Department of Pediatrics

The Profile of Infants with Structural Birth Defects in Galle, Sri Lanka

2022-02-01T00:00:00Z

The Profile of Infants with Structural Birth Defects in Galle, Sri Lanka De Silva, J.; Amarasena, S.; Jayaratne, K.; Perera, B. Birth defects among children has become a significant public health problem and epidemiological profile of such cases is imperative to make health interventions. Objective: The aim was to find out the epidemiological profile of infants with non-genetic, structural birth defects (SBD) in Galle, Sri Lanka. Methods: A hospital-based, descriptive cross-sectional study was carried out. Infants with SBD which were not found to have a genetic basis, aged up to six months residing in Galle were studied. Data on SBD, confirmed by a paediatrician were gathered from the available medical records. Results: Three-hundred and fifteen (315) infants with SBD were studied. One hundred and seventynine (57%) were male infants. Fifty-six (18%) were born preterm. Eighty-one (26%) infants had SBD found in multiple systems. A total of 620 SBD was reported. The majority were cardiovascular (CVS) defects (n=398, 64%) followed by the musculoskeletal defects (n=56, 9%, skeletal 41, muscular 15) and central nervous system (CNS) defects (n=52, 8.4%). Thirty six (6%) oral-facial clefts, 30 (5%) gastrointestinal defects and 22 (3.5%) urinary tract defects were reported. The most common SBD of the CVS was ostium secondum atrial septal defect (OS II ASD) (n=219, 55%). Isolated ASDs were found among 84 infants while the rest were presented with other CVS defects or extra cardiac defects. The second and third commonest CVS defects were patent ductus arteriosus (PDA) (n=79, 19.8%) and ventricular septal defect (VSD) (n=48, 12.1%) respectively.. The commonest CNS defect was congenital hydrocephalus (n=18, 34.6%) followed by spina bifida (n=11, 22.7%). There were three (n=3, 6%) encephaloceles and one anencephaly (2%). Congenital talipes (n=23, 56%) was the commonest skeletal defect reported while congenital defects of the diaphragm (n=11, 73%) were the commonest muscular defects. Cleft hard and soft palate (n=13, 36%) with unilateral cleft-lip was the commonest oral-facial cleft. Imperforate anus (n=11, 37%) and intestinal stenosis (n=10, 33%) were the commonest gastrointestinal defects. Conclusion: Cardiovascular, musculoskeletal and central nervous system defects were the prevalent SBD found in this sample. Health care delivery systems of Sri Lanka should prioritize and target these conditions in prevention and management of birth defects

Prevalence of Neonatal Complications Among Infants with Structural Birth Defects in Galle Sri Lanka

2022-02-01T00:00:00Z

Prevalence of Neonatal Complications Among Infants with Structural Birth Defects in Galle Sri Lanka De Silva, J.; Amarasena, S.; Jayaratne, K.; Perera, B. Introduction: Birth defects in children are considered as a significant risk factor of stillbirths, perinatal deaths and neonatal, infant and childhood morbidity and mortality. Objectives: The objective of this study was to describe the prevalence of neonatal complications in infants with non-genetic or non-syndromic structural birth defects (SBD) in Galle, Sri Lanka. Methods: A hospital-based descriptive cross-sectional study was carried out by examining 315 liveborn infants with SBD aged up to six months of age. Neonatal complications were examined using the medical records of the infants. Descriptive statistics were used to present data. Results: The sample consisted of 179 (57%) male infants. One infant had ambiguous genitalia. Fiftysix (17%) infants were born preterm (32-36 weeks: n=40, 71%; 28-31 weeks: n=12, 22%, <27weeks: n=4, 7%). Low birth weight was observed in 102 (32.4%) infants. Cardiovascular defects (n=398, 64%), musculoskeletal defects (n=56, 9%) and central nervous system defects (n=52, 8.4%) were the commonest SBDs.

Outcomes of Infants with Structural Birth Defects in Galle, Sri Lanka

2020-02-01T00:00:00Z

Outcomes of Infants with Structural Birth Defects in Galle, Sri Lanka De Silva, J.; Amarasena, S.; Jayaratne, K.; Perera, B. Birth defects are a significant health problem among children. The outcomes of structural birth defects (SBD) vary owing to the severity of the defect and availability of the management options. Outcomes of children with SBD is vital to identify the severity of the problem, to make policies and to allocate services to manage SBD. Methods: A prospective longitudinal follow-up study was carried out to follow-up 620 SBD in a sample of 315 infants during their infancy. They were not diagnosed with any genetic syndrome. At the end of the first year of life the outcomes of the infants and the outcomes of the SBD were evaluated. The infant outcomes were measured as alive or dead. The outcomes of the SBD were measured as completely corrected, partially corrected (residual defect or residual impairment present) and uncorrected. Data were analyzed using SPSS version 20. Results: There were 179(56.8%) male infants. Fifty six (17.8%) were preterm. Three (1%) infants and 6(1%) SBD were lost to follow-up. The commonest defects were the cardiovascular (CVS) defects (n=398, 64.2%) followed by the central nervous system defects (n=52, 8.4%). The commonest CVS defects were atrial septal defect (ASD) (n=219), patent ductus arteriosus (PDA) (n=79) and ventricular septal defect (VSD) (n=48). Forty-four (14%) infants died during infancy. They had a total of 141 defects and 79 out of them were lethal. The most common lethal defects were the CVS defects (n=44, 55.7%) followed by CNS defects (n=13, 16.4%). Among the 473 SBD found among live infants 134(28.3%), 71(15.0% and 268(56.6%) were completely corrected, partially corrected and uncorrected respectively. Among the completely corrected defects 77 were resolved spontaneously (including 43 ASD, 6 VSD, 24 PDA) and the rest were managed surgically (n=55) and medically (n=2). Among the infants diagnosed with CVS defects needing surgical correction (n=35), 23 underwent surgery and 5 of them died. Three infants among the rest of the 12 infants, died while awaiting surgery.

Outbreak of Severe Acute Respiratory Infection in Southern Province, Sri Lanka in 2018: a Cross-sectional Study

2020-11-01T00:00:00Z

Outbreak of Severe Acute Respiratory Infection in Southern Province, Sri Lanka in 2018: a Cross-sectional Study Vanderburg, Sky; Wijayaratne, G.; Danthanarayana, N.; Jayamaha, Jude; Piyasiri, Bhagya; Halloluwa, C.; Sheng, Tianchen; Amarasena, S.; Kurukulasooriya, R.; Nicholson, B.P.; Peiris, Joseph S.M.; Gray, Gregory C.; Gunasena, Sunethra; Nagahawatte, A.; Bodinayake, C.K.; Woods, Christopher W.; Devasiri, V.; Tillekeratne, L.G. Objectives To determine aetiology of illness among children and adults presenting during outbreak of severe respiratory illness in Southern Province, Sri Lanka, in 2018. Design Prospective, cross-sectional study. Setting 1600-bed, public, tertiary care hospital in Southern Province, Sri Lanka. Participants 410 consecutive patients, including 371 children and 39 adults, who were admitted with suspected viral pneumonia (passive surveillance) or who met case definition for acute respiratory illness (active surveillance) in May to June 2018. Results We found that cocirculation of influenza A (22.6% of cases), respiratory syncytial virus (27.8%) and adenovirus (AdV) (30.7%; type B3) was responsible for the outbreak. Mortality was noted in 4.5% of paediatric cases identified during active surveillance. Virus type and viral coinfection were not significantly associated with mortality. Conclusions This is the first report of intense cocirculation of multiple respiratory viruses as a cause of an outbreak of severe acute respiratory illness in Sri Lanka, and the first time that AdV has been documented as a cause of a respiratory outbreak in the country. Our results emphasise the need for continued vigilance in surveying for known and emerging respiratory viruses in the tropics.