1.  Title: Awareness and views of the law on termination of pregnancy and reasons for resorting to an abortion among a group of women attending a clinic in Colombo, Sri Lanka. Author: Abeyasinghe NL; Weerasundera BJ; Jayawardene PA; Somarathna SD Source: Journal of Forensic and Legal Medicine. 2009 Apr;16(3):134-7. Abstract: In Sri Lanka, induced abortion is a criminal offence except to save the life of the mother. This study determined the awareness and views of the law on abortion among women seeking an abortion. Three hundred and thirteen women were interviewed. The characteristics of the study group are discussed. 65.8% of the respondents stated they knew the current law, 25.6% stated they did not and 8.3% were unsure. On detailed analysis of each respondent's knowledge regarding the situations where abortion is legalized including those who stated that they did not know the law, only 11.2% had an accurate knowledge. More than 75% stated that abortion should be legalized when the mother's life was in danger, where there was pregnancy after rape or incest, when there was psychiatric illness in the mother and when there were fetal anomalies. Reasons for resorting to an abortion are discussed. Although 11.2% were aware of the law, there was no difference in the reasons for resorting to an abortion when compared with those who were unaware of the law. This study highlights the fact that availability of abortion services to women depend not only on the law and its awareness, but on how it is interpreted and enforced. Language: English Keywords: SRI LANKA | RESEARCH REPORT | ABORTION | ABORTION LAW | AWARENESS | INTERVIEWS | ABORTION RATE | ATTITUDES | CONTRACEPTIVE USAGE | Developing Countries | Asia, Southern | Asia | Fertility Control, Postconception | Family Planning | Knowledge | Sociocultural Factors | Data Collection | Research Methodology | Psychological Factors | Behavior | Contraception Document Number: 342188 Notification |
| 2. Title: Maternal mortality due to cardiac disease in Sri Lanka. Author: Haththotuwa HR; Attygalle D; Jayatilleka AC; Karunaratna V; Thorne SA Source: International Journal of Gynaecology and Obstetrics. 2009 Mar;104(3):194-8. Abstract: OBJECTIVE: To investigate Sri Lankan maternal deaths due to heart disease and to consider low-cost interventions to reduce these deaths. METHODS: A qualitative study based on retrospective audit of all maternal deaths and late maternal deaths in Sri Lanka caused by cardiac disease in 2004. RESULTS: A total of 145 maternal deaths were recorded in 2004, for a maternal mortality rate of 38 per 100,000. There were 42 indirect deaths, 25 of which were due to cardiac disease; 23 deaths had a specific cardiac cause listed. Standard care was identified in prepregnancy counseling, contraception, and prenatal community and specialist care. CONCLUSION: Cardiac disease is a major cause of maternal mortality in Sri Lanka, second only to postpartum hemorrhage. Rheumatic mitral valve disease is responsible for more than a third of maternal deaths from cardiac disease. Substandard care was identified in all cases; strategies to improve care could allow a reduction in maternal cardiac deaths. Language: English Keywords: SRI LANKA | RESEARCH REPORT | RETROSPECTIVE STUDIES | PREGNANT WOMEN | MATERNAL MORTALITY | HEART DISEASES | QUALITY OF HEALTH CARE | EXAMINATIONS AND DIAGNOSES | CAUSES OF DEATH | Developing Countries | Asia, Southern | Asia | Studies | Research Methodology | Population Characteristics | Demographic Factors | Population | Mortality | Population Dynamics | Diseases | Health Services Evaluation | Program Evaluation | Programs | Organization and Administration | Medical Procedures | Medicine | Health Services | Delivery of Health Care | Health Document Number: 341384 |
| 3. Title: Use of the internet by patients attending specialist clinics in Sri Lanka: a cross sectional study. Author: Kommalage M Source: BMC Medical Informatics and Decision Making. 2009;9:12. Abstract: BACKGROUND: The internet is a relatively new medium of disseminating health information. Studies on Internet usage for health information are mainly done in developed countries and very few studies have been carried out in developing countries. METHODS: The Internet usage of patients who were attending specialist clinics in Teaching Hospital Karapitiya and Southern Hospital in Galle, Sri Lanka was investigated. The study was carried out on the following specialities; General Medicine, Pediatrics, General Surgery and Cardiothoracic surgery. Information was collected using an investigator-administered questionnaire while patients were waiting for a consultation. RESULTS: Three hundred and fifty five patients (or guardians in the Pediatric clinic) participated in the study. One hundred seventy two (48.3%) participants have heard about the Internet. There was a relationship between awareness of the Internet and age, educational level and the clinic attended. There was no difference of awareness depending on the gender or the hospital. Only three participants (0.97%) have used the Internet to find information about their disease conditions. Close relatives searched the Internet about the conditions of two participants. Altogether, the Internet was used to search information on the disease condition of five participants (1.4%). CONCLUSION: Very low usage of the Internet for health information retrieval in this study is probably due to low awareness of the Internet and low educational level. This low usage of Internet and the associated reasons shown in this study can be generalized to Sri Lanka and probably to other low-income countries that have lower educational level than Sri Lanka. Language: English Keywords: SRI LANKA | RESEARCH REPORT | KAP SURVEYS | CROSS SECTIONAL ANALYSIS | TARGET POPULATION | INTERNET | INFORMATION SOURCES | AGE FACTORS | EDUCATIONAL STATUS | CLINIC ACTIVITIES | EXAMINATIONS AND DIAGNOSES | HEALTH EDUCATION | Developing Countries | Asia, Southern | Asia | Surveys | Sampling Studies | Studies | Research Methodology | Program Design | Programs | Organization and Administration | Information Networks | Communication | Information | Population Characteristics | Demographic Factors | Population | Socioeconomic Status | Socioeconomic Factors | Economic Factors | Program Activities | Medical Procedures | Medicine | Health Services | Delivery of Health Care | Health | Education Document Number: 331071 |
4.  Title: Tobacco use among students aged 13 - 15 years - Sri Lanka, 1999 - 2007. Author: United States. Center for Disease Control [CDC] Source: MMWR. Morbidity and Mortality Weekly Report. 2008 May 23;57(20):545-549. Abstract: Tobacco use is one of the major preventable causes of premature death and disease in the world. The World Health Organization (WHO) attributes approximately 5 million deaths per year to tobacco use, a number expected to exceed 8 million per year by 2030. In 1999, the Global Youth Tobacco Survey (GYTS) was initiated by WHO, CDC, and the Canadian Public Health Association to monitor tobacco use, attitudes about tobacco use, and exposure to secondhand smoke (SHS) among students aged 13-15 years. Since 1999, the survey has been completed by approximately 2 million students in 151 countries. A key goal of GYTS is for countries to repeat the survey every 4 years. This report summarizes results from GYTS conducted in Sri Lanka in 1999, 2003, and 2007. The findings indicated that during 1999-2007, the percentage of students aged 13-15 years who reported current cigarette smoking decreased, from 4.0% in 1999 to 1.2% in 2007. During this period, the percentage of never smokers in this age group likely to initiate smoking also decreased, from 5.1% in 1999 to 3.7% in 2007. Future declines in tobacco use in Sri Lanka will be enhanced through development and implementation of new tobacco-control measures and strengthening of existing measures that encourage smokers to quit, eliminate exposure to SHS, and encourage persons not to initiate tobacco use. (excerpt) Language: English Keywords: SRI LANKA | RESEARCH REPORT | SURVEYS | STUDENTS | WHO | TOBACCO USE | EXPOSURE | MASS MEDIA | SEX FACTORS | AGE FACTORS | Asia, Southern | Asia | Developing Countries | Sampling Studies | Studies | Research Methodology | Education | UN | International Agencies | Organizations | Political Factors | Sociocultural Factors | Behavior | Risk Factors | Biology | Communication | Population Characteristics | Demographic Factors | Population Document Number: 327213 |
| 5. Peer Reviewed Title: Adolescents perception of reproductive health care services in Sri Lanka. Author: Agampodi SB; Agampodi TC; UKD P Source: BMC Health Services Research. 2008 May 3;8:98. Abstract: Adolescent health needs, behaviours and expectations are unique and routine health care services are not well geared to provide these services. The purpose of this study was to explore the perceived reproductive health problems, health seeking behaviors, knowledge about available services and barriers to reach services among a group of adolescents in Sri Lanka in order to improve reproductive health service delivery. This qualitative study was conducted in a semi urban setting in Sri Lanka. A convenient sample of 32 adolescents between 17-19 years of age participated in four focus group discussions. Participants were selected from four midwife areas. A pre-tested focus group guide was used for data collection. Male and female facilitators conducted discussions separately with young males and females. All tape-recorded data was fully transcribed and thematic analysis was done. Psychological distresses due to various reasons and problems regarding menstrual cycle and masturbation were reported as the commonest health problems. Knowledge on existing services was very poor and boys were totally unaware of youth health services available through the public health system. On reproductive Health Matters, girls mainly sought help from friends whereas boys did not want to discuss their problems with anyone. Lack of availability of services was pointed out as the most important barrier in reaching the adolescent needs. Lack of access to reproductive health knowledge was an important reason for poor self-confidence among adolescents to discuss these matters. Lack of confidentiality, youth friendliness and accessibility of available services were other barriers discussed. Adolescents were happy to accept available services through public clinics and other health infrastructure for their services rather than other organizations. A demand was made for separate youth friendly services through medical practitioners. Adolescent health services are inadequate and available services are not being delivered in an acceptable manner. Proper training of health care providers on youth friendly service provision is essential. A National level integrated health care program is needed for the adolescents. (author's) Language: English Keywords: SRI LANKA | RESEARCH REPORT | QUALITATIVE RESEARCH | FOCUS GROUPS | ADOLESCENTS | REPRODUCTIVE HEALTH | ADOLESCENT HEALTH | HEALTH SERVICES | QUALITY OF HEALTH CARE | DELIVERY OF HEALTH CARE | UTILIZATION OF HEALTH CARE | PROGRAM ACCESSIBILITY | PERCEPTION | KNOWLEDGE | Asia, Southern | Asia | Developing Countries | Research Methodology | Data Collection | Youth | Age Factors | Population Characteristics | Demographic Factors | Population | Health | Health Services Evaluation | Program Evaluation | Programs | Organization and Administration | Psychological Factors | Behavior | Sociocultural Factors Document Number: 326876 |
| 6. Peer Reviewed Title: Factors associated with haemoglobin concentration among Timor-Leste children aged 6-59 months. Author: Agho KE; Dibley MJ; D'Este C; Gibberd R Source: Journal of Health, Population and Nutrition. 2008 Jun;26(2):200-209. Abstract: The study was conducted to assess the prevalence of and factors associated with haemoglobin (Hb) concentrations among children aged 6-59 months in Timor-Leste. The 2003 Demographic and Health Survey was a multi-stage cluster survey of 4,320 households from four different geographic regions in Timor-Leste. In total, 4,514 children aged 6-59 months were included in the analysis. The prevalence of anaemia (Hb concentration <11.0g/dL) was 38.2% (638/1,668) for children aged 6-23 months and 22.6% (644/2,846) for older children (p<0.001). Girls had a higher mean Hb concentration than boys (11.9g/dL vs 11.7g/ dL, p<0.006) and children who had diarrhoea in the previous two weeks had a lower Hb concentration than children without diarrhoea (11.5g/dL vs 11.9g/dL, p<0.001). Children from the richest and middleclass households had a lower average Hb concentration than those from the poorest households (11.8g/ dL, 11.7g/dL vs 12.0g/dL, p<0.001). Children of mothers with some secondary or more education had a lower mean Hb concentration than children of mothers with completed primary, some primary and no education (11.7 g/dL vs 11.9 g/dL, 11.8 g/dL, and 11.9 g/dL, p=0.002). Children from severely-anaemic mothers had a lower mean Hb concentration than children from moderately-, mild and not anaemic mothers (10.5 g/dL vs 11.1 g/dL, 11.6 g/dL, 12.0 g/dL, p<0.001). After backward stepwise hierarchical multiple regression, wasting, male sex, recent diarrhoea, household wealth index (richest and middle-class), maternal educational status (some secondary or more and some primary), and maternal anaemic status were significantly associated with a lower Hb concentration in children and increased age of child and duration of breastfeeding (6 months) with a higher Hb concentration. Anaemia-prevention programmes among children in Timor-Leste should focus on those children aged less than two years, children with recent diarrhoea, wasted children, high socioeconomic status, and anaemic mothers. (author's) Language: English Keywords: SRI LANKA | RESEARCH REPORT | DEMOGRAPHIC AND HEALTH SURVEYS | EPIDEMIOLOGIC METHODS | MULTIVARIATE ANALYSIS | CHILDREN | PREVALENCE | HEMOGLOBIN LEVEL | HUMAN GEOGRAPHY | ANEMIA | DIARRHEA | SEX FACTORS | SOCIOECONOMIC STATUS | EDUCATIONAL STATUS | MATERNAL HEALTH | Developing Countries | Asia, Southern | Asia | Demographic Surveys | Population Dynamics | Demographic Factors | Population | Research Methodology | Data Analysis | Youth | Age Factors | Population Characteristics | Measurement | Hemic System | Physiology | Biology | Geography | Social Sciences | Science | Sociocultural Factors | Diseases | Socioeconomic Factors | Economic Factors | Health Document Number: 327785 |
| 7. Peer Reviewed Title: Community factors affecting long-lasting impregnated mosquito net use for malaria control in Sri Lanka. Author: Fernando SD; Abeyasinghe RR; Galappaththy GN; Gunawardena N; Rajapakse LC Source: Transactions of the Royal Society of Tropical Medicine and Hygiene. 2008 Nov;102(11):1081-8. Abstract: The Anti Malaria Campaign distributed approximately 300,000 long-lasting impregnated nets (LLINs) to malaria-endemic areas in Sri Lanka during the years 2005 to 2007. We conducted a community-based cross-sectional survey among 2467 households distributed among the three major ethnic groups of Sri Lanka to study the perceptions and practices with regard to the use of LLINs in order to improve their use. In a majority of households the number of LLINs available was not sufficient for the number of people, although there was a small percentage of households that had excess nets. The information and advice given at the time of distribution regarding use of the nets differed amongst the three groups and was not consistent. Dissemination of this knowledge within the family was not observed. A relationship between knowledge regarding LLINs and reported practices on washing and drying of LLINs was found. It was noted that net shape may influence net use, with cone shaped nets being more popular. Efforts to increase knowledge on LLINs using behaviour change communication techniques would have more effectively contributed to achieve planned outcomes. Proper use of LLINs will undoubtedly contribute to further reduction of malaria in Sri Lanka. Language: English Keywords: SRI LANKA | RESEARCH REPORT | KAP SURVEYS | LONGITUDINAL STUDIES | CROSS SECTIONAL ANALYSIS | COMMUNITY | HOUSEHOLDS | MALARIA PREVENTION | BED NETS | PESTICIDES | LONGTERM EFFECTS | PERCEPTION | BEHAVIOR | KNOWLEDGE | ATTITUDES | Developing Countries | Asia, Southern | Asia | Surveys | Sampling Studies | Studies | Research Methodology | Residence Characteristics | Population Distribution | Geographic Factors | Population | Family and Household | Sociocultural Factors | Malaria | Parasitic Diseases | Diseases | Parasite Control | Public Health | Health | Ingredients and Chemicals | Time Factors | Population Dynamics | Demographic Factors | Psychological Factors Document Number: 330407 |
| 8. Peer Reviewed Title: Feminism, conflict, and disasters in post-tsunami Sri Lanka. Author: Hyndman J Source: Gender Technology and Development. 2008;12(1):657-65. Abstract: Social relations, including gender, are destabilized by conflict and disaster. Approaches informed by feminist thought illustrate this by probing the ways in which different identities and locations produce inequality, violence and disparate power relations. In this article, a feminist approach to development and disasters is advocated. In Sri Lanka, a country at war on and off for more than two decades, the social impact of the 2004 tsunami cannot be divorced from the pre-existing landscape with its layers of conflict, nationalism and economic disparities. This article explores the ways in which the tsunami changed people's relations of home, family and security for those who lost a spouse. Interviews with 40 widows and widowers along the east coast of Sri Lanka in February 2006 suggest that the tsunami not only reorganized gender relations among specific ethno-national groups, but also changed the meaning of 'widow' with war widows and tsunami widows positioned differently within post-tsunami society and across ethnic groups. The study shows that men with surviving young children who lost their wives view remarriage as highly desirable. The Sri Lankan government's policy of no-build buffer zones along this coast has also increased insecurity with many people still living in temporary accommodation two years after the tsunami. The prospect of remarriage for widowed women is fraught, yet more appealing as a way to mitigate insecurity than it was pre-tsunami. The author argues that a 'feminism and disaster' lens should be coupled with a 'feminism and development' approach to understanding change in the wake of the tsunami. Focusing on gender alone is insufficient. (author's) Language: English Keywords: SRI LANKA | RESEARCH REPORT | INTERVIEWS | WOMEN | WIDOWED | NATURAL DISASTERS | SOCIAL PSYCHOLOGY | SOCIAL BEHAVIOR | CHANGES | SOCIAL DEVELOPMENT | Developing Countries | Asia, Southern | Asia | Data Collection | Research Methodology | Demographic Factors | Population | Marital Status | Nuptiality | Environment | Psychology | Social Sciences | Science | Sociocultural Factors | Behavior | Social Change | Economic Factors Document Number: 329284 |
| 9. Title: Life expectancy and human capital investments: Evidence from maternal mortality declines. Author: Jayachandran S; Lleras-Muney A Source: Cambridge, Massachusetts, National Bureau of Economic Research, 2008 Apr. 51 p. (NBER Working Paper No. 13947) Abstract: Longer life expectancy should encourage human capital accumulation, since a longer time horizon increases the value of investments that pay out over time. Previous work has been unable to determine the empirical importance of this life-expectancy effect due to the difficulty of isolating it from other effects of health on education. We examine a sudden drop in maternal mortality risk in Sri Lanka between 1946 and 1953, which creates a sharp increase in life expectancy for school-age girls without contemporaneous effects on health, and which also allows for the use of boys as a control group. Using additional geographic variation, we find that the 70% reduction in maternal mortality risk over the sample period increased female life expectancy at age 15 by 4.1%, female literacy by 2.5%, and female years of education by 4.0%. (author's) Language: English Keywords: SRI LANKA | RESEARCH REPORT | THEORETICAL MODELS | VITAL STATISTICS | LIFE EXPECTANCY | MATERNAL MORTALITY | MORTALITY DECLINE | SEX FACTORS | LITERACY | EDUCATION | ECONOMIC FACTORS | INCOME | GEOGRAPHIC FACTORS | Asia, Southern | Asia | Developing Countries | Research Methodology | Population Statistics | Length of Life | Mortality | Population Dynamics | Demographic Factors | Population | Population Characteristics | Educational Status | Socioeconomic Status | Socioeconomic Factors Document Number: 326614 |
| 10. Title: Extensive microsatellite diversity in the human malaria parasite Plasmodium vivax. Author: Karunaweera ND; Ferreira MU; Munasinghe A; Barnwell JW; Collins WE Source: Gene. 2008 Feb 29;410(1):105-112. Abstract: The population structure of Plasmodium vivax remains elusive. The markers of choice for large-scale population genetic studies of eukaryotes, short tandem repeats known as microsatellites, have been recently reported to be less polymorphic in P. vivax. Here we investigate the microsatellite diversity and geographic structure in P. vivax, at both local and global levels, using 14 new markers consisting of tri- or tetranucleotide repeats. The local-level analysis, which involved 50 field isolates from Sri Lanka, revealed unexpectedly high diversity (average virtual heterozygosity [H/e], 0.807) and significant multilocus linkage disequilibrium in this region of low malaria endemicity. Multiple-clone infections occurred in 60% of isolates sampled in 2005. The global-level analysis of field isolates or monkey-adapted strains identified 150 unique haplotypes among 164 parasites from four continents. Individual P. vivax isolates could not be unambiguously assigned to geographic populations. For example, we found relatively low divergence among parasites from Central America, Africa, Southeast Asia and Oceania, but substantial differentiation between parasites from the same continent (South Asia and Southeast Asia) or even from the same country (Brazil). Parasite relapses, which may extend the duration of P. vivax carriage in humans, are suggested to facilitate the spread of strains across continents, breaking down any pre-existing geographic structure. (author's) Language: English Keywords: SRI LANKA | CENTRAL AMERICA | ASIA | AFRICA | BRAZIL | RESEARCH REPORT | MALARIA | POPULATION GENETICS | PARASITES | LABORATORY PROCEDURES | Asia, Southern | Developing Countries | Latin America | Americas | South America, Eastern | South America | Parasitic Diseases | Diseases | Genetics | Biology | Laboratory Examinations and Diagnoses | Examinations and Diagnoses | Medical Procedures | Medicine | Health Services | Delivery of Health Care | Health Document Number: 326244 |
| 11. Title: The use of websites for disseminating health information in developing countries: an experience from Sri Lanka. Author: Kommalage M; Thabrew A Source: International Journal of Electronic Healthcare. 2008;4(3-4):327-38. Abstract: This study was designed to investigate the use of websites as a health education medium in Sri Lanka. Approximately 87.2% of the websites contained less than 100 webpages. The quality score was higher in the websites owned by local nonbusiness organisations compared to the websites owned by business organisations. Only 8.1% of the websites provided health education content for the general public as their main content. The total number of websites has not increased compared to the increase in internet usage in Sri Lanka during the last few years. The internet is an underutilised health education tool despite the growth of internet usage in Sri Lanka. Language: English Keywords: SRI LANKA | DEVELOPING COUNTRIES | RESEARCH REPORT | HEALTH EDUCATION | INTERNET | INFORMATION | INFORMATION DISTRIBUTION | Asia, Southern | Asia | Education | Information Networks | Communication Document Number: 331014 |
| 12. Peer Reviewed Title: Reproductive health concerns in six conflict-affected areas of Sri Lanka. Author: Kottegoda S; Samuel K; Emmanuel S Source: Reproductive Health Matters. 2008 May;16(31):75-82. Abstract: This article draws on a study conducted by the Women and Media Collective between 2004 and 2005 to highlight some of the reproductive health concerns of women from Sinhalese, Tamil and Muslim ethnic groups, living in situations of conflict in Sri Lanka. The study focussed on women from six conflict-affected areas in the north and east of the country: Jaffna (Northern Province), Mannar and Puttalam (North-Western Province), Polonnaruwa (North-Central Province), Batticaloa and Ampara (Eastern Province). Higher levels of poverty, higher rates of school drop-out, low pay and precarious access to work, mainly in the informal sector, higher rates of early marriage, pregnancy and home births, higher levels of maternal mortality and lower levels of contraceptive use were found. Economic, social and physical insecurity were key to these phenomena. Physically and psychologically, women were at high risk of sexual and physical violence, mainly from their partners/spouses but also from family members, often related to dowry. The article brings out the voices of women whose lives have been overshadowed by conflict and displacement, and the nature of structural barriers that impede their right to health care services, to make informed decisions about their lives and to live free of familial violence. (author's) Language: English Keywords: SRI LANKA | RESEARCH REPORT | ETHNIC GROUPS | INTERNALLY DISPLACED PERSONS | REPRODUCTIVE HEALTH | WAR | HEALTH SERVICES | SOCIOECONOMIC STATUS | SOCIOCULTURAL FACTORS | ADOLESCENT PREGNANCY | DOMESTIC VIOLENCE | SEXUAL ABUSE | Asia, Southern | Asia | Developing Countries | Cultural Background | Population Characteristics | Demographic Factors | Population | Settlement and Resettlement | Migration | Population Dynamics | Health | Political Factors | Delivery of Health Care | Socioeconomic Factors | Economic Factors | Reproductive Behavior | Fertility | Crime | Social Problems Document Number: 327192 |
| 13. Peer Reviewed Title: A simple screening approach for assessing community prevalence and phenotype of polycystic ovary syndrome in a semiurban population in Sri Lanka. Author: Kumarapeli V; Seneviratne RD; Wijeyaratne CN; Yapa RM; Dodampahala SH Source: American Journal of Epidemiology. 2008;168(3):321-328. Abstract: In most of South Asia, prevalences and phenotypes of polycystic ovary syndrome (PCOS) among women in the community are unknown. The authors aimed to estimate prevalence and phenotype in a community setting in Sri Lanka and to test a valid, feasible screening approach to early diagnosis. A community-based, cross-sectional study was carried out in 2005-2006. A random sample of 3,030 women aged 15-39 years was selected by cluster sampling proportionate to population size. An interviewer-administered questionnaire was utilized to screen for "probable cases" of PCOS based on menstrual history and clinical manifestations of hyperandrogenism. Selected "probable cases" underwent clinical, biochemical, and ovarian ultrasound assessment. The response rate was 96.2% (n = 2,915). A total of 220 (7.5%) "probable cases" were identified: 209 women with oligo/amenorrhea (95%) and 11 women with hirsutism (5%). Further evaluation of the 220 probable cases confirmed 164 newly diagnosed cases of PCOS based on the 2003 Rotterdam diagnostic criteria. With 19 previously diagnosed cases already present, total prevalence was 6.3% (95% confidence interval: 5.9, 6.8). Of the women with "oligo/amenorrhea and/or hirsutism," 91.1% were confirmed to have PCOS; 99.4% of women with "regular cycles in the absence of clinical hyperandrogenism" were confirmed as normal. The most common phenotypes of PCOS were oligo/amenorrhea and polycystic ovaries (91.4%) and oligo/amenorrhea and hirsutism (48.3%). Language: English Keywords: SRI LANKA | RESEARCH REPORT | METHODOLOGICAL STUDIES | EPIDEMIOLOGIC METHODS | CLINICAL RESEARCH | CROSS SECTIONAL ANALYSIS | GENETIC TECHNIQUES | KAP SURVEYS | COMMUNITY | URBAN POPULATION | PREVALENCE | OVARIAN CYSTS | SCREENING | GENETICS | MENSTRUAL CYCLE | Developing Countries | Asia, Southern | Asia | Research Methodology | Laboratory Examinations and Diagnoses | Examinations and Diagnoses | Medical Procedures | Medicine | Health Services | Delivery of Health Care | Health | Surveys | Sampling Studies | Studies | Residence Characteristics | Population Distribution | Geographic Factors | Population | Population Characteristics | Demographic Factors | Measurement | Diseases | Biology | Menstruation | Reproduction Document Number: 327748 |
| 14. Title: Adequacy of vitamin A and fat in the breast milk of lactating women in south Sri Lanka. Author: Liyanage C; Hettiarachchi M; Mangalajeewa P; Malawipathirana S Source: Public Health Nutrition. 2008 Jul;11(7):747-50. Abstract: OBJECTIVE: To determine vitamin A (retinol) and fat concentrations in breast milk during early lactation. METHODS: Healthy lactating women (n 88) aged between 18 and 35 years were randomly selected for the study from urban, semi-urban, rural and estate (plantation) sectors of Galle District. Their anthropometry was recorded; breast milk samples were collected from the right breast one hour after the last feed. Breast milk retinol was determined by HPLC and fat content by the crematocrit method. RESULTS: Subjects were in the 2nd to 9th month of lactation. Retinol concentrations of the breast milk samples ranged from 0.10 to 2.46 micromol/l, with a mean of 0.50 micromol/l, and correlated positively with parity (Pearson correlation coefficient, r = 0.307; P = 0.01) and negatively with period of lactation (r = -0.209; P = 0.05). The fat content of breast milk ranged between 5.09 and 56.46 g/l with a mean of 26.95 g/l. A significant difference in either breast milk fat or retinol content and mean birth weight of the babies was not seen between the groups. The ratio of retinol to fat in breast milk was positively correlated with weight (r = 0.274; P = 0.01) and height (r = 0.328; P < 0.001) of the mothers. CONCLUSIONS: In this primary investigation on breast milk quality the fat content was found to be marginal; the majority of lactating mothers (92.0%) were not providing the minimum daily requirement (1.05 micromol/l) of retinol to their babies. Language: English Keywords: SRI LANKA | RESEARCH REPORT | ANTHROPOMETRY | WOMEN | HUMAN MILK | LACTATION | VITAMIN A | LIPIDS | TIME FACTORS | Developing Countries | Asia, Southern | Asia | Measurement | Research Methodology | Demographic Factors | Population | Maternal Physiology | Physiology | Biology | Vitamins and Minerals | Population Dynamics Document Number: 328817 |
| 15. Title: "Violence Is an International Language" Tamil women's perceptions of intimate partner violence. Author: Mason R; Hyman I; Berman H; Guruge S; Kanagaratnam P Source: Violence Against Women. 2008 Dec;14(12):1397-1412. Abstract: Research on intimate partner violence (IPV) across populations is challenging because of the multiplicity of definitions and lack of clarity about the behaviors that constitute IPV. The purpose of this study was to examine the ways in which Sri Lankan Tamil women in Toronto understand, define, and experience IPV. Focus group interviews were conducted with women representing different ages and stages of life. Findings suggest that definitions of IPV were not culturally specific. Rather, the Tamil women defined IPV broadly and recognized different forms of coercive control. However, psychologically abusive behaviors were identified that held particular meanings for this community. Language: English Keywords: SRI LANKA | RESEARCH REPORT | CROSS-CULTURAL COMPARISONS | COUPLES | DOMESTIC VIOLENCE | PSYCHOLOGICAL ABUSE | PERCEPTION | Developing Countries | Asia, Southern | Asia | Comparative Studies | Studies | Research Methodology | Family Characteristics | Family and Household | Sociocultural Factors | Crime | Social Problems | Aggression | Behavior | Psychological Factors Document Number: 340221 |
| 16. Title: Diagnosis of tuberculous lymphadenitis: combining cytomorphology, microbiology and molecular techniques - a study from Sri Lanka. Author: Mudduwa LK; Nagahawatte Ade S Source: Indian Journal of Pathology and Microbiology. 2008 Apr-Jun;51(2):195-7. Abstract: BACKGROUND: Fine needle aspiration is a simple technique to obtain material for early diagnosis of tuberculous lymphadenitis. Objective: To assess the value of fine needle aspiration cytology (FNAC) in the diagnosis of tuberculous lymphadenitis. MATERIALS AND METHODS: A total of 43 aspirates from patients who were clinically suspected to have tuberculous lymphadenitis were included in the study. Apart from FNAC, aspirates were smeared for Ziehl Neelsen stain and cultured on Middlebrook 7H9 and 7H10 media. Culture was considered the gold standard. Positive and negative predictive values and agreement between the gold standard and five diagnostic criteria were assessed. Kappa value was used to calculate the agreement. RESULTS: The presence of epithelioid cells either with caseation or positive Ziehl Neelsen had the highest agreement (kappa value 0.84), with high positive and negative predictive values (85.71% and 96.55%). Positive Ziehl Neelsen alone and presence of epithelioid cells with positive Ziehl Neelsen had 100% positive predictive values, but the kappa values were lower (0.62 and 0.52) with lower negative predictive values (83.33% and 81.08%). Epithelioid cells alone had a high negative predictive value (93.35%), but the positive predictive value was lower (84.62%). When epithelioid cells were taken together with caseation, the positive predictive value reduced further (83.33%). CONCLUSION: The presence of epithelioid cells either with caseation or positive Ziehl Neelsen stain appears to be the best diagnostic criteria, with a very good agreement with the gold standard and high positive and negative predictive values. Language: English Keywords: SRI LANKA | RESEARCH REPORT | METHODOLOGICAL STUDIES | CLINICAL RESEARCH | COMPARATIVE STUDIES | TARGET POPULATION | TUBERCULOSIS | LABORATORY EXAMINATIONS AND DIAGNOSES | CYTOLOGY | Developing Countries | Asia, Southern | Asia | Research Methodology | Studies | Program Design | Programs | Organization and Administration | Infections | Diseases | Examinations and Diagnoses | Medical Procedures | Medicine | Health Services | Delivery of Health Care | Health | Biology Document Number: 328987 |
| 17. Title: Effects of placental infarctions on the fetal outcome in pregnancies complicated by hypertension. Author: Salgado SS; Pathmeswaran A Source: Journal of the College of Physicians and Surgeons, Pakistan. 2008;18(4):213-216. Abstract: The objective was to determine the frequency of placental infarcts and its effects on the fetal outcome in pregnancies complicated by hypertension. The study design was a case control. The place and duration of study was the Obstetrics Unit of North Colombo Teaching Hospital, Ragama, Sri Lanka, from January 2003 to January 2004. Placentae of 150 normotensive women and 200 hypertensive women were studied to detect the number of placentae with infarctions. Apgar score, birth weight and the head circumference of the newborns were measured and analyzed. The frequency of placental infarcts was significantly higher in hypertensive group (30%) compared to normotensive group (18.7%). An association between placental infarction and low Apgar score of the newborn was seen in the hypertensive group (p less than 0.001). The difference in the birth weight of the newborns in hypertensive and normotensive groups in relation to placental infarction was statistically significant (2.2 vs. 3.1 kg, p less than 0.001). A highly significant difference was observed in the head circumference of the newborns of hypertensive group compared to normotensive group in relation to placental infarctions (30.7 cm vs. 32.3 cm, p less than 0.001). The frequency of placental infarcts was higher in hypertensive women when compared to normotensives. Placental infarctions had an adverse effect on growth and development of the newborns. This information can be useful in planning and management of future pregnancies. (author's) Language: English Keywords: SRI LANKA | RESEARCH REPORT | CASE CONTROL STUDIES | PREGNANT WOMEN | PREECLAMPSIA | HYPERTENSION | FETAL TISSUE | BIRTH WEIGHT | ANTHROPOMETRY | Asia, Southern | Asia | Developing Countries | Studies | Research Methodology | Population Characteristics | Demographic Factors | Population | Pregnancy Complications | Diseases | Vascular Diseases | Fetal Membranes | Fetus | Pregnancy | Reproduction | Body Weight | Physiology | Biology | Measurement Document Number: 326957 |
| 18. Title: The demography of South Asia from the 1950s to the 2000s: a summary of changes and a statistical assessment. Author: Veron J Source: Population-E. 2008;63(1):9-90. Abstract: The countries of South Asia (Afghanistan, Bangladesh, Bhutan, India, the Maldives, Nepal, Pakistan and Sri Lanka) cover less than 4% of the Earth's surface, but their combined population of some 1.6 billion inhabitants in 2007 represents nearly a quarter of the world total. India, the largest country in the region, alone has 1.17 billion inhabitants. This chronicle charts the main demographic trends since the 1950s, which are explained in part by the countries' diverse levels of development. Their demographic transitions also exhibit broad diversity. There is no single transition model specific to the region, just as there is no single transition in India, as the comparison of its states makes clear. Except in Sri Lanka, where the process is complete, the fertility transition is ongoing, and the mortality transition is in general very advanced. The potential for demographic growth remains high in South Asia, and the United Nations expects the region's population to grow by 600 million inhabitants up to 2040. The future course of demographic change has major implications for development, since most of the countries need to reduce poverty and raise educational levels while at the same time coping with rapid urban growth and addressing environmental issues. (author's) Language: English Keywords: AFGHANISTAN | BANGLADESH | BHUTAN | INDIA | MALDIVES | NEPAL | PAKISTAN | SRI LANKA | RESEARCH REPORT | DEMOGRAPHIC TRANSITION | POPULATION GROWTH | SOCIOECONOMIC FACTORS | POPULATION DYNAMICS | MIGRATION | FERTILITY CHANGES | CONTRACEPTIVE USAGE | MORTALITY CHANGES | URBANIZATION | Asia, Southern | Asia | Developing Countries | Demographic Factors | Population | Economic Factors | Fertility | Contraception | Family Planning | Mortality | Urban Population Distribution | Population Distribution | Geographic Factors Document Number: 327925 |
| 19. Title: Breastfeeding practices in a public health field practice area in Sri Lanka: A survival analysis. Author: Agampodi SB; Agampodi TC; Piyaseeli UD Source: International Breastfeeding Journal. 2007 Oct 11;2(1):[23] p. Abstract: Exclusive breastfeeding up to the completion of the sixth month of age is the national infant feeding recommendation for Sri Lanka. The objective of the present study was to collect data on exclusive breastfeeding up to six months and to describe the association between exclusive breastfeeding and selected socio-demographic factors. A clinic based cross-sectional study was conducted in the Medical Officer of Health area, Beruwala, Sri Lanka in June 2006. Mothers with infants aged 4 to 12 months, attending the 19 child welfare clinics in the area were included in the study. Infants with specific feeding problems (cleft lip and palate and primary lactose intolerance) were excluded. Cluster sampling technique was used and consecutive infants fulfilling the inclusion criteria were enrolled. A total of 219 mothers participated in the study. The statistical tests used were survival analysis (Kaplan-Meier survival curves and Cox proportional Hazard model). All 219 mothers had initiated breastfeeding. Themedian duration of exclusive breastfeeding was four months (95% CI 3.75, 4.25). The rates of exclusive breastfeeding at 4 and 6 months were 61.6% (135/219) and 15.5% (24/155) respectively. Bivariate analysis showed that the Muslim ethnicity (p = 0.004), lower levels of parental education (p less than 0.001) and being an unemployed mother (p = 0.021) were important associations of early cessation of exclusive breastfeeding. At the time of the study, 62% (135/219) of infants were receiving feeds via a bottle and 23% (51/219) were receiving infant formula. Muslim ethnicity was significantly associated with bottle and formula feeding (p less than 0.001). Bottle feeding was also significantly higher among mothers with a low level of education and among employed mothers. The rate of breastfeeding initiation and exclusive breastfeeding up to the fourth month is very high in Medical Officer of Health area, Beruwala, Sri Lanka. However exclusive breastfeeding up to six months is still low and the prevalence of inappropriate feeding practices is high. (author's) Language: English Keywords: SRI LANKA | RESEARCH REPORT | CROSS SECTIONAL ANALYSIS | BREASTFEEDING, EXCLUSIVE | PREVALENCE | MOTHERS | SOCIOECONOMIC STATUS | ISLAM | Asia, Southern | Asia | Developing Countries | Research Methodology | Breastfeeding | Infant Nutrition | Nutrition | Health | Measurement | Parents | Family Relationships | Family Characteristics | Family and Household | Sociocultural Factors | Socioeconomic Factors | Economic Factors | Religion Document Number: 313910 |
| 20. Title: Private sector contribution to childhood immunization: Sri Lankan experience. Author: Agampodi SB; Amarasinghe DA Source: Indian Journal of Medical Sciences. 2007 Apr;61(4):192-199. Abstract: The main service provider for childhood immunization in Sri Lanka is the government sector. However, utilization of private sector for childhood immunization is increasing rapidly. Existing national immunization data does not routinely include statistics on private sector immunization delivery adequately. The objective was to estimate the proportion of children immunized in the private sector; describe sociodemographic characteristics of private sector users and compare these with government sector users. A community-based cross-sectional descriptive study was conducted using a pre-tested interviewer-administered structured questionnaire. This was done in the Colombo municipal council area using the WHO 30 cluster methodology. The total number of households in the sample was 553. Out of the 5,028 total immunizations reported in the present study, around one-third (2,544) was obtained through the private sector. Nineteen percent (104) of children were exclusively immunized from the private sector. The distribution of usual immunization provider was - government sector 72.3% (400) and private sector 27.7% (153). Significant differences were observed (P < 0.001) between private and government sector users with regard to family income, social class, ethnicity, religion and educational level of the mother. The age-appropriate immunization among the 12- to 23-month age group was 92.3% (144) in the government sector, whereas it was 95% (38) in the private sector. Among the 24- to 35-month age group, it was 91.7% (121) and 92.7% (76) respectively. The age-adjusted immunization coverage rates were almost same among the government and private sector users except for the measles vaccine, where the private sector users had significantly (P = 0.016) higher coverage. Utilization of private sector immunization services is high in the Colombo municipal council area. (author's) Language: English Keywords: SRI LANKA | RESEARCH REPORT | KAP SURVEYS | CROSS SECTIONAL ANALYSIS | CHILDREN | PRIVATE SECTOR | IMMUNIZATION | UTILIZATION OF HEALTH CARE | PREVALENCE | Asia, Southern | Asia | Developing Countries | Surveys | Sampling Studies | Studies | Research Methodology | Youth | Age Factors | Population Characteristics | Demographic Factors | Population | Macroeconomic Factors | Economic Factors | Primary Health Care | Health Services | Delivery of Health Care | Health | Measurement Document Number: 318146 |
| 21. Peer Reviewed Title: Disaster mitigation and furthering women's rights: learning from the Tsunami. Author: Akerkar S Source: Gender Technology and Development. 2007;11(3):357-388. Abstract: Vulnerability has long been accepted as an important factor in post-disaster recovery which affects the ability of the survivors to recover from multi-dimensional impacts. This comparative and cross-cultural study of the effects of tsunami on women in four countries looks more closely into the factors and processes that have led to the exclusion of certain groups of women from relief and recovery assistance. These include female heads of households, widows, the elderly and those belonging to marginalized groups such as migrants and stateless communities. Examining the current gender-neutral framing of social protection systems in the disaster areas and their operations, I show that vulnerability is not only an outcome of localized and individual dimensions like age, gender and marital status but that they have deeper relations with national and global powers who perpetuate institutionalized discrimination through such systems, and how they are unable to give these groups of women the much needed protection and assistance to live with dignity. A case is made for the recognition of compounded discrimination based on the fact that their vulnerable positions prior to the disaster have indeed led to their exclusion from relief and recovery activities, leaving them poorer and worst-off. Further, to redress this trend I propose a women's human rights strategy in disaster management which adopts as its core a combination of the recognition of vulnerability derived from identities with corresponding gender-based redistributive principles to be integrated in policies, practices and social protection systems. As a discursive construct, the women's human rights approach in disasters would not only reduce the vulnerability of disaster survivors but also create new gender-just post-disaster societies. (author's) Language: English Keywords: INDIA | SRI LANKA | INDONESIA | THAILAND | SOMALIA | MALDIVES | RESEARCH REPORT | COMPARATIVE STUDIES | WOMEN | NATURAL DISASTERS | HUMAN RIGHTS | SOCIAL DISCRIMINATION | PARTICIPATION | NATURAL RESOURCES | IMPACT | PROGRAM ACCESSIBILITY | Asia, Southern | Asia | Developing Countries | Asia, Southeastern | Africa, Eastern | Africa, Sub Saharan | Africa | Studies | Research Methodology | Demographic Factors | Population | Environment | Political Factors | Sociocultural Factors | Social Problems | Social Behavior | Behavior | Communication | Program Evaluation | Programs | Organization and Administration Document Number: 329310 |
| 22. Peer Reviewed Title: Intestinal parasites and the growth status of internally displaced children in Sri Lanka. Author: Chandrasena TG; Hapuarachchi HC; Dayanath MY; Pathmeswaran A; de Silva NR Source: Tropical Doctor. 2007 Jul;37(3):163-165. Abstract: The growth status and intestinal parasitic infections among a group of children displaced by war in Sri Lanka was investigated. There was a high prevalence of growth retardation (wasting, stunting and underweight being 41%, 28% and 69.9%, respectively) and intestinal parasitic infections (40.2%) among the study population. Provision of adequate food, purified drinking water, sanitation and broad-spectrum anthelmintics is recommended. (author's) Language: English Keywords: SRI LANKA | RESEARCH REPORT | CLINICAL RESEARCH | INTERNALLY DISPLACED PERSONS | CHILDREN | PARASITES | PARASITIC DISEASES | GROWTH | BODY HEIGHT | BODY WEIGHT | WAR | PREVALENCE | CHILD NUTRITION | Asia, Southern | Asia | Developing Countries | Research Methodology | Settlement and Resettlement | Migration | Population Dynamics | Demographic Factors | Population | Youth | Age Factors | Population Characteristics | Biology | Diseases | Child Development | Physiology | Political Factors | Sociocultural Factors | Measurement | Nutrition | Health Document Number: 324907 |
| 23. Title: Morbidity and mortality associated with pre-eclampsia at two tertiary care hospitals in Sri Lanka. Author: Dissanayake VH; Samarasinghe HD; Morgan L; Jayasekara RW; Seneviratne HR Source: Journal of Obstetrics and Gynaecology Research. 2007 Feb;33(1):56-62. Abstract: The aim was to report the occurrence of morbidity and mortality associated with carefully phenotyped pre-eclampsia in a sample of nulliparous Sinhalese women with strictly defined disease. A phenotyping database of 180 nulliparous women with pre-eclampsia and 180 nulliparous normotensive pregnant women who were recruited for a study into genetics of pre-eclampsia was analyzed. Women who developed pre-eclampsia had significantly higher systolic blood pressure (SBP; P = 0.002) and diastolic blood pressure (DBP; P = 0.002) at booking (at approximately 13 weeks of gestation). 38.3%, 28.3% and 33.3% of women delivered at < 34 weeks, at 34--36 weeks, and at term, respectively. 78% required a cesarean section. Complications included SBP = 160 mmHg (75.5%); DBP = 110 mmHg (83.8%); proteinuria = 3 + (150 mg/dL) in the urine protein heat coagulation test (87%); renal failure requiring dialysis (2%); platelet counts < 100 x 10/9/L (13%); = 70 U/L in aspartate and/or alanine aminotransaminase (15%); placentalabruption (4%); eclampsia (9%); and one maternal death. Maternal complications indicative of severe disease, apart from the incidence of SBP = 160 mmHg and DBP = 110 mmHg, were not significantly different in early and late-onset pre-eclampsia; fetal outcome was better with late-onset disease. 48% of babies were small for gestational age. Only 80 of 135 babies of women with pre-eclampsia whose condition could be confirmed at 6 weeks post-partum were alive. Pre-eclampsia in Sinhalese women is associated with severe maternal morbidity and fetal morbidity and mortality, suggesting that modification of the Western diagnostic criteria and/or guidelines for medical care may be necessary. There is an urgent need to improve neonatal intensive care services in Sri Lanka. (author's) Language: English Keywords: SRI LANKA | RESEARCH REPORT | PROSPECTIVE STUDIES | PREGNANT WOMEN | HOSPITALS | MORTALITY | NULLIPARITY | GESTATIONAL AGE | PREECLAMPSIA | TREATMENT | BLOOD PRESSURE | MORBIDITY | Developing Countries | Asia, Southern | Asia | Studies | Research Methodology | Population Characteristics | Demographic Factors | Population | Health Facilities | Delivery of Health Care | Health | Population Dynamics | Parity | Fertility Measurements | Fertility | Fetus | Pregnancy | Reproduction | Pregnancy Complications | Diseases | Medical Procedures | Medicine | Health Services | Hemic System | Physiology | Biology Document Number: 314471 |
| 24. Title: Use of unsafe condoms and unsafe use of good condoms [letter] Author: Jayawardena H Source: Reproductive Health Matters. 2007 May;15(29):192. Abstract: FOLLOWING from the article on unsafe condoms and other unsafe sex accessories by Ditmore and Neth in your November 2006 journal, I would like to point out that the practice of unsafe use of good quality condoms is also an issue that needs to be addressed. In a study among 47 sex workers that I recently concluded in 2005 in Sri Lanka, almost half the women (44.7%) said they had experienced breakage of condoms during their professional life. This seemed very high considering the fact that the average number of years they had been in the sex trade was 5.4 years (SD 5.62).Upon further inquiry, it became clear that the condom-breakage was due not to accidental damage or the poor quality of condoms but the result of purposeful condom damage on the part of clients. Sex workers said that they soon come to know when a condom is broken as they can feel it. Condom breakage, they said, was often preceded by the man slipping his penis out of the vagina, seemingly inadvertently, and manually re-inserting it. During the re-insertion the man would purposely damage the condom with his fingernails. This was not inadvertent but an attempt to deceive the sex worker. When the sex worker realised the condom had been broken, she would stop sexual activity to get the client to put on another one. A few of the women also said they verbally abused clients who did such things. (excerpt) Language: English Keywords: SRI LANKA | SUMMARY REPORT | WOMEN | SEX WORKERS | CONDOM FAILURE | SAFETY | Developing Countries | Asia, Southern | Asia | Demographic Factors | Population | Sex Behavior | Behavior | Condoms | Barrier Methods | Contraceptive Methods | Contraception | Family Planning | Public Health | Health Document Number: 316702 |
| 25. Title: Birds of freedom? Perspectives on female emancipation and Sri Lanka's liberation tigers of Tamil Eelam. Author: Jordan K; Denov M Source: Journal of International Women's Studies. 2007 Nov;9(1):42-62. Abstract: Over the last decade, females have been an integral part of fighting forces in both international conflicts and in armed struggle in at least 38 internal conflicts. While some scholars argue that recent wars have thrust women into new roles, enabling them to transform their social situations, identities and destinies, others question whether females achieve 'emancipation' through active participation in warfare. The Liberation Tigers of Tamil Eelam (LTTE) in Sri Lanka that has been engaged in conflict with the Sri Lankan government since 1983, and actively recruits female cadres, provides an interesting context to explore issues of female empowerment in the context of armed struggle. Drawing from interviews with four Sri Lankans living in Canada, this paper traces the perceived extent of female emancipation within the LTTE. While the participation of females in unconventional military roles represents a drastic change in behaviour expected of Tamil women, the militant movement appears to reinforceexisting patterns of gender constructions, ultimately impeding the attainment of meaningful empowerment for females. (author's) Language: English Keywords: SRI LANKA | RESEARCH REPORT | MILITARY PERSONNEL | GENDER ISSUES | WAR | FEMALE ROLE | WOMEN'S EMPOWERMENT | PERCEPTION | INTERVIEWS | CULTURE | Asia, Southern | Asia | Developing Countries | Government | Political Factors | Sociocultural Factors | Social Behavior | Behavior | Women's Status | Socioeconomic Factors | Economic Factors | Psychological Factors | Data Collection | Research Methodology Document Number: 323703 |
| 26. Title: Morbidity and mortality associated with pre-eclampsia at two tertiary care hospitals in Sri Lanka [letter] Author: Marasinghe JP; Amarasinghe AA Source: Journal of Obstetrics and Gynaecology Research. 2007 Dec;33(6):888. Abstract: The exercise by Dissanayake et al. made an interesting read. Their conclusion that pre-eclampsia in Sinhalese women is associated with increased maternal morbidity, and fetal morbidity and mortality is an eye opener to the local health-care providers, policy makers and program managers. It also invites further studies on blood pressure variation during pregnancy in Sinhalese women and the postulation of a different cut-off level for diagnosing elevated blood pressure in pregnancy. It may be prudent to educate local obstetricians and other care providers of pregnant women of the detrimental effects of delaying intervention until blood pressure reaches 140/90 mmHg, and the likelihood of developing more severe disease by the time the blood pressure reaches the cut-off level, which seems to be more suitable for Caucasian women. The study re-evaluates the importance of pre-pregnancy counseling and assessment, including blood pressure in fertile women, in assessing the rise in blood pressure. As the authors correctly suggest, there is an urgent need to invest in specialized maternal care services managing women with pre-eclampsia and neonatal intensive care services in Sri Lanka. In the meantime, there are a few drawbacks to the study which need to be considered. The two hospitals utilized to recruit the study samples were teaching hospitals in metropolitan Colombo. These institutions represented only a prescreened and referred group of women from local hospitals and antenatal clinics. So, the applicability of the results generated to a larger population is questionable. There may be a type II error accounting for the statistically non-significant result obtained with the booking blood pressures of early onset and late onset groups of pre-eclampsia. This is in contrast to our day-to-day experience in which we often see fluctuating blood pressure values with on-and-off higher readings in early onset preeclamptic patients. The value of uterine artery Doppler in detecting such a subtle change may need to be considered with its reasonable sensitivity, specificity, rapidity and non-invasiveness in detecting pregnancies destined to develop pre-eclampsia. Though Sri Lanka is not yet ready to supplement all pregnant mothers with a Doppler analysis, the future is promising. Moreover it is well-known that blood pressure is poorly measured in clinical practice, with digit preference (rounding the final digit of blood pressure to 0). We failed to find a note on this regard in the study. The study does however add some valuable tips to our existing knowledge on gestational hypertension in Sri Lankan women. It opens the door for further studies to generate a novel diagnostic criterion for preeclampsia for Sri Lankan women. (full text) Language: English Keywords: SRI LANKA | CRITIQUE | RECOMMENDATIONS | CLINICAL RESEARCH | PREGNANT WOMEN | WOMEN IN DEVELOPMENT | PREECLAMPSIA | PREGNANCY COMPLICATIONS | FETAL DEATH | BLOOD PRESSURE | MONITORING | ULTRASONICS | Asia, Southern | Asia | Developing Countries | Research Methodology | Population Characteristics | Demographic Factors | Population | Economic Development | Economic Factors | Diseases | Mortality | Population Dynamics | Hemic System | Physiology | Biology | Evaluation | Medical Procedures | Medicine | Health Services | Delivery of Health Care | Health Document Number: 322697 |
| 27. Title: Nitric oxide donor isosorbide mononitrate for pre-induction cervical ripening at 41 weeks' gestation: A randomized controlled trial. Author: Rameez MF; Goonewardene IM Source: Journal of Obstetrics and Gynaecology Research. 2007 Aug;33(4):452-456. Abstract: Nitric oxide donors have been shown to cause cervical ripening. The aim of this study was to determine whether sustained release isosorbide mononitrate (ISMN-SR) 60 mg administered vaginally is effective for pre induction cervical ripening at 41 weeks' gestation. A double-blind randomised controlled trial was carried out at the University Obstetric Unit, Galle, Sri Lanka for a period of 9 months, commencing 1st August 2003. One hundred and fifty-six consecutive women with uncomplicated singleton pregnancies at 41 weeks' gestation with a modified Bishop Score <5 were allocated by stratified (primip/multip) block randomization to receive either ISMN-SR 60 mg (n = 78) or vitamin C 100 mg (n = 78) vaginally. Modified Bishop Score at 41 weeks + 2 days' gestation and the proportions establishing spontaneous labor or becoming favorable for induction of labor (IOL) by 41 weeks + 2 days' gestation were evaluated in each group. At the commencement of the study there were no differences between the mean age,parity or modified Bishop Score of the two groups. In the ISMN-SR group, there was a marked increase in the proportion establishing spontaneous labor (28% vs 7.5%, P < 0.01) and being favorable for IOL (40% vs 9% P < 0.001), 2 days after therapy. In the ISMN-SR group, there was a significantly higher increase in the mean modified Bishop Score (3.8, 95% CI 2.3-5.3 vs 1.3, 95% CI 0.3-2.2, P < 0.01) and a marked decrease in the proportion of subjects requiring further ripening of the cervix with a Foley catheter. (32% vs 79%, P < 0.001). The cesarean section rates were similar in both groups. Sustained release ISMN administered vaginally is effective for preinduction cervical ripening. (author's) Language: English Keywords: SRI LANKA | RESEARCH REPORT | CLINICAL TRIALS | PREGNANT WOMEN | PREGNANCY, THIRD TRIMESTER | ASCORBIC ACID | DRUGS | ADMINISTRATION AND DOSAGE | CHILDBIRTH | CERVICAL EFFECTS | CONTRACEPTIVE USE-EFFECTIVENESS | Asia, Southern | Asia | Developing Countries | Clinical Research | Research Methodology | Population Characteristics | Demographic Factors | Population | Pregnancy | Reproduction | Vitamins and Minerals | Physiology | Biology | Treatment | Medical Procedures | Medicine | Health Services | Delivery of Health Care | Health | Pregnancy Outcomes | Cervix | Uterus | Genitalia, Female | Genitalia | Urogenital System | Contraceptive Effectiveness | Contraception | Family Planning Document Number: 319415 |
| 28. Title: Awareness and action: The ethno-gender dynamics of Sri Lankan NGOs. Author: Ruwanpura KN Source: Gender, Place and Culture. 2007 Jun;14(3):317-333. Abstract: Non-governmental organizations (NGOs) are the modus operandi in the development arena at this juncture. Many, including feminists, place much faith in these actors for creating a progressive space for social, political, and economic activities to be undertaken. This article employs fieldwork evidence from eastern Sri Lanka, carried out in 1998-1999 and early 2004, to challenge this simplistic reading. The primary social group that was studied during the fieldwork period was female-headed households. This article argues that there are different types of NGO working in multiple ways in the region, and it is important to distinguish between these differences. NGOs that primarily execute development-oriented projects without considering the ethno-nationalist and gender politics are culpable of the violence of development. It is only when NGOs are in local communities for the long haul that they are able to develop a commitment to reassess and evaluate the social transformative potential of their activities. Using a feminist political economy perspective this article argues that it is important and necessary that NGOs confront social, political, and economic structures, including ethnic identity politics, if their activities are to lead to transformative feminist politics. In other words, NGOs would have to do more than pay lip service to gender mainstreaming, as is more often the case. These actors need to recognize and understand the potency of ethno-nationalist politics, social structures, social exclusion, and social injustice in order to create social spaces that are enabling of women's agency in the local communities within which they work and operate. (author's) Language: English Keywords: SRI LANKA | RESEARCH REPORT | QUALITATIVE RESEARCH | NONGOVERNMENTAL ORGANIZATIONS | ETHNIC GROUPS | WOMEN IN DEVELOPMENT | HEAD OF HOUSEHOLD | DEMOGRAPHY | GENDER RELATIONS | POLITICAL FACTORS | SEX DISCRIMINATION | SOCIAL CHANGE | FEMINISM | Developing Countries | Asia, Southern | Asia | Research Methodology | Organizations | Sociocultural Factors | Cultural Background | Population Characteristics | Demographic Factors | Population | Economic Development | Economic Factors | Households | Family and Household | Social Sciences | Science | Gender Issues | Social Discrimination | Social Problems Document Number: 313552 |
| 29. Title: Effect of training for care providers on practice of essential newborn care in hospitals in Sri Lanka. Author: Senarath U; Fernando DN; Rodrigo I Source: Journal of Obstetric, Gynecologic, and Neonatal Nursing. 2007 Nov-Dec;36(6):531-541. Abstract: The objective was to evaluate the effectiveness of a training program for care providers in improving practice of essential newborn care in obstetric units. The design used was a before-and-after study with an intervention and a control group. The setting for the study was five hospitals in the Puttalam district in Sri Lanka. Eight hundred and ninety-two mother-newborn pairs (446 before and 446 three months after) were studied. The design used a 4-day training program on essential newborn care for doctors, nurses, and midwives of the obstetric units in two hospitals. By direct observation, practices of essential newborn care at delivery in the labor room on a subsample were measured by interviewing mothers, immediate skin-to-skin contact and early initiation of breastfeeding. From health records, "undesirable health events" of the newborns. Practices of cleanliness, thermal protection, and neonatal assessment improved significantly in the intervention group. The intervention was effective in improving skin-to-skin contact by 1.5 times and early initiation of breastfeeding by 3.4 times. Undesirable health events declined from 32 to 21 per 223 newborns in the intervention group and from 20 to 17 per 223 newborns in the control group. A comprehensive 4-day training program can be followed by a significant improvement in essential newborn care practices in obstetric units. (author's) Language: English Keywords: SRI LANKA | RESEARCH REPORT | EVALUATION | HEALTH PERSONNEL | HOSPITALS | TRAINING PROGRAMS | OBSTETRICS | ANTENATAL CARE | PERFORMANCE IMPROVEMENT | MATERNAL MORTALITY | INFANT MORTALITY | PREVENTION AND CONTROL | INTERVENTIONS | Asia, Southern | Asia | Developing Countries | Delivery of Health Care | Health | Health Facilities | Education | Medicine | Health Services | Maternal Health Services | Maternal-Child Health Services | Primary Health Care | Management | Organization and Administration | Mortality | Population Dynamics | Demographic Factors | Population | Diseases | Programs Document Number: 321818 |
| 30. Peer Reviewed Title: Factors associated with maternal knowledge of newborn care among hospital-delivered mothers in Sri Lanka. Author: Senarath U; Fernando DN; Vimpani G; Rodrigo I Source: Transactions of the Royal Society of Tropical Medicine and Hygiene. 2007 Aug;101(8):823-830. Abstract: The aim of this study was to assess mothers' knowledge on newborn care as well as factors associated with poor knowledge. A cross-sectional study sampled 446 mother-newborn pairs from five hospitals in the Puttalam district of Sri Lanka by stratified random sampling. Maternal knowledge on newborn care was assessed using a questionnaire with 50 statements via exit interview. A knowledge score was created by allocating 1 point for each correct response, which was dichotomised as 'satisfactory' or 'poor' by the median score. Only 21.7% correctly answered that 'surgical spirit' (70% isopropyl alcohol) should not be applied on the umbilical stump. More than 90% of mothers knew about breastfeeding on demand, the advantages of colostrum and the duration of exclusive breastfeeding. Except for a few conditions, mothers demonstrated a satisfactory knowledge in recognising danger signs of the newborn. According to multivariate analysis, primiparae (odds ratio (OR) = 2.31; 95% CI 1.53-3.50), unemployed women (OR = 3.31; 95% CI 1.89-5.80) and those with delayed antenatal booking visits (OR = 2.02; 95% CI 1.26-2.23) were more likely to have poor knowledge. In conclusion, mothers had a satisfactory level of knowledge about breastfeeding and recognition of danger signs, but knowledge about care of the umbilical cord was poor. Maternal education programmes should place more emphasis on first-time mothers, unemployed women and those with delayed booking visits. (author's) Language: English Keywords: SRI LANKA | RESEARCH REPORT | MOTHERS | INFANT HEALTH | KNOWLEDGE | BREASTFEEDING | IMMUNIZATION | SIGNS AND SYMPTOMS | ANTENATAL CARE | MATERNAL AGE | SOCIOECONOMIC STATUS | HEALTH EDUCATION | Asia, Southern | Asia | Developing Countries | Parents | Family Relationships | Family Characteristics | Family and Household | Sociocultural Factors | Child Health | Health | Infant Nutrition | Nutrition | Primary Health Care | Health Services | Delivery of Health Care | Diseases | Maternal Health Services | Maternal-Child Health Services | Parental Age | Age Factors | Population Characteristics | Demographic Factors | Population | Socioeconomic Factors | Economic Factors | Education Document Number: 317931 |
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