Around 75% of child deaths below 5 years in Sri Lanka, occur during the first four weeks (28 days) of life (Neonatal deaths). Of the neonatal deaths, more than one-third are due to preterm births, the leading cause of death, National Program Manager, Maternal and Child Health Surveillance, Dr Kapila Jayaratne told the Sunday Observer.
He said that “ideally a baby should be in utero (womb) for forty weeks. Babies born before 37 weeks or earlier are called preterm births. Every year around 26,000 babies are born preterm in Sri Lanka. Preterm babies are prone to many consequences including mortality.” Pre term births burden the health system, families and society not only by the significant number of deaths but also due to acute and chronic complications. Usually, a higher percentage of preterm babies ends up with adverse neonatal outcomes. This percentage further increases as the period of gestation decreases or in other words, when the baby is born very early and immature. Preterm birth is a major risk factor for neurological problems and disability. It also gives rise to chronic lung disease, neonatal infections, severe brain injury, necrotising enterocolitis and retinopathy of prematurity.” he explained.
To mitigate the negative effects of preterm birth, he said that recently a team comprising Dr. Dimuth Peiris, Prof Rohini Seneviratne and himself conducted a research study to identify risk factors of preterm births in Sri Lanka. The principal investigator, Dr. Dimuth Peiris, said,“This was done in all the government hospitals in the Colombo district. Though several contributory factors have been identified globally, this study identified country specific factors. Our research identified eleven risk factors and one protective factor. The risk factors included: multiple pregnancy, a recent stressful life event, pregnancy induced hypertension, unsatisfactory oral hygiene, standing long hours during 3rd trimester of pregnancy and cooking using firewood”. He also said that abstaining from sexual intercourse within seven days of labour was identified as a protective factor for preterm labour.
Dr. Peiris noted that some of these factors could be avoided and others could be given higher attention to reduce preterm births or to minimize the complications by referring them to a health facility where they could be managed properly and offered optimal care. Many developed countries have successfully reduced preterm births and also the complications.
Fifteen million babies are born preterm globally, revealing a rising trend across the world, a problem that deserves immediate preventive action, he emphasized.
Presidential Task Force on Dengue Control calls for collective action by public to control disease spread
The call for strengthening measures to control the spread of dengue and avoid an epidemic situation, has been reiterated by the Presidential Task Force in the wake of mounting cases of dengue reported by the Epidemiology Unit islandwide.
The number of suspected cases of dengue fever reported to the Epidemiology Unit as at August 14 2019, stands at 36,858 with a reported 54 deaths, as compared to 58 deaths for the whole of last last year.. They said the highest number of cases ( approximately 45.1 %) were reported from the Western Province, with Colombo district leading the rest.
Epidemiology Unit officials told the Sunday Observer they had identified five high risk districts - Colombo, Gampaha , Kalutara , Ratnapaura ,Galle and Matara and sources told the newspaper that Colombo recorded the highest number, 7,880 cases of suspected dengue as at August 13, with 620 cases at the time of going to press. At least 10 districts have now exceeded the 1,000 mark in the number of dengue fever cases although the numbers are steadily falling due to preventive measures by the Dengue Prevention Unit as well as the armed forces and tri forces under the guidance of the Presidential Task Force on Dengue Control, informed sources told the newspaper.
Noting that the elimination of breeding sites was the key strategy in dengue elimination, Epidemiology officials and the Dengue Control Unit have called for extensive and regular removal of possible mosquito breeding sites from the environment. Health Ministry officials told the newspaper that they had also sent out circulars to all medical officers of health at regional, provincial and district levels on the management of fever and the mortality rate was thus relatively low. “We have also advised patients to seek medical attention in the event of fever and seek laboratory investigations at least by day three of the illness. However, pregnant women should seek treatment on the first day of fever,” the officials said.
The public has also been warned against taking drugs such as Aspirin, Ibuprofen, and mafenamic acid as well as any other non steroidal anti-inflammatory drugs ( NSAID). Doctors who treat fever patients should avoid prescribing these drugs as they can cause bleeding,” a health official told the Sunday Observer.
About 40% of Aedes mosquitoes breed in discarded containers and utensils. Epidemiology officials told the Sunday Observer that with the school holidays now on, special attention was being given to cleaning school grounds ahead of the new term starting next month. Additionally, attention will be given to construction sites, religious places and other institutions where there are large tracts of mosquito breeding sites. “ We will be conducting an ongoing dengue control program until the rains cease. We have also requested all private and government institutions to clean their premises for an hour in a selected day every week, to sustain the program.”