Search

Sri Lanka has one of the fastest aging populations in the world. Measurement of quality of life (QoL) in the elderly needs instruments developed that encompass the sociocultural settings. An instrument was developed to measure QoL in the young elderly in Sri Lanka (QLI-YES), using accepted methods to generate and reduce items. The measure was validated using a community sample. Construct, criterion and predictive validity and reliability were tested. A first-order model of 24 items with 6 domains was found to have good fit indices (CMIN/df = 1.567, RMR = 0.05, CFI = 0.95, and RMSEA = 0.053). Both criterion and predictive validity were demonstrated. Good internal consistency reliability (Cronbach’s α = 0.93) was shown. The development of the QLI-YES using a societal perspective relevant to the social and cultural beliefs has resulted in a robust and valid instrument to measure QoL for the young elderly in Sri Lanka.

Storage temperature plays a major role in causing changes in quality and safety of poultry meat. Product should retain its desired sensory, chemical, physical, functional and microbiological characteristics. Authorized Officers are expected to guide and inspect on food safety and security measures of the country. After conducting comprehensive food outlet inspections covering the whole Medical Officer Health (MOH) area and legal prosecutions over violation of law related to food safety, inspections of food transporting vehicles were conducted. Twenty vehicles were inspected and 7 out of them were released after giving strict advice, 3 were detained to produce before courts. By entering a plea of guilty, first two defendants were admitting their guilt and fined 67 USD each. Last case was charged against the chicken company transporting chicken at temperature of +50 Centigrade (standard -180 Centigrade), where company lawyer admitted a plea of guilt, but pleaded to release all chicken worth of 2700 USD. Usually in Sri Lankan context, temperature of container was measuring by thermometers as a spot reading of whole passage of cold chain of frozen foods. Upon the expert opinion and scientific explaining by the MOH of the impact of releasing this bulk of chicken on the health of the general public, the Magistrate made decision against the company with strict advice to maintain all vehicles in good sanitary condition, fined 67 USD and ordered to destroy the entire bulk quantity of chicken worth 2000 USD under the supervision of the MOH. This would set future reference/ benchmark in field of food safety in Sri Lanka to supervise and examine of temperature record by Authorized officers using smart phones on data lodgers, which records should be maintained by all frozen food companies thorough out their cold chain, and it can be used as weighted and firm evidence for their legal submissions in future as a complete reflection of cold chain.

Since 1950, cardiovascular disease (CVD) has emerged as a leading cause of mortality in Sri Lanka, especially in men. In 2014, a survey in Kalutara to assess CVD and type 2 diabetes mellitus (T2DM) risk factors in adults aged 25 to 64 years (n = 1011), and associations with sex and socioeconomic status (SES), found similar CVD risk factors in both sexes, except for daily tobacco smoking at 19% in men and nil in women, and higher body mass index (BMI) in women than men. With increasing SES in men, there were significant linear increases in mean BMI, waist circumference, mean systolic and diastolic blood pressure, mean fasting plasma glucose, and T2DM prevalence, but decreases in tobacco smoking. Whereas in women higher SES was associated with a significant increase in mean BMI, but a significant decrease in hypertension prevalence. Tobacco smoking is the main risk factor explaining higher CVD mortality in men compared with women.

Background Information on socioeconomic determinants in the management of diabetes mellitus is scarce in lower middle income countries. The aim of this study is to describe the socioeconomic determinants of management and complications of diabetes mellitus in a lower middle income setting. Methods Cross sectional descriptive study on a stratified random sample of 1300 individuals was conducted by an interviewer administered questionnaire, clinical examinations and blood investigations. A single fasting venous blood sugar of ≥126 mg/dl was considered diagnostic of new diabetics and poor control of diabetes mellitus as HbA1C > 6.5 %. Results There were 202 (14.7 %) with diabetes mellitus. Poor control was seen in 130 (90.7 %) while 71 (49.6 %) were not on regular treatment. Highest proportions of poor control and not on regular medication were observed in estate sector, poorest social status category and poorest geographical area. The annual HbA1C, microalbuminuria, retinal and neuropathy examination were performed in less than 6.0 %. Social gradient not observed in the management lapses. Most (76.6 %) had accessed private sector while those in estate (58.1 %) accessed the state system. The microvascular complications of retinopathy, neuropathy and microalbuminuria observed in 11.1 %, 79.3 % and 54.5 % respectively. Among the macrovascular diseases, angina, ischaemic heart disease and peripheral arterial disease seen in 15.5 %, 15.7 % and 5.5 % respectively. These complications do not show a social gradient. Conclusions Diabetes mellitus patients, irrespective of their socioeconomic status, are poorly managed and have high rates of complications. Most depend on the private healthcare system with overall poor access to care in the estate sector.

Introduction: The negative health effects of dental caries are cumulative, tracking from childhood to adulthood and most dental caries is now occurring in adults [1-3]. Oral diseases such as dental caries, gingivitis, and periodontal diseases can occur during pregnancy [4-9]. This study was carried out in Medical officer of health (MOH) area, Ambalantota, Sri Lanka. 363 pregnant women in first visit attending antenatal clinic were recruited. Written informed consent was obtained from all subjects who agreed to take part in the study. Ethical approval was taken from faculty of Medicine, University of Ruhuna. Prior to a dental examination, demographic information regarding age, education, occupation, socioeconomic status and residence were obtained from the participants using interviewer administered questionnaire. Findings of dental examination were entered examination table separately. The mean DMFT among antenatal women was 3.8 ± 5.17, with 3.27 (± 2.31) decayed teeth, 1.85 (± 1.87) missing teeth, and 1.4 (± 1.4) filled teeth. Results were shown in table 3 with binary logistic analysis of DMFT for the overall sample of 363 pregnant women. The final model explained 6.3% to 8.4% of DMFT variation (dependant variable) with variation of independent variables (educational level up to Ordinary level, Sinhla over non-sinhala, income over 30,000, knowledge on dental services free by government and ever taken treatment) and the p-value for Hosmer–Lemeshow test of goodness of fit was 0.957, which indicated an acceptable fit of the model. In the final model significant predictors were Sinhala: Non-sinhala (adjusted OR [95% CI]: 5.67 [1.25-25.99], p=0.026) and “ever taken treatment for dental diseases”( Yes vs No: adjusted OR [95% CI]: 0.432 [0.274-0.680], p

Introduction Obesity is an increasing problem in South Asian countries and Sri Lanka is no exception. The socioeconomic determinants of obesity in Sri Lanka, and in neighbouring countries are inadequately described. Aim was to describe social, cultural and economic determinants of obesity in a representative sample from Kalutara District in Sri Lanka. Methods This was a cross sectional descriptive study conducted among adults aged 35–64 years. A representative sample was selected using stratified random cluster sampling method from urban, rural and plantation sectors of Kalutara District. Data were collected using a pre-tested questionnaire. A body mass index of 23.01 kg/m2-27.50 kg/m2 was considered as overweight and ≥27.51 kg/m2 as obese. Waist circumference (WC) of ≥ 90 cm and ≥80 cm was regarded as high for men and women respectively. Significance of prevalence of obesity categories across different socio-economic strata was determined by chi square test for trend. Results Of 1234 adults who were screened, age and sex adjusted prevalence of overweight, obesity and abdominal obesity (high WC) were 33.2% (male 27.3%/female 38.7%), 14.3% (male 9.2%/female 19.2%) and 33.6% (male 17.7%/female 49.0%) respectively. The Muslims had the highest prevalence of all three obesity categories. Sector, education, social status quintiles and area level deprivation categories show a non linear social gradient while income shows a linear social gradient in all obesity categories, mean BMI and mean WC. The differences observed for mean BMI and mean WC between the lowest and highest socioeconomic groups were statistically significant. Conclusion There is a social gradient in all three obesity categories with higher prevalence observed in the more educated, urban, high income and high social status segments of society. The higher socioeconomic groups are still at a higher risk of all types of obesity despite other public health indicators such as maternal and infant mortality displaying an established social gradient. Electronic supplementary material The online version of this article (doi:10.1186/s12939-015-0140-8) contains supplementary material, which is available to authorized users.

Introduction Sri Lanka is a country that is expected to face a high burden of diabetes mellitus (DM). There is a paucity of data on social and demographic determinants of DM, especially in the plantation sector. Aims To describe social and economic correlates and inequalities of DM in Kalutara District. Methods A cross sectional descriptive study was carried out among adults over the age of 35 years. A sample of 1300 individuals was selected using stratified random cluster sampling method from 65 Grama Niladari Divisions (GND), which were representative of urban, rural and plantation sectors. Twenty households were randomly selected from each division and one adult was randomly selected from each household. Data were collected using a pre-tested questionnaire. Fasting plasma blood sugar of ≥126mg/dl was used to define DM. Significance of prevalence of diseases and risk factors across different socio-economic strata were determined by chi square test for trend. Results Of 1234 adults who were screened (628 males), 202 (14.7%) had DM. Higher DM proportions (16.1%) were seen in the highest income quintile and in those educated up to Advanced Levels (AL) and above (17.3%). Prevalence in the urban, rural and plantation sectors were 23.6%, 15.5% and 8.5% respectively. Prevalence among Sinhalese, Tamils and Muslims were 14.4%, 29.0% and 20.0% respectively. There was a gradient in prevalence according to the unsatisfactory basic needs index of the GND with the highest proportion (20.7%) observed in the richest GND. The highest social status quintile demonstrated the highest proportion (17.4%) with diabetes mellitus. Conclusion There is a higher prevalence of diabetes mellitus in the more affluent and educated segments of society. There is also a higher prevalence among urban compared to rural and estates. Sri Lanka is in an early stage of the epidemic where the wealthy people are at a higher risk of DM.