
Anuradhani KasturiratneUniversity of Kelaniya · Faculty of Medicine
Anuradhani Kasturiratne
MBBS, MSc, MD
About
261
Publications
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Introduction
Additional affiliations
August 2008 - August 2009
October 2008 - present
Publications
Publications (261)
Introduction
Models derived from non-Sri Lankan cohorts are used for cardiovascular (CV) risk stratification of Sri Lankans.
Objective
To develop a CV risk prediction model using machine learning (ML) based on data from a Sri Lankan cohort followed up for 10 years, and to compare the predictions with WHO risk charts.
Design
Cohort study.
Setting...
There are no CV risk prediction models derived from Sri Lankan cohorts. Therefore, the World Health Organization(WHO) risk charts developed for the Southeast Asia Region are being used to risk stratify Sri Lankans. However, Sri Lankans are quite different to some Southeast Asian countries and may not agree with Sri Lankans. Therefore, we aimed to d...
Background: Evidence on effects of carbohydrate intake with cardiovascular disease risk factors is inconsistent and has limited generalizability to diverse populations such as South Asians, whose carbohydrate intakes are typically high.
Aims: We examined the association of the quantity and types of carbohydrate intake with two risk factors for majo...
Background
There are few community-based data on childhood obesity. We investigated the community prevalence and associations of adolescent obesity in a birth cohort from
an urban community in Sri Lanka.
Methods
The study population consisted of 14-year-olds (Year-2000 birth-cohort), from the Ragama MOH area were invited to participate in the study...
Objective
Healthy lifestyle centres (HLCs), a state service that screens for major non-communicable disease (NCD) risk factors and promotes lifestyle modifications in Sri Lanka, report underutilisation. The study aimed to assess the effectiveness of a participatory intervention to empower communities in improving HLC utilisation.
Design
A quasi-ex...
Background
Escalation of ultra-processed foods (UPFs) sales has been recorded in low-to-middle-income countries, including in South Asia. However, individual consumption levels and sociodemographic characteristics influencing UPF consumption remain largely unknown in South Asia. We aimed to quantify UPF consumption and investigate its sociodemograp...
Background
The increasing prevalence of diet-related non-communicable diseases (NCDs) in South Asia is concerning, with type 2 diabetes projected to rise to 68%, compared to the global increase of 44%. Encouraging healthy diets requires stronger policies for healthier food environments.
Methods
This study reviewed and assessed food environment po...
There is limited data on the prevalence and outcome of prediabetes and the incidence of type 2 diabetes in South Asia.
We conducted a prospective, community-based study involving a cohort of urban adults in Sri Lanka, with a seven-year follow-up period.
Participants were selected using age-stratified random sampling, initially screened in 2007, and...
Background
Healthy Lifestyle Centres (HLCs) are state-owned, free-of-charge facilities that screen for major noncommunicable disease risks and promote healthy lifestyles among adults older than 35 years in Sri Lanka. The key challenge to their effectiveness is their underutilisation. This study aimed to describe the underutilisation and determine t...
Hypertension is a leading risk factor for cardiovascular disease in South Asia. The authors aimed to assess the cross‐country differences in 24‐h ambulatory, daytime, and nighttime systolic blood pressure (SBP) among rural population with uncontrolled clinic hypertension in Bangladesh, Pakistan, and Sri Lanka. The authors studied patients with unco...
Type 2 diabetes (T2D) is a heterogeneous disease that develops through diverse pathophysiological processes1,2 and molecular mechanisms that are often specific to cell type3,4. Here, to characterize the genetic contribution to these processes across ancestry groups, we aggregate genome-wide association study data from 2,535,601 individuals (39.7% n...
Introduction
Tobacco use, in both smoking and smokeless forms, is highly prevalent among South Asian adults. The aims of the study were twofold: (1) describe patterns of SLT and combustible tobacco product use in four South Asian countries stratified by country and sex, and (2) assess the relationships between SLT and smoking intensity, smoking qu...
Introduction
Tobacco use, in both smoking and smokeless forms, is highly prevalent among South Asian adults. The aims of the study were twofold: (1) describe patterns of SLT and combustible tobacco product use in four South Asian countries stratified by country and sex, and (2) assess the relationships between SLT and smoking intensity, smoking qui...
A qualitative study on barriers to healthy eating among overweight/obese women
Introduction:
The COVID-19 pandemic negatively impacted the global economy, disrupted essential health services, and distorted social determinants of health, reducing healthcare accessibility and increasing financial risk.
Aim:
we aimed to assess the impact of COVID-19 on healthcare accessibility and financial risk protection in Sri Lanka.
Meth...
Introduction: Overweight and obesity are rising burdens in the w orld. Gender disparities in its prevalence are more evident in developing countries compared to developed countries. Objectives: To determine the prevalence of overweight and obesity among 35-44-year-old women in Bandaragama and Horana Medical Officer of Health (MOH) areas Methods: Th...
Physical inactivity and obesity are among the leading risk factors for premature mortality and several non-communicable diseases. Therefore it is necessary to explore the perceived barriers to physical activity among 35- 44-year-old overweight and obese women in Kalutara district, Western province, Sri Lanka. It is vitally essential for the primary...
Background
Tobacco use, in both smoking and smokeless forms, is highly prevalent among South Asian adults. The aims of the study were twofold: 1) describe patterns of SLT and combustible tobacco product use in four South Asian countries stratified by country and sex, and 2) assess the relationships between SLT and smoking intensity, smoking quit at...
Objective
Healthy lifestyle centres (HLCs) in Sri Lanka provide screening and lifestyle modification services targeting major non-communicable diseases (NCDs). Even though the service is highly accessible and affordable, HLCs are underused by its target population (adults >35 years). We aimed to explore the factors that influence the decision-makin...
Type 2 diabetes (T2D) is a heterogeneous disease that develops through diverse pathophysiological processes. To characterise the genetic contribution to these processes across ancestry groups, we aggregate genome-wide association study (GWAS) data from 2,535,601 individuals (39.7% non-European ancestry), including 428,452 T2D cases. We identify 1,2...
Snakebite affects more than 1.8 million people annually. Factors explaining snakebite variability include farmers’ behaviors, snake ecology and climate. One unstudied issue is how farmers’ adaptation to novel climates affect their health. Here we examined potential impacts of adaptation on snakebite using individual-based simulations, focusing on s...
Information seeking behavior involves identifying needs, searching approaches and the use of information. This study aims to explore the information seeking behavior of medical students in Sri Lanka. A qualitative study, using focus group discussions, was conducted with 85 final year medical students of four universities in Sri Lanka. 47 of the par...
Background:
Data on the alcoholic fatty liver (AFL) is limited. Therefore, we investigated alcohol use and AFL patterns among urban, adult Sri Lankans.
Methods:
The study population (selected by age-stratified random sampling) was screened in 2007 (35-64 years) and re-evaluated in 2014. They were assessed by structured interviews, anthropometric...
Common single-nucleotide polymorphisms (SNPs) are predicted to collectively explain 40–50% of phenotypic variation in human height, but identifying the specific variants and associated regions requires huge sample sizes¹. Here, using data from a genome-wide association study of 5.4 million individuals of diverse ancestries, we show that 12,111 inde...
Background:
Snakebite envenoming is a neglected tropical disease. Data from the worst affected countries are limited because conducting epidemiological surveys is challenging. We assessed the utility of inhibitory geostatistical design with close pairs (ICP) to estimate snakebite envenoming incidence.
Methods:
The National Snakebite Survey (NSS)...
Background:
South Asians are at high risk of type 2 diabetes (T2D). Lifestyle modification is effective at preventing T2D amongst South Asians, but the approaches to screening and intervention are limited by high costs, poor scalability and thus low impact on T2D burden. An intensive family-based lifestyle modification programme for the prevention...
Community health workers (CHWs) play an important role in controlling non-communicable diseases in low- and middle-income countries. The aim of this review was to describe the characteristics and outcomes of CHW training programs that focused on the prevention and control of cardiometabolic diseases in low- and middle-income countries (LMICs). Medl...
Background
There is little data to accurate interpretation of spirometry data in South Asia, a major global region with high reported burden for chronic respiratory disease.
Method
We measured lung function in 7,453 healthy men and women aged over 18 years, from Bangladesh, North India, South India, Pakistan and Sri Lanka, as part of the South Asi...
Background
Data on alcoholic fatty liver (AFL) is limited. We investigated patterns of alcohol use and AFL, among urban, adult, Sri Lankans.
Methods
The study population (selected by age-stratified random sampling) was screened in 2007 (35–64 years) and re-evaluated in 2014. On both occasions they were assessed by structured-interview, anthropomet...
We assembled an ancestrally diverse collection of genome-wide association studies (GWAS) of type 2 diabetes (T2D) in 180,834 affected individuals and 1,159,055 controls (48.9% non-European descent) through the Diabetes Meta-Analysis of Trans-Ethnic association studies (DIAMANTE) Consortium. Multi-ancestry GWAS meta-analysis identified 237 loci atta...
Background
Snakebite envenoming is a neglected tropical disease. Data from the worst affected countries are limited because conducting epidemiological surveys is challenging. We assessed the utility of inhibitory geostatistical design with close pairs (ICP) to estimate snakebite incidence.
Methods
The National Snakebite Survey (NSS) in Sri Lanka a...
Background
The global epidemic of type 2 diabetes mellitus (T2DM) renders its prevention a major public health priority. A key risk factor of diabetes is obesity and poor diets. Food environments have been found to influence people’s diets and obesity, positing they may play a role in the prevalence of diabetes. Yet, there is scant evidence on the...
South Asians are at high risk of developing type 2 diabetes (T2D). We carried out a genome-wide association meta-analysis with South Asian T2D cases (n = 16,677) and controls (n = 33,856), followed by combined analyses with Europeans (neff = 231,420). We identify 21 novel genetic loci for significant association with T2D (P = 4.7 × 10−8 to 5.2 × 10...
Air pollution is a multifaceted environmental toxin affecting the Central Nervous System (CNS) through diverse pathways. The CNS of young children is particularly susceptible to the detrimental effects of toxins, as brain development continues postnatally with the formation of interneuronal connections, glial cell proliferation and myelination of a...
Introduction:
In low-middle income countries (LMICs) the role of food environments on obesity has been understudied. We address this gap by 1) examining the effect of food environments on adults' body size (BMI, waist circumference) and obesity; 2) measuring the heterogeneity of such effects by income and sex.
Methods:
This cross-sectional study...
Abstract Background People from South Asia are at increased risk of type 2 diabetes (T2D). There is an urgent need to develop approaches for the prevention of T2D in South Asians that are cost-effective, generalisable and scalable across settings. Hypothesis Compared to usual care, the risk of T2D can be reduced amongst South Asians with central ob...
Despite important implications for human health, distribution, abundance and behaviour of most medically relevant snakes remain poorly understood. Such data deficiencies hamper efforts to characterise the causal pathways of snakebite envenoming and to prioritise management options in the areas at greatest risk.
We estimated the spatial patterns of...
Introduction
South Asians are at high risk of type 2 diabetes (T2D). We assessed whether intensive family-based lifestyle intervention leads to significant weight loss, improved glycaemia and blood pressure in adults at elevated risk for T2D.
Methods
This cluster randomised controlled trial (iHealth-T2D) was conducted at 120 locations across India...
Information seeking behaviour is a set of actions expressing information needs, searching, evaluating, selecting, and utilization of information. The study aimed to develop and validate a tool to measure the information seeking behaviour of medical undergraduates in Sri Lanka. Final and penultimate year students in medical faculties in universities...
Introduction & Objectives
Chronic kidney disease (CKD) affects 700 million people worldwide. In 2017, deaths due to CKD accounted for 4.6% of mortality globally. Prevalence of CKD is increasing worldwide, with increasing diabetes and hypertension in aging populations. Our objective was to determine prevalence of CKD in an urban, adult cohort, since...
Background:
Postpartum hemorrhage (PPH) is the leading cause of maternal death worldwide. When PPH occurs, early identification of bleeding and prompt management using evidence-based guidelines, can avert most PPH-related severe morbidities and deaths. However, adherence to the World Health Organization recommended practices remains a critical cha...
The burden of disability among survivors and the socio-economic impact of snakebite have not been adequately researched. We reviewed original research articles, case reports and small case series relating to chronic physical, mental and psycho-social disability and economic burden of snakebite. Both physical and psychological health problems seem c...
Introduction and objectives
There are no cardiovascular (CV) risk prediction models for Sri Lankans. Different risk prediction models not validated for Sri Lankans are being used to predict CV risk of Sri Lankans. We validated the WHO/ISH (SEAR-B) risk prediction charts prospectively in a population-based cohort of Sri Lankans.
Method
We selected...
Background
Snakebite incidence shows both spatial and temporal variation. However, no study has evaluated spatiotemporal patterns of snakebites across a country or region in detail. We used a nationally representative population sample to evaluate spatiotemporal patterns of snakebite in Sri Lanka.
Methodology
We conducted a community-based cross-s...
Solid fuel combustion is an important risk factor of morbidity. This study was conducted to determine the effect of indoor air pollution (IAP) due to solid fuel combustion on physical growth in 262 Sri Lankan children under five. Exposure was defined by the type of fuel used for cooking. Pollutant levels were measured in a subsample of households....
Background
Inadequate treatment of hypertension is a widespread problem, especially in South Asian countries where cardiovascular disease mortality rates are high. We aimed to explore the effect of a multicomponent intervention (MCI) on antihypertensive medication intensification among rural South Asians with hypertension.
Methods
A post-hoc analy...
Background
COBRA-BPS (Control of Blood Pressure and Risk Attenuation-Bangladesh, Pakistan, Sri Lanka), a multi-component hypertension management programme that is led by community health workers, has been shown to be efficacious at reducing systolic blood pressure in rural communities in Bangladesh, Pakistan, and Sri Lanka. In this study, we aimed...
Limited data are available on physical activity tracking among adults in low- and middle-income countries. Using a longitudinal design, we assessed trends and correlates of physical activity among Sri Lankan adults. Individuals selected through age-stratified random sampling, were screened initially in 2007 (n = 2986) and reevaluated in 2014 (n = 2...
Background
The term “metabolic (dysfunction)-associated fatty liver disease” (MAFLD) is suggested alternative for “non-alcoholic fatty liver disease” (NAFLD), as it better reflects metabolic dysfunction. No study has compared outcomes of the two diagnostic criteria.
Methods
In an ongoing, community-based, cohort-study in suburban Sri Lanka, partic...
Background:
South Asia has become a major epicentre of the COVID-19 pandemic. Understanding South Asians' awareness, attitudes and experiences of early measures for the prevention of COVID-19 is key to improving the effectiveness and mitigating the social and economic impacts of pandemic responses at a critical time for the Region.
Methods:
We a...
Snakebite causes more than 1.8 million envenoming cases annually and is a major cause of death in the tropics especially for poor farmers. While both social and ecological factors influence the chance encounter between snakes and people, the spatio-temporal processes underlying snakebites remain poorly explored. Previous research has focused on sta...
Objectives
Despite its widespread use there is no consensus on ultrasound criteria to diagnose fatty liver.
Method
In an ongoing, cohort-study, participants were initially screened in 2007 and reassessed in 2014 by interview, anthropometric measurements, liver ultrasonography, and blood tests. We evaluated utility of increased hepatic echogenicity...
Background
South Asians are at high risk of type 2 diabetes (T2D). Lifestyle modification is effective at preventing T2D amongst South Asians, but the approaches to screening and intervention are limited by high-costs, poor scalability and thus low impact on T2D burden. An intensive family-based lifestyle modification programme for prevention of T2...
Background
There is limited data on prevalence and outcome of prediabetes (PDM) and incidence of type 2 diabetes mellitus (T2DM) from South Asia. We investigated this in an urban, adult population in Sri Lanka that was followed-up for seven years.
Methods
The study population (selected by age-stratified random sampling from the community) was initi...
Background
People from South Asia are at increased risk of type 2 diabetes (T2D). There is an urgent need to develop approaches for prevention of T2D in South Asians, that are cost-effective, generalisable and scalable across settings.
Hypothesis
Compared to usual care, risk of T2D can be reduced amongst South Asians with central obesity or raised...
Background
South Asia has become a major epicentre of the COVID-19 pandemic. Understanding South Asians’ awareness, attitudes and experiences of early measures for the prevention of COVID-19 is key to improving the effectiveness and mitigating the social and economic impacts of pandemic responses at a critical time for the Region.
Methods
We asses...
Objective:
To describe patterns and predictors of mortality in a semi-urban population in Sri Lanka.
Design:
A prospective population-based cohort study.
Setting:
Ragama Medical Officer of Health area in the Gampaha district, Sri Lanka.
Participants:
Adults between 35 and 64 years of age were recruited using an age stratified random sampling...
Introduction
Metabolic (dysfunction)-associated fatty liver disease (MAFLD) is a recently suggested alternative to Non-alcoholic fatty liver disease (NAFLD). We compared baseline metabolic traits and outcomes of NAFLD and MAFLD.
Methods
In an ongoing, community-based, cohort study, participants were first screened in 2007 by structured-interview, a...
We assembled an ancestrally diverse collection of genome-wide association studies of type 2 diabetes (T2D) in 180,834 cases and 1,159,055 controls (48.9% non-European descent). We identified 277 loci at genome-wide significance (p<5x10-8), including 237 attaining a more stringent trans-ancestry threshold (p<5x10-9), which were delineated to 338 dis...
Background and aims: This paper describes the data resource profile of South Asia Biobank (SAB), which was set up in South Asia from November 2018 to March 2020, to identify the risk factors and their complex interactions underlying the development of type-2 diabetes mellitus, cardiovascular disease and other chronic diseases in South Asians.
Data...
Background:
The burden of hypertension is escalating, and control rates are poor in low- and middle-income countries. Cardiovascular mortality is high in rural areas.
Methods:
We conducted a cluster-randomized, controlled trial in rural districts in Bangladesh, Pakistan, and Sri Lanka. A total of 30 communities were randomly assigned to either a...
Background: Data on outcomes of non-alcoholic fatty liver disease (NAFLD) from South Asia are lacking. We compared mortality, among those with- and without-NAFLD, after 10-years follow-up among urban, adult Sri Lankans. Method: Participants (aged 35-64 years), selected by age-stratified random sampling, were screened by structured-interview in 2007...