Ceylon Medical Journal最新文献

Background: There is a co-existence of different forms of malnutrition leading to a Triple Burden of Malnutrition (TBM) in Sri Lanka. Accessing basic needs and services was a challenge during COVID-19 pandemic, which led to issues in food security with an effect on nutrition status of the population.

Objectives: To estimate the prevalence of malnutrition and dietary intakes of the population aged 1 to 60 years. Methods: This study was conducted in 2021. A multistage cluster sample was drawn to represent households at national level using 75 clusters, and 24-hour dietary recalls were compared with estimated average requirements of different age groups. Height and weight of all selected participants were measured.

Results: A total of 1776 households and 2991 individuals were studied. The prevalence of wasting, stunting and overweight of children aged 1-4 years (n=486) was 14%, 16.3% and 0.8% respectively. Thinness, stunting, overweight and obesity of children aged 5-9 years (n=388) was 21.4%, 8.5%, 5.2%, 5.1%; children aged 10-17 years (n=355) was 21.1%, 14.1%,11%, 8.2%; and adults aged 18-60 years (n=1762) was 9.9%, 5.4%, 32.6% and 11.5% respectively. Dietary intake gaps were minimal with energy and protein while it was wider with majority of vitamins, iron and calcium. Stunting of children aged 1-4 years was significantly associated with the low calcium and iron intakes.

Conclusions: The presence of TBM amongst children and adults were observed with a dietary gap of essential micronutrients. This study highlights the need to re-orient the nutritional interventions to control TBM at population level.

Introduction: The COVID-19 pandemic severely strained the health care in Sri Lanka. The subsequent economic crisis compounded this issue. Priority was given to treating those afflicted with COVID-19 and preventing its spread, and healthcare staff faced immense difficulties dealing with the situation. The psychosocial impact of COVID on health care staff has not been properly assessed or addressed.

Objectives: A study was conducted to identify the psychosocial impact of COVID-19 among four different categories of health care workers, and perform a needs assessment among these groups.

Methods: A convenient sample of frontline health workers, mental health teams, 1926 mental health helpline workers and 1990 Suwa Sariya emergency ambulance service staff were assessed via a self-administered questionnaire for mental health impact, work capacities and needs.

Results: Among frontline workers (n=188), 42.5% experienced anxiety symptoms, 12.8% depressive symptoms and 4.1% suicidal thoughts. Most (58.9%) lacked a psychological support system at the workplace. Only 20% have accessed specific programs or services at their workplace to obtain support for mental health issues, and all have benefitted from them. All categories of health workers lacked training and resources.

Conclusion: The findings demonstrate that a significant amount of health care workers undergo psychological problems in the course of their work especially in the aftermath of the COVID-19 pandemic. The analysis reveals that Sri Lanka lacks structured psychological support systems for health workers and needs more resources and training. Psychological support for health workers through strengthening resources and training should be prioritised when planning service development.

Introduction: Post-vaccination infections impart the need for real-world data on protection conferred by the vaccines against SARS-CoV-2. We aimed to evaluate the severity of post-vaccination COVID-19 and the predictors of severe disease.

Methods: This cross-sectional study analysed data from 307 patients admitted to the University Hospital KDU with confirmed COVID- 19 from March 1st to November 1st, 2021, after receiving at least a single dose of a vaccine against SARS-CoV-2. Vaccination status and the disease severity were classified using standard definitions. A binary logistic regression model was fitted to investigate severe/critical disease predictors.

Results: Of the surveyed patients, 122(39.7%) were fully vaccinated, 127(41.4%) were partially vaccinated and 58 (18.9%) had developed the disease within 14 days of the first vaccine dose. Most were Sinopharm vaccine recipients (52.4 %). Non- severe disease was observed among 249(81.1%) patients and 47(15.3%) had severe disease, while 11(3.6%) needed ICU care (critical illness). Severe/critical disease was reported among 32(25.2%) partially vaccinated and 13(22.4%) patients who developed the disease within 14 days of the first vaccine dose. Of the patients deemed to have vaccine breakthrough infections (122 fully vaccinated patients), 13(10.6%) suffered severe/critical disease. Patients with comorbidity experienced more severe/critical illness (adjusted odds ratio [AOR]= 3.684, P=0.003) than those without pre-existing medical conditions. Disease progression to severe or critical illness was significantly higher among Sinopharm recipients than Covisheild recipients (AOR:2.064, P=0.048).

Conclusions: Comorbidity was the most important predictor of severe COVID-19 irrespective of the vaccination status. Observed higher incidence of severe disease among Sinopharm recipients warrants more extensive population studies.

Introduction: Internet addiction disorder is growing as a potentially problematic condition, especially among adolescents. Nonetheless, the condition is widespread and problematic, limited scientific evidence is available on the prevention, and efficacy of the treatment globally as well as locally. Objectives: The objective of this study was to determine the effectiveness of the developed educational package for the prevention of Internet addiction disorder among 15-19-year-old adolescents in Colombo district.

Methods: The study was a quasi-experimental study to determine the effectiveness of an educational intervention for the prevention of Internet addiction disorder. The educational package was developed on Social Cognitive Theory. The contents were designed following a literature review, expertise from a multidisciplinary panel, and using the preliminary results of the descriptive cross-sectional study. Adolescents from two educational zones in Colombo district were purposefully selected for the Intervention group (n=280) and control group (n=290). A self-administered questionnaire including a validated Internet Addiction Test(IAT) Sinhala version was used for the data collection. Following the implementation of the educational package, primary and secondary outcomes were compared between study groups by chi-square test and paired t-test using the SPSS-21 version.

Results: Following the intervention, the proportion of adolescents with Internet addiction disorder in the intervention group was less in comparison with the control group and the difference was statistically significant (χ2=9.026, df=1, p=0.003). There was a statistically significant difference between the mean differences of pretest and post-test IAT scores (t=-0.412, df=279, p=0.001) with the reduction of mean IAT scores among the intervention group. The proportion of study participants engaged in social media (χ2=10.6,df=1, p=0.001) and excessive engagement in internet gaming (χ2=5.514, df=1, p=0.019) among the intervention and the control groups revealed a statistically significant difference in favor of the intervention group.

Conclusions: The developed educational package was found effective for the prevention of Internet Addiction Disorder and recommended to use in future prevention programs and to aid the policymakers and administrators in the prevention, diagnosis, and management of Internet addiction disorder among this age group.