Lanka.

Knowledge and attitudes on attention deficit hyperactivity disorder (ADHD) among school teachers in Anuradhapura district, Sri Lanka: a descriptive cross-sectional study.

Objective: This study aimed to assess the knowledge and attitude of school teachers from a rural district in a developing country towards children with attention deficit hyperactivity disorder (ADHD).

Design: A population-based descriptive cross-sectional study was conducted using probability proportionate to size cluster sampling.

Setting: This study was conducted in 21 government schools in Anuradhapura district, Sri Lanka.

Postmortem clots (PMC) of the heart; is it merely an artifact or a predictor of cause of death?

Background: Post Mortem Clots (PMC) are considered as artifacts observed during forensic autopsies; hence, their medico legal importance has not been evaluated at length in the past. This study was designed with the intent of finding the association of age, gender, cause of death (COD) and postmortem interval (PI) with PMC formation.

Methods: Secondary data of all postmortems performed by the 1st author from June,2015 to June,2018 at Teaching Hospital Anuradhapura were extracted.

Incorporating early pregnancy mental health screening and management into routine maternal care: experience from the Rajarata Pregnancy Cohort (RaPCo), Sri Lanka.

Early identification of mental health problems in pregnancy in low-income and middle-income countries is scarcely reported. We present the experience of a programme assimilating screening and management of antenatal anxiety and depression in conjunction with the Rajarata Pregnancy Cohort, in Sri Lanka. We adopted a two-stage screening approach to identify the symptoms and the reasons for anxiety and depression.

Complete genome sequences of twelve strains of Leptospira interrogans isolated from humans in Sri Lanka.

Leptospirosis, a major zoonotic disease caused by pathogenic Leptospira spp. is recognized globally as an emerging zoonotic disease. Whole-genome sequencing reveals hidden messages about Leptospira's pathogenesis.

Serum creatinine and estimated glomerular filtration rate (eGFR) in early pregnancy and changes during the pregnancy.

Renal functions in pregnancy undergo rapid changes, and the thresholds for normal values are a major research gap and are still debatable. The lack of prospective population-based studies with early pregnancy recruitment hampered the decision-making process on the best thresholds to be used in clinical practice. We present the serum creatinine (sCr) and sCr-based estimated glomerular filtration rates (eGFR) in early pregnancy with changes over the gestational period in a large prospective, community-based cohort, the Rajarata Pregnancy Cohort (RaPCo).

Asthma in a prospective cohort of rural pregnant women from Sri Lanka: Need for better care during the pre-conceptional and antenatal period.

Objectives: To describe the epidemiology and the effect of asthma on pregnancy outcomes in pregnant women from a rural geography.

Methods: We conducted a prospective cohort study in Anuradhapura district, Sri Lanka enrolling all eligible pregnant women registered in the maternal care program. An interviewer-administered questionnaire-based symptom analysis and clinical assessment was conducted in the first and second trimesters.

Demographic, exposure, clinical, biochemical and diagnostic data of febrile patients recruited for the largest field study on leptospirosis in Sri Lanka.

This dataset includes data from febrile patients recruited for a large hospital-based study in Sri Lanka from 2016 to 2019. The variables include primary socio-demographic data, exposure data, clinical data, biochemical and investigation data. Some of these data are available as serial data from admission to discharge daily.

Fatty Liver Index is a valid predictor of non-alcoholic fatty liver disease (NAFLD) in pregnancy.

Background: Despite the evidence for adverse pregnancy outcomes, non-alcoholic fatty liver disease (NAFLD) is not routinely addressed in early pregnancy. The Fatty Liver Index (FLI) has been proposed as a screening tool for NAFLD in the general population. We aim to develop mathematical models for predicting NAFLD in pregnancy and validate the FLI for first-trimester pregnant women.

The mismatch between canteen guidelines and their implementation at canteens in medical institutions in Anuradhapura District.

Introduction: The 'Guidelines for a healthy canteen in workplaces' (guidelines) was published in 2013 by the Ministry of Health to improve food choices & healthy eating of working community.

Objectives: To determine the extent of implementation of guidelines in canteens at medical institutions in Anuradhapura District.

Methods: A descriptive cross-sectional study was conducted on random working days in canteens providing all three main meals in medical institutions in Anuradhapura District in August and September 2018.

Diagnostic method-based underestimation of leptospirosis in clinical and research settings; an experience from a large prospective study in a high endemic setting.

Background: Leptospirosis has globally significant human mortality and morbidity, yet estimating the clinical and public health burden of leptospirosis is challenging because timely diagnosis remains limited. The goal of the present study was to evaluate leptospirosis undercounting by current standard methods in both clinical and epidemiological study settings.

Methodology/principal Findings: A prospective hospital-based study was conducted in multiple hospitals in Sri Lanka from 2016 to 2019.

Non-alcoholic fatty liver disease (NAFLD): a significant predictor of gestational diabetes mellitus (GDM) and early pregnancy miscarriages-prospective study in Rajarata Pregnancy Cohort (RaPCo).

Background And Aims: Non-alcoholic fatty liver disease (NAFLD) is increasing globally with a mounting body of evidence on various adverse effects on pregnancy. Yet, prospective studies, especially from low-income and middle-income countries, are lacking in examining the impact of NAFLD in pregnancy. In this study, we explored the effect of NAFLD on the development of gestational diabetes mellitus (GDM) and early pregnancy miscarriages.

Temporal Variation and Factors Associated with Allergic Rhinitis in a Cohort of Rural Preschool Children from Sri Lanka.

Background: Allergic rhinitis is a common chronic childhood disease with a low diagnosis rate, causing poor quality of life, absenteeism, decreased school performance and significant healthcare cost. However, data on the prevalence of allergic rhinitis is sparse in preschoolers of rural geography, especially in developing countries.

Aim: To describe the epidemiology of allergic rhinitis in preschoolers from a rural geography of a developing country.

The variable presence of Leptospira in the environment; an epidemiological explanation based on serial analysis of water samples.

Human leptospirosis involves the classic epidemiological triad (agent, host and environment); hence the investigations should include the knowledge on Leptospira within the animals and the environment. The objectives of this study are to explore the abundance of Leptospira in different climate zones of Sri Lanka and to describe the presence of Leptospira in the same water source at serial time points. First, water and soil samples were collected from different parts of Sri Lanka (Component-1); second, water sampling continued only in the dry zone (Component-2).

Neglecting the neglected during the COVID-19 pandemic: the case of leptospirosis in Sri Lanka.

The coronavirus disease 2019 (COVID-19) pandemic has disrupted global health systems and affected the transmission dynamics as well as the surveillance of other infectious diseases. This study described the probable effect of the COVID-19 pandemic on the surveillance and control of leptospirosis in Sri Lanka. With 8,579 reported cases and more than 800 estimated deaths, the Sri Lankan public health surveillance system documented the largest outbreak of leptospirosis in Sri Lankan history in 2020.

Clinical spectrum of endemic leptospirosis in relation to cytokine response.

Objectives: To describe the clinical spectrum and the cytokine response of leptospirosis patients in an endemic setting of Sri Lanka.

Methods: Patients presenting to the university teaching hospital, Anuradhapura, Sri Lanka with a leptospirosis-compatible illness were recruited over a period of 12 months starting from June 2012. Daily clinical and biochemical parameters of the patients were prospectively assessed with a follow-up of 14 days after discharge.

Epidemiology of wheeze among preschool children: a population-based cross-sectional study from rural Sri Lanka.

Objectives: To assess the prevalence of wheeze and factors associated with its severity among 3-6 years old children.

Methodology: DESIGN: A population-based, cross-sectional study using the WHO 30 cluster methodology with probability proportionate to size sampling.

Setting: 36 preschools registered at the divisional secretariat offices of Anuradhapura district, Sri Lanka.

The hidden burden of adolescent pregnancies in rural Sri Lanka; findings of the Rajarata Pregnancy Cohort.

Background: Adolescent fertility is a main indicator of the Sustainable Developmental Goal (SGD) three. Although Sri Lanka is exemplary in maternal health, the utilization of Sexual and Reproductive Health services (SRH) by adolescents is less documented. We describe the hidden burden, associated biological and psychosocial factors and utilization patterns of pre-conceptional services among pregnant adolescents in rural Sri Lanka.

Optimizing the microscopic agglutination test (MAT) panel for the diagnosis of Leptospirosis in a low resource, hyper-endemic setting with varied microgeographic variation in reactivity.

The microscopic agglutination test (MAT) is the standard serological reference test for the diagnosis of leptospirosis, despite being a technically demanding and laborious procedure. The use of a locally optimised MAT panel is considered essential for proper performance and interpretation of results. This paper describes the procedure of selecting such an optimised panel for Sri Lanka, a country hyper-endemic for leptospirosis.

Improving the leptospirosis disease burden assessment by including ambulatory patients from outpatient departments: a cross-sectional study.

In Sri Lanka, the disease burden of leptospirosis is estimated based on a routine notification system, which is predominated by patients ill enough to be hospitalized. The notification system does not function well with ambulatory patients in outpatient departments (OPDs). The objective of this study was to determine the proportion of leptospirosis in an OPD setting in a regional public hospital in Sri Lanka to provide further estimation of disease burden.