One Health in action in Sri Lanka

Abstract Background: Chronic kidney disease of unknown etiology (CKDu) was first recognized in Sri Lanka in the early 1990s, and since then it has reached epidemic levels in the North Central Province of the country. The prevalence of CKDu is reportedly highest among communities that engage in chena and paddy farming, which is most often practiced in the dry zone including the North Central and East Central Provinces of Sri Lanka. Previous studies have suggested varied hypotheses for the etiology of CKDu; however, there is not yet a consensus on the primary risk factors, possibly due to disparate study designs, sample populations, and methodologies.Methods: The goal of this pilot case-control study was to evaluate the relationships between key demographic, cultural, and occupational variables as risk factors for CKDu, with a primary interest in pesticide exposure both occupationally and through its potential use as an ingredient in brewed kasippu alcohol. An extensive one health focused survey was developed with in cooperation with the Centre for Research, Education, and Training on Kidney Diseases of Sri Lanka. Results: A total of 56 CKDu cases and 54 control individuals were surveyed using a proctored, self-reported questionnaire. Occupational pesticide exposure and alcohol consumption were not found to be significant risk factors for CKDu. However, a statistically significant association with CKDu was observed with chewing betel (adjusted odds ratio [aOR]: 6.11, 95% confidence interval [CI]: 1.93, 19.35), age (aOR: 1.07, 95% CI: 1.02, 1.13), owning a pet dog (aOR: 3.74, 95% CI: 1.38, 10.11), water treatment (aOR: 3.68, 95% CI: 1.09, 12.43) and pests in the house (aOR: 5.81, 95% CI: 1.56, 21.60).Conclusions: The findings of this study suggest future research should focus on practices associated with chewing betel, potential animal interactions including pests in the home and pets, and risk factors associated with water.

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A pilot case-control study using a one health approach to evaluate behavioral, environmental, and occupational risk factors for chronic kidney disease of unknown etiology in Sri Lanka

One Health Outlook ◽

10.1186/s42522-020-00034-3 ◽

2021 ◽

Vol 3 (1) ◽

Author(s):

Jake M Pry ◽

Wendi Jackson ◽

Ruwini Rupasinghe ◽

Guneratne Lishanthe ◽

Zied Badurdeen ◽

...

Keyword(s):

Risk Factors ◽

Sri Lanka ◽

One Health ◽

Case Control Study ◽

Pesticide Exposure ◽

Case Control ◽

Unknown Etiology ◽

North Central ◽

The North ◽

Control Study

Abstract Background Chronic kidney disease of unknown etiology (CKDu) was first recognized in Sri Lanka in the early 1990s, and since then it has reached epidemic levels in the North Central Province of the country. The prevalence of CKDu is reportedly highest among communities that engage in chena and paddy farming, which is most often practiced in the dry zone including the North Central and East Central Provinces of Sri Lanka. Previous studies have suggested varied hypotheses for the etiology of CKDu; however, there is not yet a consensus on the primary risk factors, possibly due to disparate study designs, sample populations, and methodologies. Methods The goal of this pilot case-control study was to evaluate the relationships between key demographic, cultural, and occupational variables as risk factors for CKDu, with a primary interest in pesticide exposure both occupationally and through its potential use as an ingredient in brewed kasippu alcohol. An extensive one health focused survey was developed with in cooperation with the Centre for Research, Education, and Training on Kidney Diseases of Sri Lanka. Results A total of 56 CKDu cases and 54 control individuals were surveyed using a proctored, self-reported questionnaire. Occupational pesticide exposure and alcohol consumption were not found to be significant risk factors for CKDu. However, a statistically significant association with CKDu was observed with chewing betel (adjusted odds ratio [aOR]: 6.11, 95% confidence interval [CI]: 1.93, 19.35), age (aOR: 1.07, 95% CI: 1.02, 1.13), owning a pet dog (aOR: 3.74, 95% CI: 1.38, 10.11), water treatment (aOR: 3.68, 95% CI: 1.09, 12.43) and pests in the house (aOR: 5.81, 95% CI: 1.56, 21.60). Conclusions The findings of this study suggest future research should focus on practices associated with chewing betel, potential animal interactions including pests in the home and pets, and risk factors associated with water.

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A One Health Framework for the Evaluation of Rabies Control Programmes: A Case Study from Colombo City, Sri Lanka

PLoS Neglected Tropical Diseases ◽

10.1371/journal.pntd.0003270 ◽

2014 ◽

Vol 8 (10) ◽

pp. e3270 ◽

Cited By ~ 23

Author(s):

Barbara Häsler ◽

Elly Hiby ◽

Will Gilbert ◽

Nalinika Obeyesekere ◽

Houda Bennani ◽

...

Keyword(s):

Sri Lanka ◽

One Health ◽

Rabies Control ◽

Control Programmes

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A Pilot Case-Control Study Using a One Health Approach to Evaluate Behavioral, Environmental, and Occupational Risk Factors for Chronic Kidney Disease of Unknown Etiology in Sri Lanka

10.21203/rs.3.rs-35799/v1 ◽

2020 ◽

Author(s):

Jake Pry ◽

Wendi Jackson ◽

Ruwini Rupasinghe ◽

Guneratne Lishanthe ◽

Zied Badurdeen ◽

...

Keyword(s):

Risk Factors ◽

Sri Lanka ◽

One Health ◽

Case Control Study ◽

Pesticide Exposure ◽

Case Control ◽

Unknown Etiology ◽

North Central ◽

The North ◽

Control Study

Abstract Background: Chronic kidney disease of unknown etiology (CKDu) was first recognized in Sri Lanka in the early 1990s, and since then it has reached epidemic levels in the North Central Province of the country. The prevalence of CKDu is reportedly highest among communities that engage in chena and paddy farming, which is most often practiced in the dry zone including the North Central and East Central Provinces of Sri Lanka. Previous studies have suggested varied hypotheses for the etiology of CKDu; however, there is not yet a consensus on the primary risk factors, possibly due to disparate study designs, sample populations, and methodologies.Methods: The goal of this pilot case-control study was to evaluate the relationships between key demographic, cultural, and occupational variables as risk factors for CKDu, with a primary interest in pesticide exposure both occupationally and through its potential use as an ingredient in brewed kasippu alcohol. An extensive one health focused survey was developed with in cooperation with the Centre for Research, Education, and Training on Kidney Diseases of Sri Lanka. Results: A total of 56 CKDu cases and 54 control individuals were surveyed using a proctored, self-reported questionnaire. Occupational pesticide exposure and alcohol consumption were not found to be significant risk factors for CKDu. However, a statistically significant association with CKDu was observed with chewing betel (adjusted odds ratio [aOR]: 6.11, 95% confidence interval [CI]: 1.93, 19.35), age (aOR: 1.07, 95% CI: 1.02, 1.13), owning a pet dog (aOR: 3.74, 95% CI: 1.38, 10.11), water treatment (aOR: 3.68, 95% CI: 1.09, 12.43) and pests in the house (aOR: 5.81, 95% CI: 1.56, 21.60).Conclusions: The findings of this study suggest future research should focus on practices associated with chewing betel, potential animal interactions including pests in the home and pets, and risk factors associated with water.

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Abstract #604: Detection of Cardiovascular Risk Factors by Anthropometric Measures in Adults Living in an Urban Setting in Sri Lanka

Endocrine Practice ◽

10.1016/s1530-891x(20)42668-0 ◽

2015 ◽

Vol 21 ◽

pp. 114-115

Author(s):

Kavinga Gunawardane ◽

Noel Somasundaram ◽

Neil Thalagala ◽

Pubudu Chulasiri ◽

Sudath Fernando

Keyword(s):

Risk Factors ◽

Cardiovascular Risk ◽

Sri Lanka ◽

Cardiovascular Risk Factors ◽

Urban Setting ◽

Anthropometric Measures

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Prevalence of Suicidal Ideation in Sri Lanka

Crisis ◽

10.1027/0227-5910/a000010 ◽

2010 ◽

Vol 31 (1) ◽

pp. 30-35 ◽

Cited By ~ 3

Author(s):

Sudath Samaraweera ◽

Athula Sumathipala ◽

Sisira Siribaddana ◽

S. Sivayogan ◽

Dinesh Bhugra

Keyword(s):

Suicidal Ideation ◽

Sri Lanka ◽

General Population ◽

Suicide Attempts ◽

National Average ◽

The West ◽

Suicide Methods ◽

Suicide Rates ◽

Completed Suicide ◽

The World

Background: Suicidal ideation can often lead to suicide attempts and completed suicide. Studies have shown that Sri Lanka has one of the highest rates of suicide in the world but so far no studies have looked at prevalence of suicidal ideation in a general population in Sri Lanka. Aims: We wanted to determine the prevalence of suicidal ideation by randomly selecting six Divisional Secretariats (Dss) out of 17 in one district. This district is known to have higher than national average rates of suicide. Methods: 808 participants were interviewed using Sinhala versions of GHQ-30 and Beck’s Scale for Suicidal Ideation. Of these, 387 (48%) were males, and 421 (52%) were female. Results: On Beck’s Scale for Suicidal Ideation, 29 individuals (4%) had active suicidal ideation and 23 (3%) had passive suicidal ideation. The active suicidal ideators were young, physically ill and had higher levels of helplessness and hopelessness. Conclusions: The prevalence of suicidal ideation in Sri Lanka is lower than reported from the West and yet suicide rates are higher. Further work must explore cultural and religious factors.

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Suicide on the Indian Subcontinent

Crisis ◽

10.1027//0227-5910.23.3.104 ◽

2002 ◽

Vol 23 (3) ◽

pp. 104-107 ◽

Cited By ~ 36

Author(s):

Murad M. Khan

Keyword(s):

Sri Lanka ◽

Mental Health Professionals ◽

Indian Subcontinent ◽

Interpersonal Relationship ◽

Public Health Problem ◽

Elderly Subjects ◽

Important Public Health Problem ◽

Policy Makers ◽

Formidable Challenge ◽

Causative Factors

Summary: The Indian subcontinent comprises eight countries (India, Pakistan, Bangladesh, Nepal, Sri Lanka, Afghanistan, Bhutan, and the Maldives) and a collective population of more than 1.3 billion people. 10% of the world's suicides (more than 100,000 people) take place in just three of these countries, viz. India, Sri Lanka, and Pakistan. There is very little information on suicides from the other four countries. Some differences from suicides in Western countries include the high use of organophosphate insecticides, larger numbers of married women, fewer elderly subjects, and interpersonal relationship problems and life events as important causative factors. There is need for more and better information regarding suicide in the countries of the Indian subcontinent. In particular, studies must address culture-specific risk factors associated with suicide in these countries. The prevention of this important public health problem in an area of the world with myriad socio-economic problems, meager resources, and stigmatization of mental illness poses a formidable challenge to mental health professionals, policy makers, and governments of these countries.

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