University of Kelaniya
  • Kelaniya, Sri Lanka
Recent publications
The COVID-19 pandemic has highlighted the urgency of adopting innovative approaches and technological advancements to foster environmental sustainability and social welfare. Financial technology (Fintech) emerges as a key player in this movement, offering solutions to shape a more sustainable world post-pandemic. Leveraging Fintech presents opportunities to advance eco-conscious business practices and facilitate the transition towards sustainable finance models. Moreover, the convergence of Fintech with healthcare holds promise for enhancing access, affordability, and efficiency in healthcare delivery. This chapter aims to explore key sustainability implications of Fintech in three key areas—strategizing Fintech for eco-conscious business and financial empowerment, regulatory innovation and collaboration strategies for accelerating ESG-driven finance, and Fintech’s potential in healthcare services. Furthermore, benefits, costs, opportunities, and threats of leveraging Fintech for sustainability are identified. Policy implications are discussed, emphasizing the need for regulatory frameworks that promote green financing, ethical operations, and digital resilience while addressing disparities in Fintech access and benefits. Overall, embracing Fintech for sustainability signifies a paradigm shift towards a resilient, inclusive, and environmentally conscious future.
While it is clear that current human impact on the earth system is unprecedented in scope and scale, much less is known about the long-term histories of human land use and their effects on vegetation, carbon cycling, and other factors relevant to climate change. Current debates over the possible importance of human activities since the mid second millennium CE cannot be effectively resolved without evidence-based reconstructions of past land use and its consequences. The goal of the PAGES LandCover 6K working group is to reconstruct human land use and land cover over the past 12,000 years. In this paper, we present the first large-scale synthesis of archaeological evidence for human land use in South Asia at 12 and 6kya, a critical period for the transition to agriculture, arguably one of the land use transitions most consequential in terms of human impact on the Earth system. Perhaps the most important narrative we can pick out is that while there are some shifts in land use across these time windows, hunter-gatherer-fisher-foraging remained the dominant land use, and within this there was a mosaic of strategies exploiting diverse and complex landscapes and ecologies. This is not necessarily a new conclusion–it is not new to state that South Asia is comprised of many niches, but demonstrating the deep time history of how people have adapted to these and adapted them is an important step for modelling the impacts of human populations and thinking about their footprints in a longue-durée perspective. Despite the new development of food production between the early and mid-Holocene by overall area foraging life ways continued as the dominant land use practice into the 6kya time window. The development of agriculture and food production was not unimportant–it is the beginning of a land use that eventually comes to dominate the sub-continent, but at 6kya agriculture was restricted to specific contexts. Across 12kya to 6kya and different land uses, the use of mosaic ecologies, diverse strategies and the importance of water as a resource stand out as shared themes.
Introduction Low birth weight continues to pose significant challenges to healthcare systems worldwide. Despite substantial improvement in various public health indicators, many developing countries have failed to achieve a significant reduction in low birth weight rates. One major obstacle is the sparsity of data on the determinants of low birth weight. Here, we aim to determine the composition and risk factors for low birth weight in Sri Lanka, a prototype developing nation. Methodology We conducted a countrywide multicentre cross-sectional study in August and September 2023 in 13 purposively selected hospitals representing all nine provinces and different tiers of specialist hospitals in Sri Lanka. All live-born neonates were recruited prospectively, and their mothers were interviewed by trained data collectors to gather information on socio-demographic background, medical and obstetric history, and delivery details. Birth weight was measured immediately after the birth by trained healthcare personnel attending the delivery. Results A total of 9130 live-born neonates were recruited, of which 52% were males. The mean birth weight was 2827g (95%CI 2817-2838g), and 1865 (20.4%) newborns were low birth weight. The prevalence of prematurity was 10.9% (n = 998), and 1819 (20.0%) neonates were born small for gestational age. Of the low birth weight neonates, 64% were small for gestational age, and 37% were preterm; 11% were both small for gestational age and preterm. Teenage pregnancy (p = 0.022), low maternal pre-pregnancy body mass index (p<0.001), inadequate weight gain during pregnancy (p<0.001), maternal anaemia at delivery (p = 0.020), chronic lung disease (p = 0.019), and pregnancy induced hypertension (p = 0.019) were significant modifiable risk factors for small for gestational age. Conclusion This study presents the results of one of the most extensive country-wide studies evaluating the composition and determinants of low birth weight. The study highlights the importance of considering small for gestational age and prematurity as separate categories of low birth weight. Small for gestational age contributes to approximately two-thirds of the low birth weight burden. Therefore, targeting modifiable risk factors for small for gestational age while mitigating the burden of prematurity is the most feasible approach to reduce the prevalence of low birth weight in developing countries, including Sri Lanka.
Background Human Cytomegalovirus (HCMV) spreads through direct contact with blood, and other body fluids such as urine, saliva and breast milk. It is transmitted sexually and can also be passed from a pregnant mother to fetus via the placenta. While often asymptomatic in healthy individuals, HCMV causes symptomatic infections in immunocompromised people and congenital infections in fetuses. It is a common global congenital infection and can lead to morbidity and occasional mortality in newborns. Latent HCMV may reactivate in immunosuppressed individuals. This study aimed to determine the age and gender specific seroprevalence of HCMV in selected populations in Sri Lanka. Methods A total of 820 blood samples obtained from 820 participants of selected low and high-risk populations in Sri Lanka, namely; hospital inpatients (n = 200), antenatal women (n = 80), blood donors (n = 80), cancer patients (n = 200), Sexually Transmitted Disease (STD) clinic attendees (n = 160) and Chronic Kidney Disease (CKD) patients on haemodialysis (n = 100) were tested for IgG antibodies against HCMV by Enzyme Linked Immunosorbent Assay (ELISA). Statistical analysis was performed using IBM SPSS Statistics version 30 (IBM® Corporation, New York, USA). Results Overall HCMV seroprevalence was found to be 94.9% (778/820), whereas in males it was 95.2% (395/415) and in females it was 94.6% (383/405) (p = 0.691). Seroprevalence of HCMV in hospital inpatients, antenatal women, blood donors, cancer patients, STD clinic attendees and CKD patients on haemodialysis were found to be 92.5% (185/200), 100% (80/80), 90% (72/80), 96% (192/200), 93.1% (149/160) and 100% (100/100) respectively. Overall seroprevalence of HCMV increases with age ranging from 94.3% (33/35) in 15–19 years age group to 98.8% (84/85) in ≥ 60 years age group. Conclusions Seroprevalence of HCMV in diverse low and high-risk populations of Sri Lanka was studied for the first time. HCMV seroprevalence is similar between genders (p > 0.05) and increases with age. Over 90% of individuals are infected with HCMV by age 15, indicating a high prevalence of primary infections from early childhood to adolescence. This study provides essential background information on HCMV infection and its impacts in diverse populations of Sri Lanka and aids in executing preventive and therapeutic measures in high-risk populations.
Objectives Thalassaemia is a genetic disorder of haemoglobin synthesis characterised by life-long chronic anaemia. Although the endocrine and cardiac complications of thalassaemia are well-studied, hepatic and renal complications are understudied. This study aims to describe the hepatic and renal functions and to understand their determinants among paediatric patients with β-thalassaemia. Design Cross-sectional study. Setting Two largest thalassaemia centres in Sri Lanka. Participants All haematologically confirmed patients with β-thalassaemia aged 1–16 years attending the study sites were recruited between 1 January and 31 March 2023. Data were collected by interviewing parents and patients, performing physical examinations and perusing clinical records. Results 72 children (girls 52.8%) were recruited. The mean age was 7.3 years (SD 3.8). A majority (44 (61.1%)) had β-thalassaemia major, while 22 (30.6%) had haemoglobin E β-thalassaemia. 55 children (76.4%) were transfusion dependent. Hepatomegaly was found in 47 (65.3%), while 28 (38.9%) had elevations of both alanine and aspartate transaminases. Haemoglobin E β-thalassaemia type (OR 13.6, 95% CI 2.0 to 92, p=0.008) and high ferritin above 1000 ng/mL (OR 6.2, 95% CI 1.0 to 38, p=0.047) were independent factors associated with high transaminases. 11 (15.5%) patients had an estimated glomerular filtration rate (eGFR) below 90 mL/min. The proportion of children with low eGFR was higher in β-thalassaemia major (23.3%), transfusion-dependent (18.5%) and deferasirox treatment (18.5%) groups. Conclusions Elevation of hepatic transaminases is common among children with thalassaemia, especially among the subset of patients with haemoglobin E β-thalassaemia and those with high ferritin. Milder reductions in eGFR are noted in some patients with transfusion-dependent β-thalassaemia major.
Objectives: Inflammatory bowel disease (IBD) is an emerging disease in the South Asia. We conducted a systematic review to determine the characteristics and overall prevalence of IBD among South Asian adults. Design: We searched the PubMed database and included descriptive, epidemiological studies with satisfactory methodological quality, reporting the epidemiology of IBD with histological confirmation. The quality of the studies was assessed using Joanna Briggs Institute Critical Appraisal Checklist for Prevalence Studies. Two authors screened and extracted data independently. A random-effects meta-analysis of characteristics and overall prevalence of IBD was performed. Results: This review analysed data from over 9000 IBD patients from 21 studies across multiple South Asian countries. It found a higher prevalence of ulcerative colitis (UC) compared to Crohn's disease (CD) (2:1). There was a male predominance and modest familial aggregation of IBD cases. Left-sided colitis was the most common disease extent for UC. Colonic involvement was more frequent than ileal involvement for CD. The non-stricturing, non-penetrating behaviour was dominant in CD cases. Joint manifestations were commonly reported in both UC and CD. Immunomodulators, such as azathioprine, were used in a significant proportion of patients, particularly for CD. The use of biological agents like infliximab was relatively low. Surgical intervention rates were lower than in Western cohorts but higher in CD compared to UC. Conclusions: This study provides an epidemiological overview of adult IBD characteristics, phenotypes, and treatment patterns in the South Asian region. There were epidemiological, clinical, phenotypic and treatment differences compared to western IBD.
Background In the World Health Organization (WHO) geographical region of South-East Asia, the mental health burden of adolescents appears high. Addressing this burden requires development of mental health policies consistent with international standards to assist governance, resource allocation and delivery of mental healthcare effectively. The aim was to identify current national mental health policies/plans/programs/legislation in South-East Asia, assess compliance with international standards and review inclusion of adolescents in these documents. Methods Searches were conducted on WHO MiNDbank, official government websites, Google and Google Scholar. Documents were compiled and screened, data were extracted and evaluated following WHO Guidelines on Monitoring and Evaluation of Mental Health Policies and Plans. Frequencies of checklist and subsection scores were calculated. Data were narratively synthesised. Findings Fourteen mental health policies/plans/programs/legislation from 8 countries met inclusion criteria. Maldivian and Bangladeshi documents complied the greatest with WHO guidelines. All 8 countries considered adolescents to some extent in their documents. Only Indian documents consulted child health groups during policy development. Intra/Inter sectoral collaboration with child health divisions was highlighted in documents from Sri Lanka, Bangladesh, India and Maldives. Interpretation Most South-East Asian nations had developed separate national mental health governance documents. However, their incorporation of adolescent mental health is rare and compliance with international standards were inconsistent. Binding mental health legislation separate from health legislation; inclusion of adolescents; addressing resource constraints; and guidelines for mental health policy development catered to low-and-middle-income countries are all essential to address the complex mental health needs of South-East Asian adolescents.
Objective Salicornia brachiata, an euhalophyte thriving in saline environments, can be processed into a dried powder (termed bio-salt) from its tender aerial parts. This study aimed to evaluate how three distinct drying methods; freeze-drying (FD), microwave-vacuum drying (MVD) as low temperature drying methods, and heat pump oven drying (HPOD) as a high temperature drying method, affect nutritional composition and bioactivities of S. brachiata. Ultimately, this research aims to identify the most suitable drying approach that retains bioactive and nutritional properties to preserve the health benefits of bio-salt. Methods The aerial parts of S. brachiata were washed, air-dried overnight, and then subjected to various drying methods. The proximate composition, colour measurements, mineral composition, and microbial quality of the dried powders were evaluated. The lipid extracts were analyzed using GC-MS and the total phenolic content and antioxidant activity of the resulting powders were assessed. Results Among the methods, FD best preserved the plant's color and yielded the highest levels of carbohydrates (42.64%), crude fat (0.88%), and dietary fibers (29.72%). Methanolic extracts of FD powders exhibited the highest phenolic content (43.68 ± 0.04 mg GAE/g DW) and superior antioxidant activity, with IC50 values of 8.72 ± 0.50 µg/mL for the DPPH assay and 19.49 ± 0.76 µg/mL for the ABTS assay, outperforming both MVD and HPOD. The FD extracts contained a higher proportion of unsaturated fatty acids compared to saturated fatty acids. In vitro antibacterial assays revealed that the FD extract at 100 mg/mL demonstrated the strongest inhibition against test bacteria. In an anti-inflammatory assay, FD was identified as the most effective drying method, yielding the lowest IC50 value of 314.78 ± 1.55 µg/mL. Conclusion These results suggest that freeze-drying is the most suitable drying method for preserving the bioactive properties and health benefits of bio-salt derived from the aerial parts of S. brachiata.
Background and Aim The APAGE Position Statements aimed to provide guidance to healthcare practitioners on clinical practices aligned with climate sustainability. Methods A taskforce convened by APAGE proposed provisional statements. Twenty‐two gastroenterologists from the Asian Pacific region participated in online voting and consensus was assessed through an anonymized and iterative Delphi process. Results There were five sections that addressed the rationale for climate action, the importance of adopting principles of waste management, clinical practice, gastrointestinal endoscopy, and issues related to advocacy and research. Sixteen statements achieved consensus and included the following: 1. APAGE recommends adopting prompt measures to reduce the carbon footprint of clinical practice due to the importance of climate action and its health cobenefits. 5. APAGE recommends adherence to professional clinical guidelines to optimize clinical care delivery in gastroenterology and hepatology to avoid the environmental impact of unnecessary procedures and tests. 8. APAGE recommends an emphasis on health promotion, disease prevention, and appropriate screening and surveillance, when resources are available, to reduce the environmental impact of managing more advanced diseases that require more intensive resources. 12. APAGE recommends that technological advances in endoscopic imaging and artificial intelligence, when available, be used to improve the precision of endoscopic diagnosis to reduce the risk of missed lesions and need for unnecessary biopsies. 13. APAGE recommends against the routine use of single‐use endoscopes. Conclusion The position statements provide guidance to healthcare practitioners on clinical practices in gastroenterology, hepatology, and endoscopy that promote climate sustainability.
Background Neuroblastoma is an embryological malignancy of neural crest cells that may have diverse presentations owing to direct effects, metastases, or paraneoplastic syndromes. Facial nerve palsy is an extremely rare presentation of neuroblastoma. Case presentation A previously healthy 1-year-and-10-month-old Sinhalese girl presented with difficulty in closing her left eye for 2 weeks, preceded by deviation of her mouth to opposite side. Initial physical examination was normal, apart from left lower-motor-type facial nerve palsy. Initial laboratory investigations were also normal. A tentative diagnosis of Bell’s palsy was made. However, magnetic resonance imaging of the brain was performed owing to the incidental detection of a painless bulge in the left zygomatic region with overlying skin bruising, in the absence of any preceding trauma. Magnetic resonance imaging of the brain revealed a soft-tissue mass in the left lateral orbital wall, extending to the body of the sphenoid and bulging into the left anterior fossa. Contrast-enhanced computed tomography of the abdomen, performed subsequently, showed an intra-abdominal large paravertebral soft-tissue mass. Histology of the abdominal mass confirmed poorly differentiated neuroblastoma. Conclusion Facial nerve palsy is well recognized to have a myriad of underlying etiologies, including hematological malignancies, solid tumors, and paraneoplastic syndromes. However, its timely diagnosis is often challenging in the absence of other supportive clinical features. These children need careful and thorough evaluation for malignancies before commencing steroids, especially when underlying malignancy is likely.
Background Basella alba L. (Malabar spinach) is a widely consumed leafy vegetable, well known for its nutritional and therapeutic properties. These properties arise from the availability of essential nutrients, phytochemicals, and antioxidant potential, which may vary depending on environmental factors induced by the geographical location. In this study our aim is to investigate the correlation between the geographical location and proximate composition, phytochemical content, and antioxidant activity of B. alba harvested from fifteen locations in Sri Lanka. Results According to the statistical analysis by ANOVA and Tukey test, the results of proximate analysis confirmed that samples from different locations showed statistically significant variance in nutritional content. Furthermore, phytochemical content and antioxidant potential varied showing a significant difference between locations in total chlorophyll (27.53 to 6.69 µg/g dry weight), carotene (4.54 to 1.15 µg/g dry weight), total flavonoid content (10.54 to 3.94 mg/g dry weight in Quercetin equivalents), total phenolic content (8.33 to 0.46 mg/g dry weight in gallic acid equivalents), 1,1-diphenyl-2-picrylhydrazyl radical scavenging activity (38.03–11.4% inhibition), and ferric ion-reducing antioxidant power (1.23 to 3.76 mg/g dry weight in ascorbic acid equivalents) (p < 0.05). The Pearson correlation showed a strong positive correlation between total phenolic content and antioxidant activity. Principal component analysis indicates the role of antioxidant activity and chlorophyll content in location differentiation, forming distinct clusters. Cluster analysis categorized samples into four groups, linking biochemical traits to agro-climatic zones. The principal component analysis and cluster analysis showed a close relationship between some locations due to their high antioxidant and phytochemical accumulation. Conclusion This study exhibits the importance of geographical location on the phytochemical profile and antioxidant properties of B. alba. These findings can be used to refine optimal cultivation sites for B. alba to enhance the efficacy of its nutraceutical and pharmaceutical potential.
Background Leishmaniasis is a health problem in many regions with poor health and poor life resources. According to the World Health Organization (WHO), an estimated 700,000–1 million new cases arise annually. Effective control of sand fly vector populations is crucial for reducing the transmission of this disease. Therefore, this review aims to comprehensively examine and evaluate the current methods for controlling sand fly populations, focusing on biological and gene drive techniques. Methods and findings A detailed, comprehensive literature search was carried out using databases including Google Scholar, PubMed, ScienceDirect, and the National Library of Medicine (NIH). These searches were done using specific keywords related to the field of study. This current review identified several promising methods, including genetically modified sand flies, using transgenic approaches by taking advanced gene editing tools like Clustered Regularly Interspaced Short Palindromic Repeats (CRISPR/Cas9) and genetic modification of symbiotic microorganisms for controlling sand fly populations, which appeared to be proven under laboratory and field settings. Conclusion Genetic control approaches have many benefits over chemical control, including long-lasting effects on targets, high specificity, and less environmental impact. Advances in genetic engineering technologies, particularly CRISPR/Cas9, sterile insect techniques, and gene drive insect modification, offer new avenues for precise and efficient sand fly management. Future research should prioritize optimizing rearing and sterilization techniques, conducting controlled field trials, and fostering collaboration across disciplines to realize the potential of genetic control strategies in combating leishmaniasis.
Congenital titinopathy has recently emerged as one of the most common congenital muscle disorders. Objective To better understand the presentation and clinical needs of the under‐characterized extreme end of the congenital titinopathy severity spectrum. Methods We comprehensively analyzed the clinical, imaging, pathology, autopsy, and genetic findings in 15 severely affected individuals from 11 families. Results Prenatal features included hypokinesia or akinesia and growth restriction. Six pregnancies were terminated. Nine infants were born at or near term with severe‐to‐profound weakness and required resuscitation. Seven died following withdrawal of life support. Two surviving children require ongoing respiratory support. Most cohort members had at least 1 disease‐causing variant predicted to result in some near‐normal‐length titin expression. The exceptions, from 2 unrelated families, had homozygous truncating variants predicted to induce complete nonsense mediated decay. However, subsequent analyses suggested that the causative variant in each family had an additional previously unrecognized impact on splicing likely to result in some near‐normal‐length titin expression. This impact was confirmed by minigene assay for 1 variant. Interpretation This study confirms the clinical variability of congenital titinopathy. Severely affected individuals succumb prenatally/during infancy, whereas others survive into adulthood. It is likely that this variability is because of differences in the amount and/or length of expressed titin. If confirmed, analysis of titin expression could facilitate clinical prediction and increasing expression might be an effective treatment strategy. Our findings also further‐support the hypothesis that some near‐normal‐length titin expression is essential to early prenatal survival. Sometimes expression of normal/near‐normal‐length titin is due to disease‐causing variants having an additional impact on splicing. ANN NEUROL 2025
Background Cinnamon has been studied as a possible way to control blood glucose and serum cholesterol levels. However, there are no well-conducted randomized controlled trials that can accurately measure the lipid and glucose-lowering effects of Cinnamomum zeylanicum (C. zeylanicum) extract. This study primarily aimed to evaluate the effect of a standardized C. zeylanicum extract on serum low-density lipoprotein cholesterol (LDL-C) levels and secondarily on other lipid parameters (high-density lipoprotein cholesterol (HDL-C), total cholesterol and triglycerides), glucose levels, anthropometric measures, blood pressure, and safety outcomes in individuals with an LDL level between 100-190mg/dL. Materials and methods This was a randomized, double-blinded, placebo-controlled clinical trial. Participants were allocated to either C. zeylanicum extract or placebo group (1:1 allocation ratio). They were advised to take two capsules per day (1000 mg/day, a dose based on prior clinical studies suggesting potential efficacy and safety). Reduction in LDL-C at 12 weeks (from the baseline value) was compared between the two groups using ANCOVA. A complete-case analysis was adhered to in analyzing the outcome data. Results The mean age (SD) of the 150 participants was 50.4 (10.52) years, and 66% were females. Among the 127 participants assessed at 12 weeks, those in the C. zeylanicum extract arm had a lower LDL-C value than the placebo arm but the difference was not significant (the baseline adjusted mean difference was 6.05mg/dL; 95% CI: -2.43 to 14.52; p = 0.161). However, participants in the C. zeylanicum extract group showed significantly greater reductions in fasting blood sugar (FBS) levels (the baseline adjusted mean difference was 8.59mg/dL; 95% CI: 0.59 to 16.59; p = 0.036). There was a significant interaction effect between the supplement and participants’ glycemic status, with individuals with type 2 diabetes mellitus (T2DM) who received C. zeylanicum extract experiencing a notable reduction in FBS levels (standardized coefficient: -63, 95% CI: -102 to -25; p = 0.002). Conclusions C. zeylanicum extract did not have significantly reduce LDL-C but demonstrated a significant FBS-lowering effect, particularly in individuals with T2DM, with a favorable safety profile. Trials registration The trial was registered with the Sri Lanka Clinical Trials Registry: SLCTR/2021/011.
A 1.5 to 3 Mb microdeletion of chromosome 22q11.2 with loss of multiple genes including histone cell cycle regulator (HIRA) causes 22q11.2 deletion syndrome (22q11.2 DS), a common disorder with variable manifestations including congenital malformations affecting the heart, palate and kidneys in association with neurodevelopmental, psychiatric, endocrine and autoimmune abnormalities. The aim of this study was to develop a TaqMan based dosage analysis PCR (TaqMan qPCR) for use as a rapid, cost-effective test for clinically suspected patients fulfilling previously described criteria for molecular diagnosis of 22q11.2 DS in a lower middle-income country where the cost of testing limits its use in routine clinical practice. Nineteen patients were recruited with informed consent following ethical approval from the Ethics Review Committee (ERC), Lady Ridgway hospital, Colombo. Dosage analysis of extracted DNA was performed using a TaqMan qPCR assay by amplifying regions within the target (HIRA) and control [Testin LIM domain protein (TES)] genes of a suspected patient (P) and unaffected person (N). For detection of a deletion, the normalized values (HIRA / TES dosage) of a patient were compared with normalized values of an unaffected person. A ratio of P:N of 0.5 confirmed presence of a deletion while a ratio of 1.0 refuted this. Seven of 19 (37%) cases were confirmed to have a HIRA deletion, confirming the diagnosis of 22q11.2 DS, with these results being in complete agreement with those of fluorescence in-situ hybridization (FISH), (performed in 9/19 (47.3%) of recruited cases) and whole exome sequencing (WES) (all 19 samples tested). This TaqMan qPCR assay was able to reliably distinguish HIRA deleted cases from the non-deleted ones. The assay was both less expensive and faster compared to commercially available alternatives in our setting, including FISH and multiple ligation-dependent probe amplification (MLPA).
Background Adolescence is a sensitive phase of human development where individuals, aged 10–19 years, are particularly vulnerable to developing mental health problems (MHPs). South Asia, home to 24% of the world's population, is mostly comprised of low- and middle-income countries (LMIC). Most of the world's young people live in LMICs. This systematic review aims to assess the available evidence on the nature, prevalence and determinants of MHPs experienced by adolescents in south Asia. Methods Following PRISMA guidelines, searches were conducted in four online databases (Ovid Medline, Ovid EMBASE, Ovid Global Health, Ovid PsycInfo), titles, abstracts, and full-texts were screened, data extracted and quality assessed. Extracted data were categorised into school-based studies (SBS) and non-school-based studies (NSBS). Data were further stratified according to country, MHPs and narratively synthesised. Findings Of the 5847 records identified in the searches, 117 met inclusion criteria. Most (n = 87) were SBS. Key MHPs reported across countries include anxiety disorders and depression. Wide ranges of prevalence rates were reported for anxiety in Indian SBS (1.5–81.6%) and NSBS (1.8–88.1%), and for depression, Pakistani SBS (21–79%) and Indian NSBS (0.4–98.5%). Determinants include individual characteristics; violent victimisation; poor family/home/school environment/peer relationships; already experiencing MHPs and substance use/abuse. Increased physical activity, adequate nutrition, safe/positive homes/family environment, being unmarried females, higher maternal education, peer support/friendship, higher education level and engaging in extra-curricular activities were protective of mental well-being. Interpretation Prevalence of MHPs among south Asian adolescents appears high. Determinants include social, cultural, environmental and socioeconomic factors often beyond individual control. Mental health policies and programs and research appropriate to the cultural context, that address social determinants of MHPs and evidence gaps, are needed to tackle the significant mental health burden among south Asian adolescents.
South Korea has the highest suicide rate in the world, while Bangladesh, China, Hong Kong, Japan, Sri Lanka and Taiwan also report relatively high suicide rates. The reasons behind the higher suicide rates in these countries remain a complex issue. Conversely, Muslim countries such as Iran, Pakistan, Saudi Arabia and Turkey had relatively lower suicide rates in the world. This study aims to identify the key reasons behind the high suicide rates. Therefore, analysis revealed that there are gender impacts and economic factors that cause suicide trends mainly in South Korea, Japan, Sri Lanka and Asia. Using quantitative methodology and secondary data, the study first performed a comparative analysis of suicide rates in three selected countries, identifying trends and underlying reasons. Next, the study performed an econometric analysis using time series panel data from 2000 to 2019, focusing on a sample of 12 Asian countries. This analysis utilized pooled ordinary least-squares estimation, panel fixed effects and random effects estimation, accompanied by the Hausman test. Key findings indicate that there is an increasing trend in the suicide rate in South Korea, while there are decreasing trends in Japan and Sri Lanka. Remarkably, the study observed that the female suicide rate is higher than the male suicide rate in South Korea, while in Japan and Sri Lanka, it is the opposite. Moreover, the empirical results show that unemployment, inflation and remittances are significant economic factors influencing the suicide rate in Asia. Specifically, remittances have a significantly negative impact on suicide rates, whereas unemployment and inflation have a significantly positive effect.
Background Garment factory employees have been identified as a high-risk population for developing depression in Asian countries. Depression is recognised as a potentially reversible risk factor for low productivity in the garment factory workforce. Therefore, identification and treatment of depression in garment factory workers can improve productivity and their quality of life in general. The study aimed to determine the prevalence and correlates of depression in garment factory workers in the Hambantota district, Sri Lanka. Methods This is a cross-sectional descriptive study. The calculated sample size was 390, and a multistage random sampling method was used. Culturally validated General Health Questionnaire-12 and Beck Depression Inventory–II were used to screen for psychological morbidity and depression, respectively. Results The majority of 390 employees were females (n=325, 83.3%). The mean age was 32.9 years (SD—10.45 years). The prevalence of depression in the study sample was 16.80% (95% CI: 13.04% to 20.55%). Depression was associated with the presence of a chronic medical condition(OR-3.51, 95% CI:1.61-7.67, p<0.002), family history of psychiatric illness (OR-3.03 95% CI-1.11 to 8.26, p<0.03), history of deliberate self-harm (OR-10.79 95% CI-4.68 to 24.89, p<0.001), history of psychiatric illness (OR-6.12, 95% CI-2.39-15.73, p<0.001), and being divorced or separated from their partner. The only job-related factor that correlates with depression was working extra duty hours (OR-1.74, CI 1.01-3.02, p<0.05). Conclusions The prevalence of depression among garment factory employees in Hambantota district is high. However, it is relatively lower compared to garment factory populations in other developing Asian countries.
Institution pages aggregate content on ResearchGate related to an institution. The members listed on this page have self-identified as being affiliated with this institution. Publications listed on this page were identified by our algorithms as relating to this institution. This page was not created or approved by the institution. If you represent an institution and have questions about these pages or wish to report inaccurate content, you can contact us here.
5,813 members
Aruna Kumara Ranaweera
  • Department of Physics and Electronics
Aruni Hapangama
  • Department of Psychiatry
Madawa Chandratilake
  • Faculty of Medicine
Sachith Mettananda
  • Department of Paediatrics
W. Nirmala Sriyani Perera
  • Dept.of Forensic Medicine
Information
Address
Kelaniya, Sri Lanka