Journal of the College of Community Physicians of Sri Lanka最新文献

{"title":"Prevalence of being ‘high-risk’ of hospitalization due to exacerbation among asthma patients aged ≥ 20 years in a district of Sri Lanka.","authors":"Dhanusha Punyadasa, V. Kumarapeli, Wijith Senaratne","doi":"10.4038/jccpsl.v30i2.8670","DOIUrl":"https://doi.org/10.4038/jccpsl.v30i2.8670","url":null,"abstract":"Introduction: Hospitalizations due to exacerbated asthma remai ns high in Sri Lanka leaving a huge burden on the healthcare system. Identification of the burden of ‘high risk asthma  patients’ for hospitalization due to exacerbation is a cost-effective strategy for prioritizing management options. Objectives: To estimate the prevalence of ‘high-risk asthma patients ’ and selected risk predictors for hospitalization due to exacerbation among asthma patients aged ≥20 years in the district of  Gampaha, Sri Lanka Methods: A community-based descriptive cross-sectional study was  conducted among 1200 asthma patients aged ≥20 years, selected using a multistage sampling technique. The risk for hospi talization was assessed using a newly developed and validated risk prediction model. High-risk asthma patients were defi ned according to the cut-off value of the summary risk score of the model. Results: The prevalence of ‘high-risk asthma patients’ for hospitali zation due to exacerbation was 16.4% (95% CI: 14.2, 18.6). The prevalence of selected risk predictors: age ≥ 60 years 24.2%  (95% CI: 21.9, 26.7), poor educational attainment 67.3% (95% CI: 64.5, 70.0), having diabetes mellitus 18.8% (95%  CI: 16.5, 21.0), family history of asthma 41.3% (95% CI: 38.5, 44.2), ever smoked 12.2% (95% CI: 10.2, 14.1), ever int ubated or given intensive care 2.8% (95% CI: 1.8, 3.7), previous hospitalizations due to exacerbations 6.6% (95% CI: 5.1, 8.0) , having uncontrolled asthma 63.6% (95% CI: 60.8, 66.7), having symptomatic GORD 18% (95% CI: 15.7, 20.2) and ha ving body mass index (BMI) ≥ 25 kg/m2 36.3% (95% CI: 33.5, 39.0). Conclusions & Recommendations: A significant proportion of asthm a patients being at risk of hospitalization indicates the need to adopt cost-effective asthma management strategies to ac hieve better control of the disease. Prompt primary healthcare interventions are required to address modifiable risk predi ctors among asthma patients.","PeriodicalId":120205,"journal":{"name":"Journal of the College of Community Physicians of Sri Lanka","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-07-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141800913","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Commercial Determinants of Health (CDoH): a new frosting for a known cake?","authors":"N. Chandraratne","doi":"10.4038/jccpsl.v30i2.8688","DOIUrl":"https://doi.org/10.4038/jccpsl.v30i2.8688","url":null,"abstract":"No abstract available","PeriodicalId":120205,"journal":{"name":"Journal of the College of Community Physicians of Sri Lanka","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-07-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141800658","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A legacy of 75 years in advancing health and wellbeing","authors":"Upul Senarath","doi":"10.4038/jccpsl.v30i2.8740","DOIUrl":"https://doi.org/10.4038/jccpsl.v30i2.8740","url":null,"abstract":"No abstract available","PeriodicalId":120205,"journal":{"name":"Journal of the College of Community Physicians of Sri Lanka","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-07-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141801998","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Prevalence and correlates of anxiety disorders among school children aged 13-15 years in Colombo District, Sri Lanka","authors":"Sinha De Silva, Sudharshi Senaviratne, Dulani Samaranayake","doi":"10.4038/jccpsl.v30i2.8675","DOIUrl":"https://doi.org/10.4038/jccpsl.v30i2.8675","url":null,"abstract":"Background: Anxiety disorders (AD) being the most prevalent psychological problem among children and adolescents remain largely unrecognized due to their nature. If untreated, AD could lead to many adverse outcomes. The aim of this study was to assess the prevalence and correlates of anxiety disorders among children aged 13-15 years attending government Sinhala medium schools in Colombo district, Sri LankaMethods: A school based cross-sectional study was conducted among 1524 children in Sinhala-medium government schools aged 13-15 years old selected by stratified cluster sampling. The presence of “any anxiety disorder” and its correlates were assessed using a pre-tested self-administered questionnaire that included validated Screen for Child Anxiety Related Disorders (SCARED). Multivariable analysis with binary logistic regression was carried out using backward elimination method to determine the association between anxiety disorders and selected correlates identified at bivariate analysis at p<0.05 level.Results: The adjusted prevalence of anxiety disorders was 12.3% (95% CI: 9.8% to 14.9%) Factors significantly associated with having any anxiety disorders at the multivariable analysis  included  being female (OR=3.0, 95% CI:2.0-4.4,p<0.001), residing away from the family (OR= 4.6, 95%:1.2-17.8, p=0.027), low to moderate self-esteem (OR=1.6, 95% CI: 1.1-2.5, p=0.022), having Stress (OR=2.3, 95%, CI: 1.5-3.6, p= <0.001), having Depression (OR= 2.5, 95% CI: 1.4-4.5, p<0.001), attending tuition classes for 5-7 days per week (OR=2.9, 95% CI: 1.9-4.3, p<0.001), non-engagement in sports activities (OR=1.6, 95%CI: 1.1-2.6, p=0.028), having a sibling/s less than one year of age ( OR=2.9, 95% CI: 1.2-6.6, p=0.015), father’s low level of education (OR=2.0, 95% CI: 1.1-3.8 p=0.044) and mother engaged in foreign employment (OR=5.3 , 95% CI: 2.0-13.9,p= 0.001), having an insecure attachment style (OR=2.7, 95% CI: 1.8-4.0, p<0.001).Conclusions: The prevalence of AD is high in this community and is associated with multiple personal, family, and educational factors. Screening for ADs need to be considered at routine mental health services.","PeriodicalId":120205,"journal":{"name":"Journal of the College of Community Physicians of Sri Lanka","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-07-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141798800","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Quality of life among patients undergoing haemodialysis for chronic kidney disease: a cross-sectional study from Western India","authors":"Drashti D. Shah, Venu R. Shah, Viral R. Dave","doi":"10.4038/jccpsl.v30i2.8663","DOIUrl":"https://doi.org/10.4038/jccpsl.v30i2.8663","url":null,"abstract":"Introduction: Haemodialysis is the most often utilised therapy for  extending life of chronic kidney disease (CKD) patients. Studying their quality of life (QoL) can offer valuable insi ghts for healthcare policy makers. Objectives: To assess the QoL and factors influencing it among CK D patients undergoing haemodialysis Methods: A cross-sectional study was conducted among 200 patient s undergoing haemodialysis at randomly selected two dialysis centres of Ahmedabad City of Gujarat, India. They were  recruited using consecutive sampling method. A validated questionnaire including the Kidney Disease Quality of Life -Short Form™ version 1.3 (KDQOL-SF™ v1.3) was used to assess the QoL. Average scores for Component Summar y (CS) including kidney disease (KDCS), physical (PCS) and mental (MCS) were calculated. Factors influencing the Q oL were identified by comparing median CS scores using Kruskal Wallis ANOVA and Mann Whitney U test. Results: The mean age of participants was 55.65 (SD=12.56) yea rs and 42% were females. Mean (SD) score for KDCS, PCS and MCS were 70.49 (9.04), 57.21 (23.21) and 65.31 ( 15.26), respectively. The highest mean (SD) score was for ‘dialysis staff encouragement’ 96.25 (8.4) followed by ‘social support’ 91.5 (19.55) and cognitive function 88.33 (13.37). The burden of kidney disease 17.62 (25.12), work  status 40 (32.48) and role limitation caused by physical health 47.87 (47.73) had the lowest scores. Patients ≥ 50 ye ars and those diagnosed with both diabetes and hypertension, demonstrated markedly lower scores (p<0.01) across al l three QoL components. Other significant factors were education and occupation. Conclusions & Recommendations: Kidney diseases and mental c omponent QoL scores were better compared to physical component. Factors influencing QoL were age, education, oc cupation and comorbidities.","PeriodicalId":120205,"journal":{"name":"Journal of the College of Community Physicians of Sri Lanka","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-07-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141799920","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Reflections on the evolution of Community Medicine education","authors":"L. Rajapaksa","doi":"10.4038/jccpsl.v30i2.8746","DOIUrl":"https://doi.org/10.4038/jccpsl.v30i2.8746","url":null,"abstract":"No abstract available","PeriodicalId":120205,"journal":{"name":"Journal of the College of Community Physicians of Sri Lanka","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-07-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141798849","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Factors associated with delays in seeking treatment for leptospirosis: a prospective study in Monaragala District, Sri Lanka","authors":"Prabha Kumari, J. Vidanapathirana, J. Amarasekara, Lilani Karunanayaka","doi":"10.4038/jccpsl.v30i2.8659","DOIUrl":"https://doi.org/10.4038/jccpsl.v30i2.8659","url":null,"abstract":"Introduction: Leptospirosis is a life-threatening zoonotic infection and delayed seeking treatment has been associated with complications and poor prognosis. The aim of this study was to analyze socio-demographic factors associated with delays in seeking treatment of patients with leptospirosis in Monaragala District.Methods: A hospital-based descriptive cross-sectional study was conducted to analyze the factors associated with delays in seeking treatment of patients with leptospirosis using 450 clinically diagnosed leptospirosis patients admitted to base and above hospitals in Monaragala district, using a pretested interviewer administered questionnaire among laboratory confirmed leptospirosis.Results: The incidence of leptospirosis in Monaragala district during the study period from the present study was 59.8 per 100,000 population.  Significant socio-demographic factors associate with delays in seeking treatment by laboratory confirmed patients in bi variable analysis was marital status (OR=1.85; CI=1.02-3.33), monthly income (OR=2.63; CI=1.02-7.14), time taken to reach a health care facility (OR=4.95; CI=1.48-16.62) and cost of travel (OR=2.73; CI=1.10-6.75), while age (OR=1.25; CI=0.68-2.28), sex (OR=1.44; CI=0.69-2.98), education (OR=1.5; CI=0.88-2.77), nationality (OR=1.64; CI=0.39-6.66), occupation (OR=1.01; CI=0.56-1.81), distance from home to a health care facility (OR=1.44; CI=0.79-2.59) and mode of travel  (OR=1.78; CI=0.92-3.57) was not significant. After adjusting for the effect of confounders, only the source of infection of leptospirosis showed a significant association (AOR=3.65; 95% CI=1.48-8.98) with delay in seeking treatment. Conclusions and Recommendations: Awareness of the source of the leptospirosis infection should be more emphasized and raising awareness is needed all year to prevent medical complications and deaths.","PeriodicalId":120205,"journal":{"name":"Journal of the College of Community Physicians of Sri Lanka","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-07-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141799183","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A cross-sectional survey amongst young adults in Nigeria on their personal experience of injury and violence","authors":"Ulunma Mariere, O. Oguche, Adedotun Adesina, Oyetola Ekeria, Sample Israel, Ebiakpo Owoupele, Sandra Edeki","doi":"10.4038/jccpsl.v30i2.8662","DOIUrl":"https://doi.org/10.4038/jccpsl.v30i2.8662","url":null,"abstract":"Introduction: Injuries and violence are increasingly being recognized as a major public health problem that greatly impacts young people with potentially far-reaching consequences for their physical, reproductive, and mental health. Despite the rising incidence, there is still a high level of under-reporting.Objectives: This study sought to report the experiences of unintentional injury and violent incidents and their gender variations amongst young adults in Bayelsa state.Methods: A cross-sectional study amongst 209 randomly selected young adults. Using a self-administered questionnaire adapted from the WHO STEPwise manual on non-communicable disease, data on socio-demographic characteristics, experiences with violence and injury was obtained.Result: Mean age was 25.7 years; 51.7% were females.  In the 12 months preceding the study, about 1 in 3 respondents had an unintentional injury that required medical attention and 21.5% had been involved in a Road Traffic accident. Most threats were from close relatives and friends. A little over 3 in 5 (64.4%) respondents reported physical abuse, 25.8% had experienced sexual abuse in childhood and 24.4% experienced sexual abuse as adults; this was higher in females than males (27.8% vs 20.7%). Non-RTA injuries were significantly higher (χ2=3.58; p–0.040) in females. Except RTA injuries/violence, more females than males experienced physical/sexual violence; though no statistically difference(p>0.05).Conclusion & Recommendations: A large number of young adults experience varied forms of injury and violence in the course of life during childhood and adulthood. Females experience these more than males highlighting the need for a gender-responsive approach in addressing this public health problem","PeriodicalId":120205,"journal":{"name":"Journal of the College of Community Physicians of Sri Lanka","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-07-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141800805","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A mixed method evaluation of the quasi-experimental yoga-based intervention for the behavioural issues of school-going early adolescents in Jaffna, Sri Lanka","authors":"J. Sivashankar, Rajendra Surenthirakumaran, Nalini Sathyakumar, PA Dinesh Coonghe","doi":"10.4038/jccpsl.v30i2.8626","DOIUrl":"https://doi.org/10.4038/jccpsl.v30i2.8626","url":null,"abstract":"Introduction: Behavioural problems of adolescents, such as anger, impulsivity, hyperactivity and emotional problems is a cross-cutting issue among all communities, religions and cultures around the world. An influx of internet, social media, alcohol and illegal substances in the post-conflict period has led to the existing adolescent behaviour problems in Jaffna, Sri Lanka.Objectives: To find out the quantitative and qualitative impact of a yoga-based intervention in the personal lives of grade 8 children in selected schools in Jaffna, Sri LankaMethods: A non-randomized controlled trial was carried out in four educational zones over six months during 2017-2018. The trial implemented a yoga-based intervention package: 1) slow breathing for 5-6 minutes, 2) Surya namaskar for 6-8 minutes and 3) mindfulness meditation for 5-6 minutes. The intervention was designed by relevant experts through a desk review. In both intervention and control groups, pre/post quantitative assessments were conducted using the Strength and Difficulty Questionnaire (SDQ) of parents, teachers and students; and three focus group discussions (FGD). Thematic analysis was performed from the recordings of both FGDs.Results: The quantitative analysis indicated that according to parents’ assessments, the emotional issues (p=0.001) along with the total difficulty score (p=0.001) were reduced in the intervention group (n=584). Within the control group (n=499), teachers’ assessments indicated an increase in emotional problems (p=0.001) and a reduction in pro-social scores (p=0.001). The FGD results indicated that most of the students felt that their mind got quietened and that completing school homework was a relatively easy task after the yoga intervention.Conclusions & Recommendations: This yoga-based intervention package appeared to be effective quantitatively in reducing their externalizing and internalizing behaviour issues and qualitatively to motivate them to focus on their studies.","PeriodicalId":120205,"journal":{"name":"Journal of the College of Community Physicians of Sri Lanka","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-07-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141800488","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":" Menstrual hygiene management among government school going adolescent girls in Tumakuru District, Karnataka in India: a comparative cross-sectional study","authors":"Kusuma Achalkar","doi":"10.4038/jccpsl.v30i2.8661","DOIUrl":"https://doi.org/10.4038/jccpsl.v30i2.8661","url":null,"abstract":"Introduction: Menstruation topic remains a taboo subject shrouded  with secrecy and shame among adolescent girls, which leads to lack of discourse and dialogue. Improving menstrual hygie ne management (MHM) practices during adolescent phases reduces reproductive morbidity in future. Objectives: To estimate and compare MHM among urban and rural  government high school adolescent girls Methods: A cross-sectional comparative study was conducted am ong adolescent girls studying in 8th to 10th standard in government high schools. One urban and two rural schools were invol ved in the study to meet the required sample size. In total, 464 girls were assessed using an interviewer-administered que stionnaire. Knowledge and hygienic practices, school absenteeism, restrictions during menses and socio- demographic fa ctors were compared between the two groups. Chi-squared test was used to calculate statistical significance at p<0.05. Results: The girls were in the age group of 12-17 years; mean age of  14.6 (SD=0.92) years with the mean age of attainment of menarche 12.6 (SD=0.94) years. Knowledge on MHM was good  in 157 (62.6%) rural girls compared to 116 (54.5%) urban girls. Pads were the main type of absorbents used by girls (r ural- 128, 51.0%; urban- 167, 78.4%), however, 43% (n=108) rural girls used both cloth and pads during menstruation c ompared to 16.4% (n=35) urban girls. Dysmenorrhea was the common complaint for being absent from school. This  difference between the two groups was significant (p<0.0006). More than 50% of girls in both groups complained that t hey were not permitted to enter ritual places; however, 13.14% (n=28) urban and 22.3% (n=56) rural girls had no restrictions  during menstruation. Conclusions & Recommendations: Girls have less knowledge on m enstruation; many are still using cloth as sanitary pads and do not practice the correct method of washing and drying. A mul ti-pronged approach to improve MHM is essential.","PeriodicalId":120205,"journal":{"name":"Journal of the College of Community Physicians of Sri Lanka","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-07-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141800962","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}