PURSE 2013

Permanent URI for this collection

https://ir.lib.pdn.ac.lk/handle/20.500.14444/59

Browse

Browsing PURSE 2013 by Author "Adicaram, D. R. S."

Now showing 1 - 2 of 2
  • Thumbnail Image
    Item
    Clinical use of polymerase chain reaction based detection of Leishmania Spp. in the dianosis of cutaneous leishmaniasis
    (The University of Peradeniya, 2013-07-04) Atapattu, D. N.; Iddawela, W. M. D. R.; Adikari, S. B.; Rajapakse, R. P. V. J.; Wickramasinghe, W. D. S. J.; Samaraweera, S. S.; Senevirathne, N.; Perera, N.; Adicaram, D. R. S.; Jayawardana, G. J. K. A. A.; Dissanayake, D. M. H. N.; Bandara, D. R. L. N.; Wijesundara, N. L. S.; Nugawela, S.
    Sri Lanka is the newest reported focus of leishmaniasis in the Indian subcontinent and since 2001 there have been over 2500 clinically suspected cases referred for disease confirmation. Light microscopy remains the mainstay for diagnosis, but in spite of its wide use, as the sensitivity of microscopy is low, it can result in mismanagement of patients. The objective of this research was to study the clinical use of the polymerase chain reaction (PCR) in the diagnosis of cutaneous leishmaniasis (CL). The sensitivity of microscopy was compared with PCR amplification using a set of primers that amplified a 260-bp region in the genomic DNA of all old world Leishmania spp. The samples (n=31) were collected from patients clinically suspected of CL. The smears were stained with Giemsa and for PCR, DNA was extracted from skin scrapings. A diagnosis of CL was given if at least one of the two techniques produced positive findings. Of the sample, 64.5% were identified as CL positive by both tests. The sensitivity for microscopy and PCR were 70% and 80% respectively. PCR also detected 35% of themicroscopy negative patients. Three patients who had demonstrated negative results whenmicroscopy was repeated and two patients who were undergoing treatment for leprosy were also diagnosed positively by PCR. The PCR assay had a higher sensitivity for diagnosing CL when compared with microscopy and although time consuming and expensive, it can be recommended in those cases where microscopy is negative and the clinical diagnosis is doubtful
  • Thumbnail Image
    Item
    Toxoplasma gondii antibody positivity among patients with clinically suspected ocular toxoplasmosis
    (The University of Peradeniya, 2013-07-04) Iddawela, W. M. D. R.; Iddawela, P. B.; Senanayake, S.; Adicaram, D. R. S.; Bandara, D. R. L. N.
    Toxoplasma gondii is an important cause of chorioretinitis globally and is responsible for the majority of uveits. The infection is usually acquired congenitally or postnatally by ingesting food or water contaminated with oocysts shed by cats or by eating raw or undercooked meat containing tissue cysts. No studies have been carried out in Sri Lanka on ocular toxoplasmosis and the prevalence of ocular infection in humans is not known. This study was carried out to determine the T.gondii seropositivity among clinically suspected ocular toxoplasmosis patients and to assess the clinical manifestations amongst the seropositives. A total of 104 (females 47 and males 57) clinically suspected ocular toxoplasmosis patients referred by eye surgeons in Kandy, Badulla, Nuwera Eliya and Nawalapitiya were studied between September 2010 and May 2012. Data on age, sex, fundoscopic findings were obtained from the referral letter. Serum samples from each patient were subjected to T.gondii specific IgG and IgM assays. The median age of the patients was 34years (range 4 – 74 years). The T. gondii IgG positivity was 33.7% (35) with only one patient having both IgG and IgM. They presented with the following eye lesions: uveitis (67), vitritis (8), macular scar (8) granuloma of eye (7), retinal scar (5) endophthalmitis (4) choroiditis (3) and vasculitis (2). The majority of seropositives 26 (74%) had uveitis. Of these, 15 had pan uveitis, 8 had posterior uveitis and 3 had anterior uveitis. The majority (18/34) of seropositives were in the age group of 30 – 60 years. The seropositivity in males (34%) was higher than in females (29.7%) but this difference was not significant. Of the patients who were seropositive, 80% presented with poor vision and all seropositive patients had unilateral eye lesions. This study shows for the first time in Sri Lanka, the impact of ocular toxoplasmosis in the community. There was 33.7% seroprevalence of toxoplasmosis among clinically suspected patients indicating a high level of transmission. The study indicates that toxoplasmosis plays an important role in uveitis thus stressing the need for laboratory tests to confirm Toxoplasma aetiology in clinically suspected patients. Improved molecular diagnostic techniques are recommended to diagnose and treat toxoplasmosis in the acute stage in order to minimize the deleterious effects on the eye.