PRIMER REPORTE DE LESIONES PARASITARIAS COMPATIBLES CON Oslerus osleri (COBBOLD, 1876) EN AGUARÁ GUAZÚ, Chrysocyon brachyurus (ILLIGER, 1811) DE LA PROVINCIA DE SANTA FE.

The necropsy of 5 specimens of C. brachyurus which were accidentally run over on different routes in the north-central province of Santa Fe. All of these had multiple whitish nodules with a cystic appearance between the distal third of the trachea and bronchi containing parasites arranged in the shape of a ball inside. Morphological identification of adult’s nematodes and larvae eggs from females was performed, where it was possible to identify typical characters of the species O. osleris. Likewise, the lungs were increased in consistency, with petechial and multifocal ecchymosis and the presence of whitish nodules scattered throughout the parenchyma. Two of the canids had an increase in the size of the bronchial lymph nodes. The inspection of the respiratory system together with the observation of lesions and the nematodes found inside with their corresponding measurements, are compatible with the species O. osleri, which would imply the first report of this parasite in wild canids from Argentina.

Modernization of the left bank irrigation system of the Kaudulla reservoir of Sri Lanka

Irrigation water management in the paddy cultivation area under the left bank canal of the Kaudulla reservoir (Kaudulla tank) in the North Central Province of Sri Lanka has become a serious issue due to limited water availability and inefficient water distribution infrastructure at present. Insufficient storage capacities of the village tanks in the cultivation area, low rainfall during some months and regulated inflow from the transbasin diversion to Kaudulla tank have had a significant impact on yield in the two cultivation seasons of the year. In this article, modernization of irrigation infrastructure in the command area was investigated for effective utilization of limited available water. The results of the calibrated and validated HEC-HMS model and CROPWAT model were used with WEAP to evaluate the water balance and demand to identify the best investment for improving irrigation water supply to maximize the return. Economic analysis was carried out using the net present values for different modernization options. Accordingly, the construction of a new canal system and augmentation of the capacities of village tanks from the present total capacity of 3.8–20 MCM was found to be the most appropriate option. This intervention will increase the income from yield by 205 million with a payback period of 12 years in the Yala season.

Identification of Social and Occupational Risk Factors Associated with CKDu Patients in an Agricultural Community in Kebithigollewa, Sri Lanka

Aim: To identify the social and occupational risk factors associated with CKDu patients living in an agricultural community in Kebithigollewa, Sri Lanka.Methods: A three months community based cross sectional study was done involving 30 CKDu diagnosed patients who were attending the CKDu Ayurvedic Clinic at Kebithigollewa, North Central Province (NCP), Sri Lanka and 30 controls were taken from the same region. Socioeconomic and socio-demographic data was collected from the participants with the use of an interview administered questionnaire. Heights and weights were the anthropometric data measured for the study. Blood samples were collected as biochemical data which was later analysed using an automated blood analyser. Data collected was computerized and analysed using software Graphpad Prism 8 and SPSS version 20.Results: All the participants of the research were active residents living in the North Central Province (NCP) since birth. 83.34% of the CKDu affected individuals were from the 4th to 7th decade of life and 70% of them were males. 86.66% of the affected population carried out agricultural practices as their main source of income with chena and paddy cultivation being the common practice followed. 96.66% of the affected were from low income families who earned 0-20000 LKR per month. 40% of the affected have had only up to five years of school education. 63.33% of the CKDu patients were overweight. A significant correlation of 0.642218 was shown by Cramer’s V square test between Number of working hours/day and serum creatinine, indicating a strong association, but did not have a significant nominal logistic regression.Conclusion: Serum creatinine was high in farmers and laborers indicating that occupation impacts CKDu occurrence and progression. It was also high in age group 31-50yrs showing a significant relationship with serum creatinine which indicates the social impact on CKDu occurrence. A statistically significance of P<0.05 was shown by number of working hours and BMI.

Compliance and adherence to drug treatment on patients with chronic kidney disease in high prevalence areas of North Central Province, Sri Lanka

Background: Chronic kidney disease that cannot be explained by traditional factors such as hypertension, diabetes mellitus is called chronic kidney disease unexplained etiology. With limited evidence on the success of interventions in enhancing medication adherence, this study was designed to test patient compliance and adherence on taking medication in North Central Province in Sri Lanka.Methods: A cross sectional study was conducted in a selected area of NCP to identify compliance, adherence. Data was collected using an interviewer administered questionnaire by visiting patients at their own residences.Results: A total of 200 people participated in this study. 92.5% of the population was involved in agriculture and 63% worked more than 1 acre of farmland. Among the selected population (74%) were not educated about the side effects of medication. 60.5% had missed taking their medicines during the prescribed time period. The entire population of the study was selected among patients having a monthly income of less than 15,000 Sri Lankan rupees. There was a statistically significant association in missing doses with land extent, patient’s income and stages of the disease.Conclusions: Non adherence and compliance to the medication is common in patients that worked in largely extended lands, were in late stages of the disease and had reduced income. Compliance and Adherence to the medication can be enhanced by proper counseling and improving patient’s knowledge about their medication.

Kidney Disease, Health, and Commodification of Drinking Water: An Anthropological Inquiry into the Introduction of Reverse Osmosis Water in the North Central Province of Sri Lanka

In response to evidence suggesting that polluted drinking water is a risk factor for Chronic Kidney Disease of Unknown Etiology (CKDu) in Sri Lanka, the government introduced reverse osmosis (RO) water as an alternative form of drinking water in the North Central Province (NCP) between 2010 and 2016. We examine whether CKDu prevalence and disease progression have been reduced as a result of the introduction of RO water and behavioral changes and how villagers perceive the changes.

Evaluation of Performance of Existing RO Drinking Water Stations in the North Central Province, Sri Lanka

Reverse osmosis (RO) drinking water stations have been introduced to provide safe drinking water for areas with prevailing chronic kidney disease with unknown (CKDu) etiology in the dry zone of Sri Lanka. In this investigation, RO drinking water stations established by community-based organizations (CBO) in the North Central Province (NCP) were examined. Water samples were collected from source, permeate, and concentrate in each station to determine water quality and performance. Furthermore, the operators of the systems were interviewed to evaluate operational and maintenance practices to identify major issues related to the RO systems. Results show that the majority (>93%) of RO systems had higher salt rejection rates (>92%), while water recovery varied from 19.4% to 64%. The removal efficiencies of hardness and alkalinity were averaged at 95.8% and 86.6%, respectively. Most dominant ions such as Ca2+, Mg2+, K+, Na+, Ba2+, Sr2+ Cl−, F−, and SO42− showed higher rejections at averaged values of 93.5%, 97.4%, 86.6%, 90.8%, 95.4%, 96.3%, 95.7%, 96.6%, and 99.0%, respectively. Low recovery rates, lower fluoride levels in product water, and membrane fouling were the main challenges. Lack of knowledge and training were the major issues that could shorten the lifespan of RO systems.

Drinking Water and CKD of Unknown Etiology in Sri Lanka: A Community Perspective

People’s belief that polluted drinking water is the principal medium through which environmental toxins are absorbed into the bodies of CKD of unknown etiology (CKDu) patients in the CKDu-endemic areas in Sri Lanka has been the subject of extensive epidemiological and medical research. This study examines (a) the people’s perception and experience that polluted drinking water is the cause of CKDu, (b) how the government responded to people’s demands for potable water, and (c) the impact of the use of alternative drinking water sources on the health of CKDu patients and their families, and on the progression of the disease in CKDu patients. Data were collected in 2013 and 2019 in Anuradhapura and Polonnaruwa districts in North Central Province of Sri Lanka. People’s agitation, activism, and lobbying, together with the media’s work in bringing the issue of polluted water to the forefront of political discourse, have prompted the government, private sector agencies, and community organizations to supply clean water to affected communities. A massive change in drinking water behaviors has occurred following the government’s decision to supply reverse osmosis (RO) water to the affected communities. Informants perceived the provision of RO water as having brought about many positive outcomes in the health and disease progression of CKDu patients.

Changes In Immunological Response In Wistar Rats That Ingested Water From High And Low Disease Prevalent Areas From The North Central Province (NCP) And Low Disease Prevalent Colombo, Sri Lanka And Their Co-Relations To Histopathological Changes.

BackgroundChronic Kidney Disease of unknown etiology (CKDu) is prevalent in North Central Province (NCP) of Sri Lanka and ingestion of ground water is identified as one of the causative factors. Majority of the population in the NCP consume un-boiled dug well water. Objective of this study was to find out the haematological and immunological variations in Wistar rats that ingested water from high and low disease prevalent areas from the NCP and low disease prevalent Colombo and correlated the findings with histopathological changes.Method Wistar rats (60) were recruited to the study and their baseline WBC, DC, CD4+, CD8+, serum cytokines, creatinine, ALT, AST and BUN levels were measured. Rats were randomly divided into 6 groups by assigning 10 rats into each group. Groups 1, 2 and 3 were given water from high disease prevalent New Town Medirigiriya (NTM), Bisobandaragama (BB) and Divuldamana (DD) and group 4 was given boiled water from NTM (NTMB). Group 5 and 6 were given water from low diseases prevalent Huruluwewa (HW) from NCP and low disease prevalent Colombo (CO). Serum cytokines (IL1ß, IL6, TNFα) were measured after 8 months and other parameters and tissue cytokines were measured after 14 months. Histopathology was performed in kidney and liver tissues.Results Serum TNFα levels were significantly elevated in rats from DD and BB but tissue TNFα levels were significantly elevated only in rats from DD. Rats from high diseases prevalent areas had significantly high CD4+ and CD8+ cell than those from low disease prevalent HW and CO. Immunological findings were correlated with the changes observed in the histopathology. There was a co-relation between the kidney Tubular Interstitial Lesion index and liver lesions.Conclusion TNFα and CD4+ and CD8+ lymphocyte had an impact on kidney damage. Rats with severe TI lesions reported high percentage of portal tracts and parenchymal lesions in the liver and this expression was minimum in CO. Boiled water can reduce the liver damage but not been able to significantly reduce the kidney damage. Immune therapy targeting the CD4+, CD8+ and TNFα may reduce the disease burden in the early stage.