http://ir.lib.ruh.ac.lk/handle/iruor/7396 Wed, 08 Apr 2026 23:42:51 GMT 2026-04-08T23:42:51Z http://ir.lib.ruh.ac.lk/handle/iruor/18925 A Surveillance System for Lymphatic Filariasis after its Elimination in Sri Lanka Rahman, Mohammad A.; Yahathugoda, T.C.; Bumpei Tojo; Premaratne, P.; Fumiaki Nagaoka; Hidekazu Takagi; Kannathasan, S.; Murugananthan, A.; Weerasooriya, M.V.; Makoto Itoh Lymphatic filariasis (LF) has been declared eliminated in Sri Lanka in September 2016. To maintain elimination status, a surveillance system to detect hidden endemic foci or LF resurgence is of highest priority. In this paper, we have reported an investigation of LF transmission in Trincomalee district where a surveillance program was not carried out due to 30 years of civil unrest. Proposed surveillance system included, measurement of anti-filarial IgG4 in urine of schoolchildren in areas where LF transmission could exist and assessment of circulating filarial antigen (CFA) and microfilaria (mf) in all urine antibody positive schoolchildren, their family members and 10-15 neighbours of each urine antibody positive household. Spatial distribution of the anti-filarial antibody titers in urine in a high antibody suspected area was analyzed using GPS logger data. Among 2301 school children from 11 schools studied, 41 (1.8%) urine antibody positives were found. The antibody positive rates of the schools ranged between 0 and 4.0%. Nine of the 630 (1.4%) examined became positive for CFA but were negative for mf. Although there were no mf positives, positive CFA and antibody results indicated the existence of Wuchereria bancrofti in Trincomalee. Highest antibody titres in an area correlated with the prevalences of urine antibodies and CFA. Spatial analysis showed LF transmission foci. Therefore, a combination of the non-invasive methods, urine ELISA and GPS mapping, will be a new effective surveillance system to identify hidden LF transmission foci. Tue, 09 Oct 2018 00:00:00 GMT http://ir.lib.ruh.ac.lk/handle/iruor/18925 2018-10-09T00:00:00Z http://ir.lib.ruh.ac.lk/handle/iruor/18924 Impact of Two Follow-up Schemes on Morbidity Management and Disability Prevention (MMDP) Programme for Filarial Lymphedema in Matara, Sri Lanka. Yahathugoda, T.C.; Weerasooriya, M.V.; Sandamali, Wilfred A.; Eisaku Kimura; Makoto Itoh Alleviating morbidity due to lymphatic filariasis (LF)-especially in elderly patients who are rather ignorant-is presently the biggest challenge for the national filariasis campaign. We introduced two follow-up schemes and compared each other to address three key programmatic issues (1) locating patients, (2) educating patients, family members on practice of lymphoedema self-care (3) well sustained daily self-care. Hundred and seven lymphoedema patients were introduced to the new Community Home Based Care (CHBC) programme as a part of MMDP programme at their homes. Twenty seven of 107 patients were selected by purposive sampling and followed-up under two schemes, 14 in Daily follow-up (DFU) scheme and 13 in Monthly follow-up (MFU) scheme. Impact was assessed using a KAP score, number of entry lesions (EL) and number of ADL episodes, limb volume, its appearance, changes in the quality of life and gained benefits. Visiting patients in their homes to introduce lymphoedema care programme was a success. KAP scores of the more important activities on lymphoedema care were significantly higher in DFU scheme. Number of patients (51.9%; 14/27) who had EL/s at baseline reduced significantly to 18.5% (5/27) at one year follow-up. The mean numbers of ADL episodes/year reduced significantly in both schemes. Six photographs of 27 showed obvious improvement in lymphoedema and its grade. Mean volume of lymphoedema reduced significantly in both schemes at one year no significant difference between schemes. Benefit score at one year revealed that the patients in DFU scheme received significantly higher amount of benefits compared to MFU scheme. In conclusion daily instruction has significantly motivated the patient and his/her family bringing a new hope. Sun, 01 Apr 2018 00:00:00 GMT http://ir.lib.ruh.ac.lk/handle/iruor/18924 2018-04-01T00:00:00Z http://ir.lib.ruh.ac.lk/handle/iruor/18923 Rapid Assessment Procedures to Detect Hidden Endemic Foci in Areas not Subjected to Mass Drug Administration in Sri Lanka Yahathugoda, T.C.; Weerasooriya, M.V.; Toshihiko Sunahara; Eisaku Kimura; Samarawickrema, Wilfred A.; Makoto Itoh For the declaration of elimination of lymphatic filariasis, reliable epidemiological data in all parts of a country are required. In Sri Lanka, due to social disturbance, there are 3 provinces whose endemicity has been declared unknown. Further, a recent report revealed an endemic pocket, which is on the border with the district that was not covered by the national elimination program. These facts indicate the necessity of more extensive studies to discover hidden endemic foci. To facilitate such studies, we evaluated 2 methods of Rapid Assessment Procedure (RAP) in Hambantota district, where the filariasis endemicity was low: (1) indirect questioning by mailing a questionnaire to each local leader (IndQ), asking about the presence of clinical cases, and (2) focus group discussion (FGD) by villagers. The information given by people was validated with clinical examination by doctors (CE) and IgG4 ELISA using urine samples. In the results: there was a strong positive correlation between CE and ELISA rates. The hydrocele rates obtained by FGD or IndQ were associated significantly with CE rates. The rates by FGD or Cluster-IndQ (‘modified’ IndQ) were also associated significantly with ELISA rates. The IndQ was most cost-effective. Based on these findings, we have concluded that screening by IndQ and confirmation by the ELISA would be an effective and practical way in Sri Lanka to locate endemic foci in hitherto unsurveyed districts. Fri, 20 Sep 2013 00:00:00 GMT http://ir.lib.ruh.ac.lk/handle/iruor/18923 2013-09-20T00:00:00Z http://ir.lib.ruh.ac.lk/handle/iruor/18922 Visual Detection of Filaria-specific IgG4 in Urine using Red-colored High Density Latex Beads Fumiaki Nagaoka; Makoto Itoh, Mohammad S Samad; Hidekazu Takagi; Weerasooriya, M.V.; Yahathugoda, T.C.; Moazzem Hossain; Kazuhiko Moji; Eisaku Kimura; Samad, Mohammad S. The use of urine for the immunodiagnosis of lymphatic filariasis has a definite advantage: the sample collection is not invasive and thus well accepted by people. Urine-based ELISA to detect filaria-specific IgG4 has been used successfully. However, ELISA requires equipment such as a microplate reader, which is often not available in most endemic areas. We have developed a new visual immunodiagnosis that detects urinary IgG4 using red-colored latex beads (bead test). The sensitivity was 87.2% when ICT antigen test positive people were regarded as the standard (136/156), and the specificity was 97.2% with the non-endemic people in Japan and Bangladesh, and the urine ELISA negatives in Sri Lanka (1264/1300). In a prevalence study, the bead test could detect filarial infection more effectively than ICT test among young children in Sri Lanka, indicating the usefulness of the visual test in epidemiological studies. Thu, 06 Sep 2012 00:00:00 GMT http://ir.lib.ruh.ac.lk/handle/iruor/18922 2012-09-06T00:00:00Z