Prevention of re-establishment of malaria: historical perspective and future prospects

AbstractPrevention of re-establishment (POR) refers to the prevention of malaria outbreak/epidemic occurrence or preventing re-establishment of indigenous malaria in a malaria-free country. Understanding the effectiveness of the various strategies used for POR is, therefore, of vital importance to countries certified as “malaria-free” or to the countries to be thus certified in the near future. This review is based on extensive review of literature on both the POR strategies and elimination schemes of countries, (i) that have reached malaria-free status (e.g. Armenia, Mauritius, Sri Lanka), (ii) those that are reaching pre-elimination stage (e.g. South Korea), and (iii) countries at the control phase (e.g. India). History has clearly shown that poorly implemented POR programmes can result in deadly consequences (e.g. Sri Lanka); conversely, there are examples of robust POR programmes that have sustained malaria free status that can serve as examples to countries working toward elimination. Countries awaiting malaria elimination status should pre-plan their POR strategies. Malaria-free countries face the risk of resurgence mostly due to imported malaria cases; thus, a robust passenger screening programme and cross border collaborations are crucial in a POR setting. In addition, sustained vigilance, and continued funding for the national anti-malarial campaign programme and for related research is of vital importance for POR. With distinct intrinsic potential for malaria in each country, tailor-made POR programmes are built through continuous and robust epidemiological and entomological surveillance, particularly in countries such as Sri Lanka with increased receptivity and vulnerability for malaria transmission. In summary, across all five countries under scrutiny, common strengths of the POR programmes are (i) a multipronged approach, (ii) strong passive, active, and activated passive case detection, (iii) Indoor residual spraying (IRS), and (iv) health education/awareness programmes.

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Migration Intentions of Post War Youths in Sri Lanka: A Systematic Review of Literature on Causes of Migration

SSRN Electronic Journal ◽

10.2139/ssrn.2910352 ◽

2016 ◽

Author(s):

A. Pingama

Keyword(s):

Systematic Review ◽

Sri Lanka ◽

Review Of Literature ◽

Post War

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Effectiveness of passive case detection for imported malaria in a hospital setting in Sri Lanka during the prevention of re-introduction phase of malaria

International Health ◽

10.1093/inthealth/ihy061 ◽

2018 ◽

Author(s):

Priyani Dharmawardena ◽

Risintha Premaratne ◽

Kamini Mendis ◽

Rajitha Wickemasinghe ◽

Chaturaka Rodrigo ◽

...

Keyword(s):

Sri Lanka ◽

Hospital Setting ◽

Imported Malaria ◽

Case Detection ◽

Passive Case Detection

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A comparative analysis of the outcome of malaria case surveillance strategies in Sri Lanka in the prevention of re-establishment phase

10.21203/rs.3.rs-131531/v2 ◽

2021 ◽

Author(s):

W. M. Kumudunayana T. de A. W Gunasekera ◽

Risintha Premaratne ◽

Deepika Fernando ◽

Muzrif Munaz ◽

M. G. Y. Piyasena ◽

...

Keyword(s):

Sri Lanka ◽

Case Reports ◽

Individual Case ◽

Case Detection ◽

Malaria Surveillance ◽

Blood Smears ◽

Passive Case Detection ◽

Routine Basis ◽

Detection Strategies ◽

Very High

Abstract Background Sri Lanka sustained its malaria-free status by implementing, among other interventions, three core case detection strategies namely Passive Case Detection (PCD), Reactive Case Detection (RACD) and Proactive Case Detection (PACD). The outcomes of these strategies were analysed in terms of their effectiveness in detecting malaria infections for the period from 2017-2019. Methods Comparisons were made between the surveillance methods and between years, based on data obtained from the national malaria database and individual case reports of malaria patients. The number of blood smears examined microscopically was used as the measure of the volume of tests conducted. The yield from each case detection method was calculated as the proportion of blood smears which were positive for malaria. Within RACD and PACD, the yield of sub categories of travel cohorts and spatial cohorts was ascertained for 2019. Results A total of 158 malaria cases were reported in 2017-2019. During this period between 666,325-725,149 blood smears were examined annually. PCD detected 95.6%, with a yield of 16.1 cases per 100,000 blood smears examined. RACD and PACD produced a yield of 11.2 and 0.3, respectively. The yield of screening the sub category of travel cohorts was very high for RACD and PACD being 806.5 and 44.9 malaria cases per 100,000 smears, respectively. Despite over half of the blood smears examined being obtained by screening spatial cohorts within RACD and PACD, the yield of both was zero over all three years. Conclusions The PCD arm of case surveillance is the most effective and, therefore, has to continue and be further strengthened as the mainstay of malaria surveillance. Focus on travel cohorts within RACD and PACD should be even greater. Screening of spatial cohorts, on a routine basis and solely because people are resident in previously malarious areas, may be wasteful, except in situations where the risk of local transmission is very high, or is imminent. These findings may apply more broadly to most countries in the post-elimination phase.

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Species Composition and Diversity of Malaria Vector Breeding Habitats in Trincomalee District of Sri Lanka

BioMed Research International ◽

10.1155/2015/823810 ◽

2015 ◽

Vol 2015 ◽

pp. 1-10 ◽

Cited By ~ 8

Author(s):

Nayana Gunathilaka ◽

Wimaladharma Abeyewickreme ◽

Menaka Hapugoda ◽

Rajitha Wickremasinghe

Keyword(s):

Sri Lanka ◽

Larval Habitat ◽

Malaria Vectors ◽

Entomological Surveillance ◽

Anopheles Subpictus ◽

Control Programs ◽

Breeding Habitats ◽

Elimination Programme ◽

Total Dissolved Solid ◽

The Relationship

Introduction. Mosquito larval ecology is important in determining larval densities and species assemblage. This in turn influences malaria transmission in an area. Therefore, understanding larval habitat ecology is important in designing malaria control programs.Method. Larval surveys were conducted in 20 localities under five sentinel sites (Padavisiripura, Gomarankadawala, Thoppur, Mollipothana, and Ichchallampaththu) in Trincomalee District, Eastern Province of Sri Lanka, between June 2010 and July 2013. The relationship between seven abiotic variables (temperature, pH, conductivity, Total Dissolved Solid (TDS), turbidity, Dissolved Oxygen (DO), and salinity) was measured.Results. A total of 21,347 anophelines were recorded representing 15 species.Anopheles subpictus24.72% (5,278/21,347) was the predominant species, followed by 24.67% (5,267/21,347) ofAn. nigerrimusand 14.56% (3,109/21,347) ofAn. peditaeniatus. A total of 9,430 breeding habitats under twenty-one categories were identified.An. culcicifacieswas noted to be highest from built wells (20.5%) with high salinity (1102.3 ± 81.8 mg/L), followed by waste water collections (20.2%) having low DO levels (2.85 ± 0.03 mg/L) and high TDS (1,654 ± 140 mg/L).Conclusion. This study opens an avenue to explore new breeding habitats of malaria vectors in the country and reemphasizes the requirement of conducting entomological surveillance to detect potential transmission of malaria in Sri Lanka under the current malaria elimination programme.

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Self-Care among Adolescents with Type 1 Diabetes Mellitus and Nursing Care in Sri Lanka: Review of Literature

The Kitakanto Medical Journal ◽

10.2974/kmj.66.15 ◽

2016 ◽

Vol 66 (1) ◽

pp. 15-22

Author(s):

A.M.S. Deepanie Pathiranage ◽

Yoshie Mori ◽

Shamya De Silva

Keyword(s):

Diabetes Mellitus ◽

Type 1 Diabetes ◽

Sri Lanka ◽

Type 1 Diabetes Mellitus ◽

Nursing Care ◽

Self Care ◽

Review Of Literature

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Critical analysis of lecturer’s perception on integrating concepts of sustainability in university curricular

Integrated Science Education Journal ◽

10.37251/isej.v1i3.105 ◽

2020 ◽

Vol 1 (3) ◽

pp. 109-121

Author(s):

Anupama Gunawardana ◽

F.R. Arooz ◽

A. Peramunugamage ◽

R.U. Halwatura

Keyword(s):

Higher Education ◽

Sri Lanka ◽

Online Survey ◽

Tertiary Education ◽

Descriptive Analysis ◽

Sri Lankan ◽

Microsoft Excel ◽

University Curriculum ◽

Near Future ◽

Integrated Sustainability

Purpose of the study: The growing emphasis on incorporating sustainability concepts in tertiary education have lead higher education institutions in developing countries to infuse sustainability content into their curricula. The wider purpose of this study is to promote the integration of sustainability concepts within Sri Lankan Universities. The study uncover and presents the perception of university academics on integrating sustainability in higher education. Methodology: An online-survey was carried out in the month of January, 2019 in University of Moratuwa, Sri Lanka across four faculties; engineering, architecture, information and technology and business. A descriptive analysis was employed to present the perceptions of the respondents according to different faculties. The obtained data were analyzed using Microsoft excel. Main Findings: Results revealed, 46.93% have already integrated sustainability concepts while 59.18% are willing to integrate in near future. 80% have perceived that university curriculum should improve according to country’s need while providing particular trainings. 60% felt that knowledge and skills on ICT should be developed and adequate human resources should be deployed prior to incorporate sustainability concepts. Applications of this study: This study is aimed to identify models for mainstreaming sustainability concepts across tertiary education in Sri Lanka. Novelty/Originality of this study: Analysing the perception of univeristiy lecturers on incorporating sustainability concepts acroos university curricular, has never conducted in a Sri Lankan university. This is manily conducted to identify the gaps pertaining on intergrating sustainability concepts across university curricular and to identify the barriers exciting for education for sustainable development in Sri Lankan context.

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ELT,A CATALYST FOR RECONCILIATION: A REVIEW OF LITERATURE ON INTERCULTURAL COMMUNICATIVE COMPETENCE IN TERTIARY EDUCATION IN SRI LANKA.

International Journal of Advanced Research ◽

10.21474/ijar01/9436 ◽

2019 ◽

Vol 7 (7) ◽

pp. 875-882

Author(s):

VU Jayasinghe ◽

Keyword(s):

Sri Lanka ◽

Communicative Competence ◽

Tertiary Education ◽

Review Of Literature ◽

Intercultural Communicative Competence

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Sri Lanka’s early success in the containment of COVID-19 through its rapid response: Clinical & epidemiological evidence from the initial case series

PLoS ONE ◽

10.1371/journal.pone.0255394 ◽

2021 ◽

Vol 16 (7) ◽

pp. e0255394

Author(s):

Carukshi Arambepola ◽

Nuwan Darshana Wickramasinghe ◽

Surangi Jayakody ◽

Sumudu Avanthi Hewage ◽

Ananda Wijewickrema ◽

...

Keyword(s):

Sri Lanka ◽

Disease Surveillance ◽

Case Series ◽

Secondary Data ◽

Long Term Effects ◽

State Sector ◽

Younger Age ◽

Early Success ◽

Passive Case Detection ◽

Epidemiological Characteristics

Background Despite the rising global burden, Sri Lanka reported a relatively low caseload and mortality (13 deaths as of 20 October 2020) for COVID-19. This warrants exploration of the clinical and epidemiological characteristics of the case series during the initial passive case detection phase in Sri Lanka, in order to understand the success in containment of the disease for more than nine months in the country through its initial early and rapid pandemic response. Methods A retrospective study was conducted using secondary data (hospital records and investigation reports) extracted from all laboratory-confirmed patients admitted to the three main state-sector hospitals in Sri Lanka from 11 March to 7 April 2020. Clinical outcomes were categorized as mild, severe and critical, as per the international classification. Kruskal-Wallis H, Mann Whitney U and Fisher’s exact tests compared differences between the variables. Results The case series comprised 146 live discharges and six deaths. Majority were males (63.2%); mean age of 40.9 (SD = 17.9); and symptomatic (72.4%). Sixty-one (40.1%) had co-morbidities, the commonest being diabetes (20.4%) and hypertension (17.8%). Mild (93.4%), severe (2.6%) and critical (4.0%) disease outcomes were noted. Disease severity was significantly higher with older age (p = 0.037), co-morbidities (p = 0.026); and higher white-cell (p = 0.045) and lymphocyte (p = 0.043) counts; but not with being symptomatic (p = 0.683). The commonest symptoms were fever (62.5%), dry cough (48.0%) and sore throat (26.9%). The median duration (IQR) was 3.0 (1.0–5.0) and 18.0 (15.0–29.5) days, respectively before and during hospitalization. Conclusions In contrast to high-risk countries, the younger age, milder disease and low mortality observed in local patients during the initial phase of the pandemic, reflect the early success in containment of the pandemic in Sri Lanka. However, once the disease becomes severe, the factors determining disease fatality remain the same as in other countries. This highlights the value of establishing strong public health systems and disease surveillance in a country, which could provide long-term effects on disease control.

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Geographically extensive larval surveys reveal an unexpected scarcity of primary vector mosquitoes in a region of persistent malaria transmission in western Zambia

10.21203/rs.3.rs-43576/v1 ◽

2020 ◽

Author(s):

Dónall Eoin Cross ◽

Chris James Thomas ◽

Niall McKeown ◽

Vincent Siaziyu ◽

Amy Healey ◽

...

Keyword(s):

Malaria Transmission ◽

Nuclear Dna ◽

Indoor Residual Spraying ◽

Genetic Identification ◽

Insecticide Treated Nets ◽

Vector Species ◽

Entomological Surveillance ◽

Wet Season ◽

Genetic Sequencing ◽

Ecological Zones

Abstract Background: The Barotse floodplains of the upper Zambezi River and its tributaries are a highly dynamic environment, with seasonal flooding and transhumance presenting a shifting mosaic of potential larval habitat and human and livestock bloodmeals for malaria vector mosquitoes. However, limited entomological surveillance has been undertaken to characterise the vector community in these floodplains and their environs. Such information is necessary as, despite substantial deployment of insecticide-treated nets (ITNs) and indoor residual spraying (IRS) against Anopheles vectors, malaria transmission persists across Barotseland in Zambia’s Western Province.Methods: Geographically extensive larval surveys were undertaken in two health districts along 102 km of transects, at fine spatial resolution, during a dry season and following the peak of the successive wet season. Larvae were sampled within typical Anopheles flight range of human settlements and identified through genetic sequencing of cytochrome c oxidase I and internal transcribed spacer 2 regions of mitochondrial and nuclear DNA. This facilitated detailed comparison of taxon-specific abundance patterns between ecological zones differentiated by hydrological controls.Results: An unexpected paucity of primary vectors was revealed, with An. gambiae s.l. and An. funestus representing < 2% of 995 sequenced anophelines. Potential secondary vectors predominated in the vector community, primarily An. coustani group species and An. squamosus. Whilst the distribution of An. gambiae s.l. in the study area was highly clustered, secondary vector species were ubiquitous across the landscape in both dry and wet seasons, with some taxon-specific relationships between abundance and ecological zones by season.Conclusions: Larval survey results imply that residual transmission of malaria in Barotseland is being mediated predominantly by secondary vector species, whose known tendencies for crepuscular and outdoor biting renders them largely insensitive to prevalent vector control methods (ITNs and IRS). Alternative interventions may be required against this vector community to further reduce transmission. Larviciding is one potential supplementary intervention, although it presents a challenge in extensive wetlands such as those found in the Upper Zambezi catchment. However, the combination of advances in remote sensing of habitats, genetic identification of local vectors, and spatial modelling present a potential opportunity to optimise targeting of aerial spraying in these environments.

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