ORCID Profile
0000-0001-8404-8623
Current Organisations
Epidemiology Unit, Ministry of Health
,
University of Tasmania
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Publisher: Sciencedomain International
Date: 16-06-2022
DOI: 10.9734/AJARR/2022/V16I830487
Abstract: Telehealth is the delivery of health-related services and information using electronic information and communication technologies. Telehealth enables the health service providers to connect with a remote patient to provide care, advice, reminders, education, intervention, monitoring and facilitates remote admissions. Due to COVID-19 related travel restrictions, disruptions in access to healthcare were observed in Sri Lanka. Therefore, a telehealth solution to connect patients where specialist medical doctors were inaccessible or unavailable, was planned and implemented in the North Central province of Sri Lanka in 2020. The objective of this case study is to describe the experience during the planning and implementation of the telehealth intervention. Issues faced during planning and implementation were securing adequate funds, limited knowledge of information technology among the health staff, the reluctance of patients to explain and show the signs through video consultation, and difficulties faced during the allocation of responsibility at each step of the telehealth services and provision of network facilities to peripheral hospitals. These issues were overcome by creating awareness among the key stakeholders on telehealth and its advantages, addressing concerns of the patients and conducting awareness c aigns on telehealth, streamlining the maintenance of equipment and most importantly, addressing concerns of the administrators, including health officials, and obtaining their consensus for the implementation of telehealth services. If these key issues can be forecasted and addressed timely, telehealth services could be successfully implemented in a resource-limited country like Sri Lanka.
Publisher: Sciencedomain International
Date: 22-03-2022
DOI: 10.9734/AJMAH/2022/V20I330445
Abstract: Aims: Limited information is available on private sector contribution for maternal care in Sri Lanka. The main objective of this assessment is to describe the maternal and newborn characteristics of deliveries in private sector in Colombo District, Sri Lanka. Secondly, the assessment of the factors associated with key newborn care practices using the National Maternal and Newborn Health Management Information System of Private Health Institutions (NMNMIS-PHI)-Phase 1 was conducted. Study design: Secondary descriptive analysis was performed using data reported in the NMNMIS-PHI-Phase 1, Sri Lanka. Place and Duration of Study: All deliveries in private health institutions in Colombo District which were reported in the NMNMIS-PHI-Phase 1 was included in the study. The time period was from 1st January 2021 to 31st December 2021. Methodology: Maternal, delivery and newborn characteristics of national vs. private sector in Colombo District were compared using Z test. Associated factors for key newborn care practices was calculated using univariate and multivariate Odds ratios. Results: Incidence of Gestational DM was higher among pregnant women delivered at private sector, Colombo compared to national rate (17.9% vs. 7.1%, p .001). Further, the reported caesarean section rate in private sector was close to twofold that of the national rate (76.5% vs. 41.9%, p .001). Stillbirth rate of private sector in Colombo was comparatively low than the national rate (0.2% vs. 0.7%). Similarly, reduced number of low-birth-weight newborns was reported in private sector in comparison to national figure (12.4% vs. 13.9%). Significantly more newborns of primi-pregnant women received skin-to-skin contact (SSC) immediately after birth compared to newborns of multi-parous women (AOR=0.814, CI=0.735-0.900, p .001). Conclusion: Maternal and neonatal characteristics of pregnant women delivered in private sector in Colombo was significantly different from the national profile of pregnant women. Promotion of immediate SSC and reduction in unnecessary caesarean sections should be considered in private sector deliveries in Sri Lanka to further enhance the positive maternal and newborn outcomes.
Publisher: Cold Spring Harbor Laboratory
Date: 13-02-2022
DOI: 10.1101/2022.02.10.22270732
Abstract: This study aims to describe the population level data on neonatal and maternal outcomes of COVID-19 positive pregnant women of Sri Lanka by secondary analysis using National COVID-19 Positive Pregnant Women Surveillance. Secondary analysis of surveillance data from the National COVID-19 positive pregnant women surveillance, Sri Lanka. Data of all pregnant women whose maternal and neonatal outcomes were reported in National Surveillance from 1st March 2020 to 31st October 2021 were included in the study. Associated factors for maternal and neonatal outcomes, namely POA at delivery, mode of delivery, birthweight, immediate place of newborn care, congenital abnormalities, and condition of neonate at completion of one month were calculated using univariate and multivariate Odds ratios. Maternal COVID-19 infection reported preterm birth rate of 11.9%, LSCS rate of 54.5%, low birthweight rate16.5% and 8.3% of the newborns requiring intensive care. Neonatal mortality rate was 9 per 1000 live births. Pre-pregnancy overweight and obesity increased the risk of preterm delivery compared to pregnant women with normal BMI by 46.7% (AOR=1.467, CI=1.111-1.938, P=0.007). In contrast, the risk of preterm delivery reduced by 82.4% (AOR=0.176, CI=0.097-0.317, p .001) and presence of any type of congenital abnormalities in newborns by 72.4% among the COVID-19 positive women who required only inward treatment in comparison to women with severe COVID-19 infection requiring intensive care (AOR=0.276, CI=0.112-0.683, p=0.005). Increased severity of maternal COVID-19 infection and pre-pregnancy overweight/ obesity were associated with many adverse pregnancy and neonatal outcomes. Therefore, close observation and aggressive management of COVID-19 among the pregnant women should be considered to reduce the risk of progressing to severe illness.
Publisher: Sciencedomain International
Date: 26-05-2022
DOI: 10.9734/AJESS/2022/V29I130690
Abstract: Aims: Adolescents and youth belong to high-risk groups for sexual and reproductive issues. The aim of this investigation is to critically evaluate whether the sexual and productive health issues are addressed in adolescent and youth policies and strategies in Sri Lanka. Study Design: Two distinct methods were used. Desk review to assess the coverage of sexual and reproductive health (SRH) issues addressed in adolescent and youth policies and strategies in Sri Lanka was followed by 3 focus group discussions (FGDs) with youths and 8 key informant interviews (KII) on SRH policy issues related to sexual and reproductive health of youth. Place and Duration of Study: Both methods were conducted between June 2021 to December 2021. Youth were selected from District of Colombo for FGDs. KIIs were conducted with youth SRH experts in government, private, universities and non-governmental organizations. Methodology: Triangulation of data from FGDs, KIIs and desk review was conducted. Thematic content and narrative methods were used for analysis of data. Results: Adequacy of SRH coverage, issues and challenges was summarized using key six domains of SRH as mentioned by World Health Organization, namely overall focus on SRH, comprehensive SRH education, contraception counselling & provision, safe abortion care, sexually transmitted infections (STIs) and HIV prevention care, and violence against women and girls- prevention, support and care. All key stakeholders in education and health sector unanimously agreed that comprehensive sexual education should be implemented in the country. However, there is general disagreement on the grade (or age) of inclusion of contraception of CSE Level of skills and competencies of the teachers assigned to teach SRH and Learning aids for students on SRH. The only policy/ strategic plan which covers the SRH aspects of youth adequately was the National Strategic Plan- Adolescent and Youth Health (2018-2025) by the Family Health Bureau. Similarly, lack of priority for SRH aspects of youth was evident in youth policies and strategic plans formulated by non-health governmental organizations. Conclusion: Overall findings highlight the non-priority for SRH aspects in youth policies and strategic plans in Sri Lanka. Coordinated effort of all key stakeholders is needed to improve the SRH representation in youth policies and strategies in Sri Lanka.
Publisher: Sri Lanka Journals Online (JOL)
Date: 30-12-2021
Publisher: Sri Lanka Journals Online (JOL)
Date: 14-12-2022
Publisher: ACS Publisher
Date: 2021
DOI: 10.48165/SAJSSH.2021.2603
Abstract: Initiation and continuation of healthy relationships among youth critical for the long-term wellbeing of the youth. Present socio-cultural environment presents numerous pitfalls which inhibit such relationships. Aim of this qualitative investigation was to describe the current status, trends and patterns of love affairs, dating and sexual behaviour among unmarried youth in Sri Lanka. Case studies, key informant interviews and focus group discussions were selected as methods of data collection. Thematic analysis was used. Four themes were generated, namely initiation of love affairs dating and sexual behaviour, preferences, pattern and places phycological, physical and sexual issues and violence related to love affairs and dating behaviour assistance and advice on issues, problems in love affairs, dating and sexual behaviour. One of the key issues identified was lack of reliable person to seek advice for issues related to love affairs, dating and sexual behaviour among youth. Unmarried youth should be desensitized of the norms that inhibit the communication of love affairs, dating, sexuality and reproduction. Furthermore, a mechanism to identify high risk youth groups: those who have multiple love affairs, youth with inadequate knowledge of STIs, youth with casual sex, victims of sexual harassment need be designed and implemented
Publisher: Sciencedomain International
Date: 31-01-2022
DOI: 10.9734/OR/2022/V16I130225
Abstract: Aims: Main objective of this study was to describe the diagnosis, treatment, outcomes, and associated factors of presumed ocular tuberculosis patients attending Central Chest Clinic, Colombo. Study Design, Place and Duration: A cross sectional descriptive study was conducted among all ocular tuberculosis patients referred to Central Chest Clinic, Colombo for treatment from 1st of January 2016 to 31st June 2018. Methodology: Pretested content validated secondary data extraction form was used. Socio-demographic and work-related characteristics were analysed using frequency distributions. Association between socio-demographic characteristics and factors associated with diagnosis, treatment and outcomes were analysed using Fisher-extract test. Results: Among study respondents, 52.6% showed abnormal ESR finding ( mm), 17.8% displayed Chest X-ray abnormalities and 89.5% reported positive Tuberculin skin test ( mm in diameter). Uveitis was the most common diagnosis (87.9%). Among Uveitis patients, 36.5% presented with posterior uveitis. Out of all ocular TB patients who have completed the treatment, 77.6% reported improvement of vision following the anti-TB treatment regimen. Duration of the treatment with anti-TB drugs was similar across all types of ocular diseases among Ocular TB patients (p=0.590). Conclusions: Large number of patients received treatment for 6 months with majority reported as improved vision on completion of treatment. Further prospective studies using primary data need to be conducted to have greater insight of the ocular tuberculosis in Sri Lanka.
Publisher: Elsevier BV
Date: 08-2022
Publisher: Research Square Platform LLC
Date: 23-06-2022
DOI: 10.21203/RS.3.RS-1782899/V1
Abstract: Background Youth are at high risk for casual and unprotected sexual activities even before the marriage. The objective of the study is to describe the sexual behavior, contraceptive use among unmarried youth of Sri Lanka and to assess the factors associated with sexual behaviour. Methods Observational descriptive cross-sectional study was conducted in three selected districts in Sri Lanka from 1st of March 2019 to 31st of January 2020 among 1057 never-married youth using a self-administered questionnaire. Both stratified cluster s ling and snow-ball s ling was used to select the eligible never-married youth. Factors associated with the sexual intercourse was assessed using logistic regression. Results Compared to boys (26%), more girls (35%) were engaged in unprotected sexual intercourse. Among sexually active unmarried youth aged less than 20 years, 10% had sexual intercourse with an unknown person. Unmarried Tamil and estate sector youth displayed significantly lower chances of sexual intercourse compared to Sinhala and urban counterparts (OR=0.390, CI=0.213-0.715, p=0.002 and OR=0.807, CI=0.709-0.978, p=0.020 respectively). Youth in rural (69.5%) and urban sector (87.3%) tend to use contraceptives during the intercourse compared to the youth in the Estate sector (51.1%). Conclusions A significant portion of youth expose to sexual risk behavior including unprotected sexual intercourse even before the marriage which can contribute to many social and health consequences. Focus interventions are needed to address the issue.
Publisher: Research Square Platform LLC
Date: 21-07-2022
DOI: 10.21203/RS.3.RS-1782899/V2
Abstract: Background Youth are at high risk for casual and unprotected sexual activities even before the marriage. The objective of the study is to describe the sexual behavior, contraceptive use among unmarried youth of Sri Lanka and to assess the factors associated with sexual behaviour. Methods Observational descriptive cross-sectional study was conducted in three selected districts in Sri Lanka from 1st of March 2019 to 31st of January 2020 among 1057 never-married youth using a self-administered questionnaire. Both stratified cluster s ling and snow-ball s ling was used to select the eligible never-married youth. Factors associated with the sexual intercourse was assessed using logistic regression. Results Compared to boys (26%), more girls (35%) were engaged in unprotected sexual intercourse. Among sexually active unmarried youth aged less than 20 years, 10% had sexual intercourse with an unknown person. Unmarried Tamil and estate sector youth displayed significantly lower chances of sexual intercourse compared to Sinhala and urban counterparts (OR = 0.390, CI = 0.213–0.715, p = 0.002 and OR = 0.807, CI = 0.709–0.978, p = 0.020 respectively). Youth in rural (69.5%) and urban sector (87.3%) tend to use contraceptives during the intercourse compared to the youth in the Estate sector (51.1%). Conclusions A significant portion of youth expose to sexual risk behavior including unprotected sexual intercourse even before the marriage which can contribute to many social and health consequences. Focus interventions are needed to address the issue.
Publisher: Sri Lanka Journals Online (JOL)
Date: 31-12-2020
Publisher: Academia.edu
Date: 25-03-2022
DOI: 10.20935/AL4948
Publisher: ACS Publisher
Date: 08-02-2022
DOI: 10.48165/SAJSSH.2022.3104
Abstract: Emotional support and services provided by Public Health Midwives (PHMs) play a crucial role in identification and management of maternal mental health disorders as they are the first line contact in maternal and child-care and the focal field health members in caring for the antepartum and postpartum mothers. Aim of this study was to describe the Sri Lankan PHMs’ knowledge on maternal mental health disorders. Cross-sectional descriptive study was conducted using probability proportionate s ling, covering PHMs of all districts in Sri Lanka. Total of 434 PHMs were recruited with 99.1% response rate. A content-validated pre-tested questionnaire was administered. Univariate and multivariate analysis was used to assess the knowledge of each component with selected study variables. Respondents’ mean age was 40.6 years. Out of the 430 PHMs, 36% of them were unaware, that symptoms of Depression and anxiety could be commonly seen during antenatal and postpartum period. It was found that only 21.8% of the respondents knew the average number of maternal deaths due to suicides in Sri Lanka. Forty seven percentage of the respondents did not know, that providing understanding, empathy and support was the most appropriate step in managing mothers with Postpartum Blues. This study findings highlight major deficiencies in basic knowledge of PHMs in identifying and initial management of common maternal mental health disorders. Therefore, focus on continuous professional development of PHMs should be prioritized.
Publisher: Sciencedomain International
Date: 23-12-2021
DOI: 10.9734/AJMAH/2021/V19I1230426
Abstract: Aims: Limited knowledge exists on pregnancy outcome among COVID-19 positive pregnant women despite relatively better understanding on disease severity in pregnancy. Objective of this assessment is to describe the maternal characteristics and factors associated with disease severity and pregnancy outcome of COVID-19 positive pregnant women in Sri Lanka. Study Design: Secondary descriptive analysis was conducted using data reported in the National COVID-19 positive pregnant women surveillance, Sri Lanka. Place and Duration of Study: All pregnant women who were tested positive either by RT-PCR or by Rapid Antigen Test for SARS CoV-2 virus and their pregnancy and neonatal outcomes reported from 1st March 2020 to 31st October 2021 in the National surveillance in Sri Lanka, were included in the study. Methodology: Sri Lankan country-level pregnant women characteristics were compared with COVID-19 positive pregnant women using Z test. Associated factors for disease severity and pregnancy outcome was calculated using univariate and multivariate Odds ratios. Results: Details of pregnancy and neonatal outcomes were reported for 2493 COVID-19 positive pregnant women. Less cases of severe COVID-19 infection were observed among pregnant women with no co-morbidities compared with women having at least single co-morbidity (AOR=0.508, CI=0.293-0.879, P=0.04). Pregnant women with mild to moderate infection reported better pregnancy outcome compared to women with severe infection (AOR=7.376, CI=3.557-15.292, P .001). In contrast, COVID-19 diagnosis in 1st and 2nd trimesters significantly reduced the good pregnancy outcome compared to pregnant women with diagnosis of COVID-19 in 3rd trimester of the pregnancy (AOR=0.009, CI=0.005-0.015, P .001 and AOR=0.113, CI=0.072-0.179, P .001 respectively). Conclusion: Our study showed poor pregnancy outcome among severe vs mild to moderate infection and diagnosis in 1st and 2nd trimesters vs 3rd trimester among COVID-19 positive women. Further, increased severity of COVID-19 infection among pregnant women with co-morbidities vs no comorbidities.
Publisher: Sciencedomain International
Date: 27-06-2023
DOI: 10.9734/AJESS/2023/V46I1994
Abstract: The Sri Lankan law only permits induced or iatrogenic abortion to save the life of the mother. Despite the restricted law, law enforcement mechanisms, and reported high national contraceptive prevalence rate, a significant proportion of pregnant women terminate their pregnancy outside the law. Despite the existence of restrictions and inertia, numerous stakeholders concerned about women’s health have made several attempts to liberalize the abortion law in Sri Lanka. Although several amendments were proposed to rationalize the abortion law in Sri Lanka, nothing has been successful – we are back to square one. Expansion of legal exceptions for induced abortions and improved safe abortion with the revolutionized medical abortion (MA) were observed in numerous countries globally during the past decade. On the other hand, some countries with broadly liberal laws, including the United States, have added restrictions. How these global changes have affected countries like Sri Lanka is worth studying. This article assesses the response of the Sri Lankan government and the society towards those global changes in terms of the policies and practices on induced abortion. Authors argue that the paradigm shift in abortion practices in Sri Lanka, driven by the emerging occurrence of medical abortion, has highlighted the disparity between the existing legal status and the aspirations of most Sri Lankans. Given the widespread support for legalizing abortion in cases of rape, incest, and fetal abnormalities, it is imperative the government seriously consider legal amendments.
Publisher: Springer Science and Business Media LLC
Date: 14-09-2022
DOI: 10.1186/S40834-022-00185-W
Abstract: Youth are at high risk for casual and unprotected sexual activities even before marriage. The objective of the study is to describe the sexual behavior, and contraceptive use among unmarried youth of Sri Lanka and to assess the factors associated with sexual behaviour. An observational descriptive cross-sectional study was conducted in three selected districts in Sri Lanka from 1st March 2019 to 31st January 2020 among 1057 never-married youth using a self-administered questionnaire. Both stratified cluster s ling and snowball s ling were used to select the eligible never-married youth. Factors associated with sexual intercourse were assessed using logistic regression. Compared to boys (26%), more girls (35%) were engaged in unprotected sexual intercourse. Among sexually active unmarried youth aged less than 20 years, 10% had sexual intercourse with an unknown person. Unmarried Tamil and estate sector youth displayed significantly lower chances of sexual intercourse compared to Sinhala and urban counterparts (OR = 0.390, CI = 0.213-0.715, p = 0.002 and OR = 0.807, CI = 0.709-0.978, p = 0.020 respectively). Youth in the rural (69.5%) and urban sectors (87.3%) tend to use contraceptives during intercourse compared to the youth in the Estate sector (51.1%). A significant portion of youth are exposed to sexual risk behavior including unprotected sexual intercourse even before marriage which can contribute to many social and health consequences. Focus interventions are needed to address the issue.
Location: Sri Lanka
No related grants have been discovered for Malith Kumarasinghe.