Department of Parasitology
http://ir.lib.ruh.ac.lk/xmlui/handle/iruor/7396
2024-03-29T13:05:11ZImplication of cutaneous larva migrans and its management in a patient with coexisting filarial lymphoedema in Southern Sri Lanka
http://ir.lib.ruh.ac.lk/xmlui/handle/iruor/15406
Implication of cutaneous larva migrans and its management in a patient with coexisting filarial lymphoedema in Southern Sri Lanka
Weerasekera, C. J.; Yahathugoda, T. C.; De Silva, N. L.
2021-08-01T00:00:00ZAn Accidental Intestinal Myiasis Caused by Cochliomyia macellaria
http://ir.lib.ruh.ac.lk/xmlui/handle/iruor/15405
An Accidental Intestinal Myiasis Caused by Cochliomyia macellaria
Jayawardana, P. P.; Yahathugoda, T. C.
Intestinal myiasis is recognized as pseudomyiasis or accidental myiasis caused by dipteran fly larvae transmitted to humans via contaminated food or water. A case of intestinal myiasis acquired via contaminated food is reported in this case study. The patient is a 4-year-old boy who had frequent episodes of crampy abdominal pain and diarrhoea and the passage of many live worms at each time. As the child had the habit of eating ripe guava from his garden, the infection source was suggested as ripe guava, and the possibility was explored. All larvae collected from faeces and fruit were morphologically similar, and it has been identified as Cochliomyia macellaria. The treatment with several antihelmintics failed, and the recovery was achieved with a simple measure of abstinence from eating guava that came from his garden.
2021-02-16T00:00:00ZThe design and development of a multicentric protocol to investigate the impact of adjunctive doxycycline on the management of peripheral lymphoedema caused by lymphatic filariasis and podoconiosis
http://ir.lib.ruh.ac.lk/xmlui/handle/iruor/15404
The design and development of a multicentric protocol to investigate the impact of adjunctive doxycycline on the management of peripheral lymphoedema caused by lymphatic filariasis and podoconiosis
Horton, J.; Klarmann-Schulz, Ute; Stephens, M.; Budge, P. J.; Coulibaly, Y.; Debrah, A.; Debrah, L. B.; Yahathugoda, T. C.; Kroidl, I.; Deathe, D.; Majewski, A.; Sullivan, S.; Mackenzie, C.; Nutman, T. B.; Shott, J. P.; Weil, G.; Ottesen, E.; Hoerauf, A.
Background
As new lymphatic filariasis infections are eliminated through mass chemotherapy, previously affected individuals are left with the sequellae, especially chronic progressive lymphoedema. Currently this is managed by careful attention to limb hygiene to prevent infection. Studies over the past 15 years have suggested that the incorporation of doxycycline treatment may arrest or even reverse progression of lymphoedema. Most of this work has been observational or based on small studies, and if this intervention is effective, studies need to be conducted on a larger scale and under diverse geographical and social conditions before it can be incorporated into treatment policy.
Methods/Design
The double-blind, placebo-controlled study was designed to investigate the impact of six weeks treatment with doxycycline added to standard limb hygiene on early stage filarial lymphoedema in five sites in Africa and the Indian subcontinent. One site in Cameroon is selected for studying lymphoedema in podoconiosis. Each site was individually powered with the potential to undertake a meta-analysis on completion. Evaluation methods followed those used in Ghana in 2012 with additions resulting from advances in technology. The details of the core protocol and how it was varied to take account of differing situations at each of the sites are provided. The study will enrol up to 1800 patients and will complete in mid-2021.
Conclusions
This paper provides details of what challenges were faced during its development and discusses the issues and how they were resolved. In particular, the reasons for inclusion of new technology and the problems encountered with the supply of drugs for the studies are described in detail. By making these details available, it is hoped that the study protocol will help others interested in improving treatment for filarial lymphoedema in the design of future studies.
Trial registration India: Clintrials.gov. NCT02929121 registered 10 Oct 2016: https://clinicaltrials.gov/ct2/show/NCT02929121
Mali: Clintrials.gov. NCT02927496 registered 7 Oct 2016: https://clinicaltrials.gov/ct2/show/NCT0292749
Sri Lanka: Clintrials.gov. NCT02929134 registered 10 Oct 2016: https://clinicaltrials.gov/ct2/show/NCT02929134
Ghana: ISRCTN. 14042737 registered 10 July 2017: https://doi.org/10.1186/ISRCTN14042737
Tanzania: ISRCTN. 65756724 registered 21 July 2017: https://doi.org/10.1186/ISRCTN65756724
Cameroon: ISRCTN. 1181662 registered 25 July 2017:
2020-03-30T00:00:00ZPortable infrared imaging for longitudinal limb volume monitoring in patients with lymphatic filariasis
http://ir.lib.ruh.ac.lk/xmlui/handle/iruor/15403
Portable infrared imaging for longitudinal limb volume monitoring in patients with lymphatic filariasis
Zhou, C.; Yahathugoda, T. C.; De Silva, L.; Rathnapala, U.; Owen, G.; Weerasooriya, M. V.; Rao, R. U.; Weil, G. J.; Budge, P. J.
Background: The Global Programme to Eliminate Lymphatic Filariasis (LF) emphasizes hygiene, exercise, and other measures to reduce morbidity and disability related to LF. We recently reported that a portable, three-dimensional, infrared imaging system (3DIS) provides accurate limb volume measurements in patients with filarial lymphedema. To assess the practical utility of repeated 3DIS measurements for longitudinal lymphedema management, we examined intraday and day-to-day leg volume changes in adults with filarial lymphedema in southern Sri Lanka.
Methodology and principal findings: We assessed 41 participants with lower extremity lymphedema (stages 1-6) in their homes in the mornings (6:00-9:00 AM) and afternoons (2:00-6:00 PM) of three days within one calendar week. Two examiners performed replicate 3DIS volume measurements at each visit. Median coefficient of variation among replicate volume measurements was 1.7% (IQR 1.1% - 2.3%) for left legs and 2.2% (IQR 1.6% - 2.8%) for right legs. Median intraday volume increase was 3.0%. Range among daily volume measurements tended to be lower for afternoon measurements (median 2.25%, IQR 1.4%- 5.4%) than for morning measurements (median 3.0%, IQR 1.4% - 8.4%).
Conclusions and significance: Limb volume measurements by 3DIS are accurate and reproducible, and this technique is feasible for use in patients' homes. We have developed practical suggestions for optimal outcomes with 3DIS. Duplicate measurements should be performed and repeat assessments should be done at approximately the same time of day to minimize bias. Duplicate measures that vary by more than 8% should prompt review of scanning technique with a repeat measurement. With proper training and attention to technique, 3DIS can be a valuable tool for healthcare workers who work with lymphedema patients.
2019-10-04T00:00:00Z