BMJ Open
November 2024
Objective: To assess community awareness of cutaneous leishmaniasis (CL) in a disease-endemic district in Sri Lanka.
Design: Population-based cross-sectional study.
Setting: This study was conducted in selected 158 Grama Niladhari divisions covering all the 22 Divisional Secretariat areas of the Anuradhapura district, Sri Lanka.
BMJ Open
October 2024
Objectives: This study aimed to assess the productivity loss and cost due to maternal ill-health conditions and its associated factors throughout pregnancy in rural Sri Lanka.
Design: A follow-up study of women registered in the Rajarata Pregnancy Cohort (RaPCo).
Setting: Anuradhapura district, Sri Lanka.
Background: There is limited knowledge about the stigma associated with cutaneous leishmaniasis (CL) in Sri Lanka. To ensure that leishmaniasis researchers focus on CL-associated stigma, we provide an evidence-based framework that can be used in future research.
Methods: We conducted a systematic review on CL-associated stigma using international evidence and carried out a multimethod qualitative study in the Anuradhapura district in Sri Lanka.
Leishmaniasis is a tropical infectious disease affecting some of the world's most economically disadvantaged and resource-poor regions. Cutaneous leishmaniasis (CL) is the most common out of the three clinical types of Leishmaniasis. Since 1904 this disease has been endemic in Sri Lanka.
View Article and Find Full Text PDFBackground: Cutaneous (CL) and mucocutaneous leishmaniasis (MCL) are parasitic diseases caused by parasites of the genus leishmania leading to stigma caused by disfigurations. This study aimed to systematically review the dimensions, measurement methods, implications, and potential interventions done to reduce the CL- and MCL- associated stigma, synthesising the current evidence according to an accepted stigma framework.
Methods: This systematic review followed the PRISMA guidelines and was registered in PROSPERO (ID- CRD42021274925).
Glob Health Sci Pract
October 2023
Introduction: Global evidence suggests that high out-of-pocket (OOP) expenditure negatively affects health service utilization and creates an economic burden on households during pregnancy. This study aimed to estimate the magnitude and associated factors of OOP expenditure for antenatal care (ANC) in a rural Sri Lankan setting by following up with a large pregnancy cohort (The Rajarata Pregnancy Cohort [RaPCo]) in Anuradhapura District, Sri Lanka.
Methods: Data were collected from July 2019 to May 2020.
BMJ Open
May 2023
Objectives: This study aims to describe how household economies and health service utilisation of pregnant and postpartum women were affected during the pandemic.
Design: A cross-sectional study.
Setting: This study was conducted in the Anuradhapura district, Sri Lanka.
PLoS Negl Trop Dis
May 2023
Background: Knowledge of early clinical manifestations, people's perceptions and behaviours is crucial in preventing and controlling neglected tropical diseases (NTDs). Cutaneous leishmaniasis is an NTD that causes skin lesions and affects millions worldwide. Delayed healthcare-seeking behaviour leading to prolonged treatment periods and complications is rife among people with cutaneous leishmaniasis.
View Article and Find Full Text PDFLeishmaniasis is a neglected tropical disease with three main clinical types; cutaneous leishmaniasis (CL), mucocutaneous leishmaniasis (MCL), and visceral leishmaniasis (VL). CL and MCL are considered to be highly stigmatizing due to potentially disfiguring skin pathology. CL and MCL-associated stigma are reported across the world in different contexts assimilating different definitions and interpretations.
View Article and Find Full Text PDFBackground: Despite the intergenerational effects of metabolic disorders, evidence is greatly lacking on early pregnancy metabolic syndrome (MetS) and its effects on pregnancy outcomes from low- and middle-income countries. Thus, this prospective cohort of South Asian pregnant women aimed to evaluate how early pregnancy MetS would affect pregnancy outcomes.
Methods: A prospective cohort study was conducted among first-trimester (T1) pregnant women of Anuradhapura district, Sri Lanka recruited to the Rajarata Pregnancy Cohort in 2019.
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).
View Article and Find Full Text PDFBackground: Identifying determinants of birthweight among disadvantaged communities is critical to further reducing the inequitable burden of perinatal health issues in low-and-middle income settings. Therefore, we adopted a bio-psycho-social approach to identify the determinants of birthweight in a mother-infant cohort from a rural setting in Sri Lanka, a lower-middle-income country.
Methods: All third-trimester pregnant women with a singleton pregnancy registered for the national antenatal care programme at Ipalogama health division in 2017 were invited for a prospective cohort study.
Leishmaniasis is widely considered a disease that emerged in Sri Lanka in the 1990s. However, a comprehensive case report from 1904 suggests that the presence of Leishmaniasis was well demonstrated in Sri Lanka long before that. The Annual Administration Reports of Ceylon/Sri Lanka from 1895 to 1970 and the Ceylon Blue Book from 1821 to 1937 are official historical documents that provide an annual performance, progress, goals achieved, and finances of Sri Lanka during that time.
View Article and Find Full Text PDFReprod Health
December 2022
Background: Ending preventable maternal deaths remains a challenge in low- and middle-income countries (LMICs). Society perceived causes and real-life observations can reveal the intangible causes of maternal deaths irrespective of formal maternal death investigations. This study reports complex patterns in which social determinants act towards paving the path to maternal deaths in a rural Sri Lankan setting.
View Article and Find Full Text PDFWe provide a novel approach to understanding the multiple causations of maternal anaemia in a geospatial context, highlighting how genetics, environment and socioeconomic disparities at the micro-geographical level lead to the inequitable distribution of anaemia. All first-trimester pregnant women registered for the antenatal care programme in Anuradhapura District, Sri Lanka from July to September 2019 were invited to the Rajarata Pregnancy Cohort (RaPCo), which assessed the prevalence of anaemia in early pregnancy. The combination of the prevalence of anaemia and minor haemoglobinopathy-related anaemia (MHA) with the poverty headcount index of the 22 health divisions in the district was investigated using GeoDa spatial K-means clustering.
View Article and Find Full Text PDFGlobally, more than a third of pregnant women are anemic, and progress in its prevention and control is slow. Sri Lanka is a lower-middle-income country with a unique public health infrastructure that provides multiple interventions across the lifecycle for anemia prevention, despite which anemia in pregnancy remains a challenge. Studying the factors associated with maternal anemia in this context would provide unique information on challenges and opportunities encountered as low-and-middle-income countries attempt to control anemia by improving health care coverage.
View Article and Find Full Text PDFInt J Health Plann Manage
January 2023
Background: Owing to the lack of compiled global evidence on out-of-pocket expenditure (OOPE) for antenatal care (ANC), this systematic review and meta-analysis estimated the magnitude of OOPE for ANC in low and middle-income countries (LMICs).
Methods: An electronic search was conducted using 10 databases and a hand search of the eligible studies' reference lists. Studies on OOPE for ANC in LMICs, published in English without time restriction, were included.
Purpose: Against the backdrop of the ever-increasing aging population in Sri Lanka and the scarcity of local evidence on quality of life (QoL) among rural elderly, this study was conducted to assess the QoL of the community-dwelling older adults in rural Sri Lanka.
Methods: This cross-sectional study was conducted among community-dwelling older adults (60-74 years) in a selected rural setting in Sri Lanka. K-means cluster analysis was used to stratify participants into 'low' and 'high' levels of QoL and then significant associations between these clusters and underlying socio-demographic and self-reported health related factors were estimated using bivariate and subsequent multivariable binary logistic regression models.
PLoS One
July 2022
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.
Having an effective surveillance system is imperative to take timely and appropriate actions for disease control and prevention. In Sri Lanka, leishmaniasis was declared as a notifiable disease in 2008. This paper presents a comprehensive compilation of the up-to-date documents on the communicable disease and leishmaniasis surveillance in Sri Lanka in order to describe the importance of the existing leishmaniasis surveillance system and to identify gaps that need to be addressed.
View Article and Find Full Text PDFBackground: 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.
View Article and Find Full Text PDFRural Remote Health
May 2022
The COVID-19 pandemic has challenged population health researchers to use remote data collection methods to avoid face-to-face interaction. A proper assessment of the feasibility of these methods in low-resource settings is lacking. We share our experience from telephone interviews conducted among pregnant women in the Rajarata Pregnancy Cohort in Sri Lanka.
View Article and Find Full Text PDFF1000Res
May 2022
Investigating the out-of-pocket expenditure (OOPE) associated with maternal health is important since OOPE directly affects the affordability of health services. Global evidence suggests the importance of capturing the productivity cost during pregnancy in terms of absenteeism and presenteeism. Furthermore, the impact of the ongoing COVID-19 pandemic on the household economy needs to be further evaluated as pregnant women are one of the most vulnerable groups.
View Article and Find Full Text PDFCutaneous leishmaniasis (CL) is a parasitic skin disease endemic in at least 88 countries where it presents an urgent, albeit often "neglected" public health problem. In this paper, we discuss our model of decolonial community engagement in the ECLIPSE global health research program, which aims to improve physical and mental health outcomes for people with CL. The ECLIPSE program has four interlinked phases and underpinning each of these phases is sustained and robust community engagement and involvement that guides and informs all activities in ECLIPSE.
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