Papers by Palitha Karunapema
Zenodo (CERN European Organization for Nuclear Research), Mar 1, 2023
Introduction: Childbearing in latter part of reproductive age is challenging. Adverse pregnancy o... more Introduction: Childbearing in latter part of reproductive age is challenging. Adverse pregnancy outcomes increase with advanced (>35 years) maternal age (AMA) and comprehensive antenatal care (ANC) usage by AMA women improves their pregnancy outcomes. However, no recent local data are available on the AMA and pregnancy outcomes. Objectives: To describe utilization of ANC and pregnancy outcomes of AMA women delivering at North Colombo Teaching Hospital and assessed the association between utilization of ANC services and selected pregnancy outcomes. Methods: A descriptive cross-sectional study was conducted among 216 women aged >35 years delivered at Colombo North Teaching Hospital selected using a non-probability consecutive sampling method. Women were interviewed within 7 days postpartum inward using an interviewer-administered questionnaire. Selected data were extracted from clinical records. Key elements of ANC (booking visit, type, frequency, services etc.) were scored and their association with pregnancy outcomes were assessed. Results: A total of 216 AMA postpartum women (age range 35-45 years, mean 37.8 (SD=2.4)) were recruited (response rate 100%). Majority (91.7%, n=198) were multiparous. The current pregnancy was planned in 77.8% (n=168) and 52.7% (n=114) experienced antenatal morbidities. Adverse maternal (8.3%, n=18) and newborn (37%, n=80) outcomes were noted. Majority (75.9%, n=164) optimally utilized ANC. Sinhalese (OR=2.98, 95%CI 1.29-6.87, p=0.008), Buddhist (OR=2.53, 95%CI 1.33-4.80, p=0.004) women with intended pregnancies (OR=5.67, 95%CI 2.81-11.43, p<0.001) well utilized ANC. Women educated <10 years of formal education (OR=0.4, 95%CI 1.33-4.80, p=0.027), had contraceptive issues (OR=0.27, 95%CI 0.10-0.74, p=0.007) and had adverse newborn outcomes (OR=0.32, 95%CI 0.16-0.61, p=0.001) reported low tendency to utilize ANC. Conclusions: Many AMA women are multiparous and with planned pregnancies. Presence of adverse maternal & newborn outcomes is substantial. Majority well utilized ANC and it reduced adverse pregnancy outcomes. Effective strategies should be formulated to promote well-planned pregnancies in early reproductive ages of women.
International Journal of Current Science Research and Review
Introduction: Childbearing in latter part of reproductive age is challenging. Adverse pregnancy o... more Introduction: Childbearing in latter part of reproductive age is challenging. Adverse pregnancy outcomes increase with advanced (>35 years) maternal age (AMA) and comprehensive antenatal care (ANC) usage by AMA women improves their pregnancy outcomes. However, no recent local data are available on the AMA and pregnancy outcomes. Objectives: To describe utilization of ANC and pregnancy outcomes of AMA women delivering at North Colombo Teaching Hospital and assessed the association between utilization of ANC services and selected pregnancy outcomes. Methods: A descriptive cross-sectional study was conducted among 216 women aged >35 years delivered at Colombo North Teaching Hospital selected using a non-probability consecutive sampling method. Women were interviewed within 7 days postpartum inward using an interviewer-administered questionnaire. Selected data were extracted from clinical records. Key elements of ANC (booking visit, type, frequency, services etc.) were scored and ...
Routledge eBooks, Nov 14, 2022
Health Promotion Perspectives
The health promotion settings approach has been recognised as an effective method of health promo... more The health promotion settings approach has been recognised as an effective method of health promotion in the recent era, and mobile health (mHealth) is a highly evolving field in the health sector. The health promotion settings are shifting the focus away from the individuals and moving towards a more holistic model of health promotion. We identified five settings in Sri Lanka to promote a mHealth model, including villages, schools, preschools, workplaces, and hospitals. The specified model using mHealth helps monitor the activities at various levels of healthcare, including regional, district and national levels. The model also maps the location of the healthy settings, which provide a visual picture to the policymakers, helpful in planning and decision-making.
Asian Journal of Advanced Research and Reports
Telehealth is the delivery of health-related services and information using electronic informatio... more Telehealth is the delivery of health-related services and information using electronic information and communication technologies. Telehealth enables the health service providers to connect with a remote patient to provide care, advice, reminders, education, intervention, monitoring and facilitates remote admissions. Due to COVID-19 related travel restrictions, disruptions in access to healthcare were observed in Sri Lanka. Therefore, a telehealth solution to connect patients where specialist medical doctors were inaccessible or unavailable, was planned and implemented in the North Central province of Sri Lanka in 2020. The objective of this case study is to describe the experience during the planning and implementation of the telehealth intervention. Issues faced during planning and implementation were securing adequate funds, limited knowledge of information technology among the health staff, the reluctance of patients to explain and show the signs through video consultation, and ...
Oral Presentation Abstract (OP 37), 129th Anniversary International Medical Congress, Sri Lanka M... more Oral Presentation Abstract (OP 37), 129th Anniversary International Medical Congress, Sri Lanka Medical Association, 25-27 July 2016 Colombo, Sri Lanka
Planned environment and Communities can strongly enhance opportunities for people to improve thei... more Planned environment and Communities can strongly enhance opportunities for people to improve their levels of physical activity (PA). Peaceful area for physical activity nevertheless offer benefits to mind and body both. As most of population travel for work from sub-urban and minimal occupancy of wetland in urban busy settings, it is much beneficiary to develop walking tracks (WT) with wet, greenish surroundings in sub-urban area for the use of working community. Materials & Methods Between 10/ 2014 and 12/ 2014, a total of 428 individuals, attending to selected WTs in Kotte area were randomly assigned to collect data by using interviewer administered questionnaire. The participants were surveyed of their profile, purpose of using Walking tracks, pattern of PA and compared their PA levels after starting use WT with, PA levels before starting to use WT. Non-parametric “Wilcoxon T test” was used to assess the comparison. Levels of PA in WP (MET score /week) were analyzed in relation t...
Poster Presentation Abstract (PP128), 128th Annual Scientific Sessions, Sri Lanka Medical Associa... more Poster Presentation Abstract (PP128), 128th Annual Scientific Sessions, Sri Lanka Medical Association, 6th-8th July 2015 Colombo, Sri Lanka
Journal of Religion and Health, 2021
The COVID-19 pandemic has affected all countries irrespective of their state of development. In c... more The COVID-19 pandemic has affected all countries irrespective of their state of development. In countries with traditional societies, religious leaders have been acknowledged as key stakeholders in community engagement activities, including disease prevention. A community-level prevention model was established in 2020 by the Health Promotion Bureau (HPB), Sri Lanka, which incorporated mobilisation of the clergy to support the prevention and response schemes to COVID-19 with non-governmental stakeholders. This model was part of a more extensive community engagement network established by the HPB in cooperation with the country offices for WHO and UNICEF. Building trust, empowering behavioural traits applicable to minimise risks from COVID-19, leadership and coordination, message dissemination, addressing stigma and discrimination, supporting testing procedures, contact tracing activities and vaccination, building community resilience, spiritual and psychosocial support, and welfare provision are some of the useful factors that were identified in the model. Furthermore, a much broader and holistic approach is needed to focus on health behaviours and social and cultural aspects in a multi-faceted nature. This paper highlights a novel COVID-19 prevention model with active involvement of religious leaders that can be implemented in low resource settings. Our experience from Sri Lanka demonstrates the feasibility of implementing this model to mitigate the disastrous situation following the COVID-19 outbreak.
International Journal of Current Science Research and Review, 2021
Background: Street foods is ready- to- eat foods and beverages prepared which are sold by vendors... more Background: Street foods is ready- to- eat foods and beverages prepared which are sold by vendors in streets and other public places for immediate consumption or consumption at a later time without further processing or preparation. Street vended foods forms a distinctive part of food industry because they are mostly affordable, easily accessible. Food handlers play an important role in food safety and in transmission of food poisoning, because they can introduce pathogens into foods during production, processing, distribution and serving. Therefore, the understanding of food safety procedures and the potential factors that causes food borne diseases is very essential for all food handlers. Objective: The study was conducted with the objective of assessing the level of knowledge and practices on food safety and hygiene in street food vendors and improve the knowledge and practices through an educational intervention targeting the street food vendors. Methods: A descriptive cross-sec...
International Journal of Current Science Research and Review, 2021
Background: The World Health Organization has called upon all countries to reduce average populat... more Background: The World Health Organization has called upon all countries to reduce average population salt intake to <5 g/ day. In Sri Lanka, average adult salt consumption is around 13g /day, which is far above the WHO recommended value. Objective: To describe the knowledge and practices related to food salt use, among 18-70 year old adults in Gampaha district of Sri Lanka. Methods: A cross sectional study was conducted in Gampaha district, Western province, Sri Lanka. Data were collected using a pre-tested self-administered questionnaire. Ethical approval was obtained from the Ethical Review Committee of Faculty of Medicine Ragama. Results: The mean age of the study population is 44.3 years and male to female ratio is almost one. A majority (91.9%) of the study participants identified high salt consumption leads to adverse health effects. Only 22 % were able to identify the recommended maximum daily salt requirement. Many (78.4%) respondents expressed cutting down on salt as an ...
Asia Pacific Journal of Public Health, 2021
A new era of the fight against the COVID-19 pandemic began on December 31, 2020, with the first e... more A new era of the fight against the COVID-19 pandemic began on December 31, 2020, with the first emergency approval given for Pfizer-BioNTech vaccine by the World Health Organization (WHO), exactly 1 year from the report of a cluster of cases of pneumonia from Hubei, China. Multiple vaccines were approved for emergency use,1 and Sri Lanka was planning to start vaccination during this study period. With the reported wide variation in vaccine acceptance, it is important to understand health and illnessrelated behaviors related to vaccines. The “health belief model” (HBM) is a frequently used theory for this purpose.2
Background: Human resources are the livelihood of all types of organizations. The biggest challen... more Background: Human resources are the livelihood of all types of organizations. The biggest challenge that organizations are facing today is not only managing these resources but also retaining them. Preventive health sector plays a vital role in the healthcare system. Medical Officers of Health (MOH) are the Medical Officers providing preventive health services in Sri Lanka. This study was carried out to explore the factors affecting retention of Medical Officers of Health in the preventive health sector in Sri Lanka.Methods: A descriptive cross sectional study was carried out among Medical Officers of Health in the Colombo district which has 18 MOH Offices with 64 Medical Officers. A pre-tested self-administered questionnaire was used as the study instrument. Data were analyzed using descriptive analysis, correlation and regression analysis. Results: Of the 74 Medical Officers 64 responded with a response rate of response rate of 86.5%. Regression analysis showed that all four varia...
Journal of the College of Community Physicians of Sri Lanka, 2020
The news that an unknown virus is causing pneumonia in people in Wuhan City of China was circulat... more The news that an unknown virus is causing pneumonia in people in Wuhan City of China was circulated in media in late 2019 (1-3). A novel coronavirus was identified on 7 January 2020 (4). The city of Wuhan was placed in quarantine on 23 January 2020. The quarantine was later extended to a further 17 cities in Hubei Province, affecting over 57 million people (5-6). The first case of Coronavirus disease-2019 (COVID-19) outside China was reported in Thailand on 13 January 2020 (7). The WHO declared novel coronavirus outbreak as a Public Health Emergency of International Concern (PHEIC) on 30 January 2020 (8). On 11 March 2020, considering the alarming levels of spread and severity, the WHO categorized COVID-19 as a pandemic (9). This narrative report highlights the public health measures taken at points of entry to prevent COVID-19 in Sri Lanka. Public health response and its impact Goal to be achieved Sri Lanka was considered a high risk country for the introduction of the disease due to being an international tourist destination and having a considerable number of Chinese workers employed in mega projects and Sri Lankan migrant workers working in countries where there was rapid disease spread. Hence, the main goal was to prevent the introduction of COVID-19 to the country. With this goal, many public health measures were applied at points of entry.
Journal of the College of Community Physicians of Sri Lanka, 2020
First case of unknown pneumonia was reported in Wuhan City, Hubei Province of China on 31 Decembe... more First case of unknown pneumonia was reported in Wuhan City, Hubei Province of China on 31 December 2019. Since then, fast spread of rumours and myths were noted around the world and among Sri Lankans too. Health promotion Bureau (HPB) identified the need of a risk communication plan and also to activate and strengthen the prevailing rumour monitoring, reporting, verification and mitigation system. The HPB highlighted the issue of this novel virus at Influenza steering committee on 9 January 2020 organized by the Epidemiology Unit and informed that HPB has activated the rumour monitoring system. Risk communication refers to the exchange of real-time information, advice and opinions between experts and people facing threats to their health, economic or social well-being. It will enable people at risk to take informed decisions to protect themselves and their loved ones (1-2). Thus, it is an essential component of an effective response to public health emergencies to proactively communicate what is known, what is unknown and what is being done to get more information, with the objectives of saving lives and minimizing adverse consequences. HPB initiated the preparatory phase activities as the focal point of risk communication in early January. Locally and globally available plans of risk communication were reviewed (3-5). Risk communication plan for the preparatory phase and initial response phase and flow chart for the COVID-19 were completed by 25 January 2020 at the stage of no reported cases. Country-or region-specific risk communication plans were not available in public domain for the best of our knowledge. This narrative report highlights the risk communication process implemented for COVID-19 in Sri Lanka mediated by HPB, the risk communication focal point for the Ministry of Health Sri Lanka.
Journal of the College of Community Physicians of Sri Lanka, 2020
Introduction: The main legislation governing food labelling in Sri Lanka is the Food Act which is... more Introduction: The main legislation governing food labelling in Sri Lanka is the Food Act which is implemented by health authorities. Food labels provide information to help consumers make healthier and safe food choices. Objectives: To assess the compliance of health and nutrition claims of labels of non-alcoholic beverages with food labelling regulation Methods: A descriptive cross-sectional study was carried out in all 18 supermarkets in the Kandy Municipal Council Area. Non-alcoholic beverages were assessed. A judgmentally validated pre-tested checklist containing provisions of the labelling regulation was used as the study instrument. Data collection was done by four trained data collectors. Results: Of the 214 beverages assessed, 5.1% (n=11) did not have the common name in two languages. Claims or pictures to the effect that the beverage is recommended by medical practitioners or a professional association was present in 8.1% (n=19). Of the 56 milk products and health drinks, 8.9% (n=5) made claims that dietary fats benefit heart patients. Claim of food being an aid for slimming or weight reduction was found in 14% (n=9) of the 64 milk products, health drinks and green tea surveyed. Of the 36 beverages which made special claims, 30 (83%) did not have declarations that the natural food items also have the same characteristic. Conclusions: Labels of considerable proportions of beverages contravene the provisions of the food labelling regulation, indicating the importance of proper implementation of the regulation.
The Asia Pacific Scholar, 2020
Background: The duties of Public Health Inspectors (PHI) includes those related to food legislati... more Background: The duties of Public Health Inspectors (PHI) includes those related to food legislation. Effective methods are being explored in providing refresher training for them amidst the constraints of resources. Objective: To assess the knowledge, attitudes and skills of the PHI on food legislation and to evaluate the effectiveness of a Distance Education (DE) programme in improving these. Methodology: The study included quasi-experimental educational intervention with a pre- and post- assessments. 105and 109 PHI were recruited for the intervention and control groups. Pre and post interventional assessments on the knowledge, attitudes, self-assessed competencies and performance were done with a self-administered questionnaire and observational checklist. Intervention group was exposed to an educational intervention through a distance education programme. Post-assessments were done following four months of the intervention. Results: The pre interventional knowledge and performanc...
International Journal of Translational Medical Research and Public Health, 2020
Background and Introduction: School Medical Inspections (SMI) assess the health status of childre... more Background and Introduction: School Medical Inspections (SMI) assess the health status of children, and provide opportunities for early detection, referral and prevention of disease conditions among school-aged children in Sri Lanka. There is paucity of data on the outcomes of referrals and difficulties encountered in relation to SMI. This study describes the outcomes of identified health problems in SMI and the difficulties encountered by public health staff in the conduct of SMI in an educational zone in the Kandy District, Sri Lanka. Methods: This study is comprised of a quantitative and a qualitative component. The quantitative component - a descriptive cross sectional study was conducted with secondary data of 87 government schools in the Katugasthota Educational Zone in Kandy district, Sri Lanka. The study sample consisted of 2,876 children in whom health problems were identified and referrals were made. The qualitative component - key informant interviews (KIIs) were conducte...
Objective Occupational hazards is an area where many countries have begun to pay more emphasis as... more Objective Occupational hazards is an area where many countries have begun to pay more emphasis as it affects the health of many particularly in developing countries. However, documented literature is scarce in this regard although occupational hazards are common in workplaces. The study was carried out with the objective of describing the physical hazards and control measures adopted in the formal medium and large-scale industrial sector in Sri Lanka . Results Physical hazards detected in the workplaces were; excessive noise (78.3%), poor light (58%), increased temperature (65.2%), and poor ventilation (68.1%). Over 50% of large machinery and 33% of medium-scale machinery were not adequately guarded. Nearly 41% of the machinery were difficult to operate, of them 36.2% had controls in positions which were hard to reach. Of safety measures adopted, only 34.8% had proper demarcation of areas with 28.9% displaying safety signs. Housekeeping was poor in 59.4% and less than 40% had safe s...
Nutrition research (New York, N.Y.), 2018
The differences in the morbidity and mortality of cardiovascular diseases between Sri Lankan and ... more The differences in the morbidity and mortality of cardiovascular diseases between Sri Lankan and Japanese populations might be explained by the differences in their diet, especially fat. To test the hypothesis that the fatty acid (FA) compositions differ between Sri Lankan and Japanese populations and that high concentrations of n-3 polyunsaturated FAs and linoleic acid are associated with a low level of arteriosclerosis, the authors compared the circulating FA compositions between Sri Lankan and Japanese populations and examined the association of the circulating FA composition with arterial stiffness in each population. The study participants were patients with diabetes, dyslipidemia, or hypertension in Sri Lanka (n = 100) or Japan (n = 236). Serum FA compositions were measured by gas chromatography. Arterial stiffness was measured using the cardio-ankle vascular index (CAVI). Analysis of covariance was used to compare the FA compositions between the populations. Multiple regressi...
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Papers by Palitha Karunapema