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Champica Bodinayake

Champica Bodinayake
University of Ruhuna, Faculty of Medicine · Medicine

MBBS. MD(Colombo)FRCP (UK)

About

76
Publications
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Introduction
I work as a Professor in Medicine attached to the Department of Medicine, Faculty of Medicine, University of Ruhuna and as an honorary specialist physician at Teaching Hospital Karapitiya, Galle, southern province of Sri Lanka. My research interests include a variety of pathogens in the topics, primarily dengue, influenza, respiratory and urinary pathogens. I work in collaboration with Duke University, North Carolina USA. My clinical duties include caring for in-hospital and out patients and teaching and assessing Medical students and Post graduate doctors.

Publications

Publications (76)
Article
Full-text available
Methicillin-resistant Staphylococcus aureus (MRSA) colonization can lead to subsequent severe infections. Unlike community and hospital-associated types, Livestock-associated MRSA (LA-MRSA) transmits to humans through direct contact with livestock and contaminated livestock products. This study aimed to investigate MRSA prevalence and molecular epi...
Article
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Lower respiratory tract infection (LRTI) is a common reason for hospitalization and antibacterial use globally. There is considerable overlap in the clinical presentation of bacterial and viral LRTIs. Low- or middle-income countries (LMICs) face the dual challenge of appropriately targeting antibacterials for bacterial LRTI while reducing inappropr...
Article
Full-text available
Background Antimicrobial overprescription is common for lower respiratory tract infections (LRTI), as viral and bacterial infections generally present with similar clinical features. Overprescription is associated with downstream antimicrobial resistance. This study aims to identify the prevalence and predictors of antibiotic prescription among pat...
Article
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Diagnostic limitations challenge management of clinically indistinguishable acute infectious illness globally. Gene expression classification models show great promise distinguishing causes of fever. We generated transcriptional data for a 294-participant (USA, Sri Lanka) discovery cohort with adjudicated viral or bacterial infections of diverse et...
Article
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Background Acute respiratory infections (ARI) present a diagnostic challenge due to overlapping clinical features of bacterial and viral infections, leading to unnecessary use of antibiotics. We have previously shown that a host-based blood mRNA expression test based on a 24-gene classifier has excellent performance differentiating bacterial and vi...
Article
Full-text available
Background Leptospirosis is a tropical disease associated with life threatening complications. Identifying clinical and investigation-based parameters that predict mortality and morbidity is vital to provide optimal supportive care Methods We conducted an observational study in an endemic setting, in the southern Sri Lanka. Consecutive patients ha...
Article
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Introduction Acute febrile illness (AFI) is a common cause of hospital admissions in tropical settings. Identifying AFI aetiology is essential for guiding clinicians’ diagnoses and developing diagnostic and management guidelines. We used rigorous, gold-standard testing for diverse viral and bacterial pathogens to confirm the aetiology of AFI in sou...
Preprint
Full-text available
Background Leptospirosis is a tropical disease associated with life threatening complications. Identifying clinical and investigation-based parameters that predict mortality and morbidity is vital to provide optimal supportive care. Methods We conducted a prospective observational study in an endemic setting, in the southern Sri Lanka. Consecutive...
Article
Full-text available
Influenza causes an estimated 3 to 5 million cases of severe illness annually, along with substantial morbidity and mortality, particularly in low-and middle-income countries (LMICs). Currently, Sri Lanka has no influenza vaccination policies and does not offer vaccination within the public healthcare sector. Therefore, we performed a cost-effectiv...
Preprint
Full-text available
Limited diagnostics challenge management of acute febrile illness and sepsis (AFI/sepsis) globally. We generated transcriptomes for a 294-participant (USA, Sri Lanka) discovery cohort with AFI/sepsis. We used lasso to derive gene expression classifiers followed by cross-validation and generated: 1) a single model to distinguish bacterial vs. viral...
Article
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Background The Southern Province of Sri Lanka is endemic with dengue, with frequent outbreaks and occurrence of severe disease. However, the economic burden of dengue is poorly quantified. Therefore, we conducted a cost analysis to assess the direct and indirect costs associated with hospitalized patients with dengue to households and to the public...
Article
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Background To develop effective antimicrobial stewardship programs (ASPs) for low- and middle-income countries (LMICs), it is important to identify key targets for improving antimicrobial use. We sought to systematically describe the prevalence and patterns of antimicrobial use in three LMIC hospitals. Methods Consecutive patients admitted to the...
Article
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Background Healthcare systems in dengue-endemic countries are often overburdened due to the high number of patients hospitalized according to dengue management guidelines. We systematically evaluated clinical outcomes in a large cohort of patients hospitalized with acute dengue to support triaging of patients to ambulatory versus inpatient manageme...
Article
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Viruses cause a wide spectrum of clinical disease, the majority being acute respiratory infections (ARI). In most cases, ARI symptoms are similar for different viruses although severity can be variable. The objective of this study was to understand the shared and unique elements of the host transcriptional response to different viral pathogens. We...
Article
Antibiotic resistance is an emerging global public health threat. One of the main drivers of this threat is the inappropriate use of antibiotics. In Sri Lanka, antibiotic consumption is increasing, but little is known locally about how patients perceive antibiotics. We conducted a qualitative study to gain a better understanding of the knowledge, p...
Article
Full-text available
Background The timing of and risk factors for intestinal colonization with multidrug-resistant Enterobacteriaceae (MDRE) are still poorly understood in areas with high MDRE carriage. We determined the prevalence, timing, and risk factors associated with MDRE intestinal colonization among infants in southern Sri Lanka. Methods Women and their newbo...
Article
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Background Antimicrobial resistance has been named as one of the top ten threats to public health in the world. Hospital-based antimicrobial stewardship programs (ASPs) can help reduce antimicrobial resistance. The purpose of this study was to determine perceived barriers to the development and implementation of ASPs in tertiary care centers in thr...
Article
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Background Inappropriate antibiotic use is linked to the spread of antimicrobial resistance worldwide, but there are limited systemic data on antibiotic utilization in low- and middle-income countries. The purpose of this study was to evaluate the prevalence and patterns of antibiotic prescription in an ambulatory care setting in Sri Lanka. Method...
Article
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Background Antimicrobial resistance has been named as one of the top ten threats to health in the world. The World Health Organization has endorsed the implementation of hosptial-based antimicrobial stewardship programs (ASPs) to reduce antimicrobial resistance. We conducted a qualitative study to determine perceived barriers to the development and...
Article
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Background Antimicrobial stewardship programs (ASPs) are being developed internationally to mitigate the misuse of antimicrobials. An understanding of current practices and prescribing patterns is necessary to determine targets to develop context-specific ASPs in low- and middle-income country (LMIC) hospitals. Methods We conducted a prospective s...
Poster
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Background: Lower respiratory tract infection (LRTI) is the most common infectious cause of death worldwide. The most common bacterial agent for LRTI is Streptococcus pneumoniae. The conjugate pneumococcal vaccine protects against S. pneumoniae but is not available through the public healthcare sector of Sri Lanka. Data regarding LRTI burden d...
Poster
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Lower respiratory tract infection (LRTI) is the most common infectious cause of death worldwide. The most common bacterial agent for LRTI is Streptococcus pneumoniae. The conjugate pneumococcal vaccine protects against S. pneumoniae but is not available through the public healthcare sector of Sri Lanka. Data regarding LRTI burden due to S. pneumoni...
Article
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Abstract 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,...
Article
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Background: Eosinophilic gastroenteritis (EGE) is an uncommon disease characterized by eosinophilic infiltration of the digestive tract, which occurs due to an uncertain aetiology. Although autoimmune diseases can later present as EGE, it is unusual for EGE to have positive autoimmune antibodies without the presence of an overt autoimmune disease....
Article
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Background Pathogen-based diagnostics for acute respiratory infection (ARI) have limited ability to detect etiology of illness. We previously showed that peripheral blood-based host gene expression classifiers accurately identify bacterial and viral ARI in cohorts of European and African descent. We determined classifier performance in a South Asia...
Article
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Background: Dengue is a major cause of acute febrile illness in Sri Lanka. Dengue has historically been considered an urban disease. In 2012-2013, we documented that acute dengue was surprisingly associated with self-reported rural residence in the Southern Province of Sri Lanka. Methods: Patients admitted with an acute febrile illness were enro...
Article
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Background Skin and soft-tissue infections (SSTI) are a common reason for antimicrobial use in the outpatient and inpatient settings. Inappropriate antimicrobial use for SSTI is common. We determined the prevalence of SSTI and associated inappropriate antimicrobial use among inpatients in Sri Lanka. Methods A point-prevalence study of antimicrobia...
Article
Full-text available
Background Antibiotic resistance is an emerging global public health threat with inappropriate use of antibiotics as one of the major drivers. In Sri Lanka, antibiotic consumption is increasing, while little is known about how patients perceive antibiotics. We conducted a qualitative study to better understand patients’ knowledge, perceptions, and...
Article
Full-text available
Background The global emergence of antimicrobial resistance poses a major public health threat. However, there are little data regarding antimicrobial use from many low- or middle-income countries. In this study, we determined the prevalence and patterns of antibiotic prescription among outpatients at a tertiary healthcare facility in Sri Lanka. M...
Article
Full-text available
Background Acute respiratory infections are a common reason for antibiotic overuse. We previously showed that providing Sri Lankan clinicians with positive rapid influenza test results was associated with a reduction in antibiotic prescriptions. The economic impact of influenza diagnostic strategies is unknown. Methods We estimated the incremental...
Article
Full-text available
Methicillin-resistant Staphylococcus aureus (MRSA) causes a substantial burden of community-acquired and nosocomial infection. Prior colonization with MRSA is a recognized risk factor for MRSA infection. The study aimed to assess the prevalence of and risk factors for MRSA colonization at admission to surgical, medical and orthopaedic wards of Teac...
Article
The contribution of respiratory viruses to acute febrile illness (AFI) burden is poorly characterized. We describe the prevalence, seasonality, and clinical features of respiratory viral infection among AFI admissions in Sri Lanka. We enrolled AFI patients ≥ 1 year of age admitted to a tertiary care hospital in southern Sri Lanka, June 2012-October...
Article
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A point-prevalence study of antimicrobial use among inpatients at 5 public hospitals in Sri Lanka revealed that 54.6% were receiving antimicrobials: 43.1% in medical wards, 68.0% in surgical wards, and 97.6% in intensive care wards. Amoxicillin-clavulanate was most commonly used for major indications. Among patients receiving antimicrobials, 31.0%...
Article
Full-text available
Background Acute febrile illness is a frequent cause of hospitalization in the tropics and often presents with respiratory symptoms, even when caused by nonrespiratory pathogens. Previously, host-based gene expression signatures accurately identified acute respiratory infections as being bacterial or viral in a U.S. cohort. We determined signature...
Article
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Background Prolonged pyrexia and weight loss are recognised paraneoplastic manifestations of renal cell carcinoma (RCC). Stauffer's syndrome is a rarely described paraneoplastic manifestation, which is described early in the course of RCC. We report a patient who presented with unresolving fever with multiple pulmonary opacities with biochemical ev...
Article
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Background Dengue is a leading cause of fever and mimics other acute febrile illnesses (AFI). In 2009, the World Health Organization (WHO) revised criteria for clinical diagnosis of dengue. Methodology/Principal findings The new WHO 2009 classification of dengue divides suspected cases into three categories: dengue without warning signs, dengue wi...
Conference Paper
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Molecular and antibiotic profile confirmed that more than half of patients were colonised with CA-MRSA on admission .......
Article
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In tropical and subtropical settings, the epidemiology of viral acute respiratory tract infections varies widely between countries. We determined the etiology, seasonality, and clinical presentation of viral acute respiratory tract infections among outpatients in southern Sri Lanka. From March 2013 to January 2015, we enrolled outpatients presentin...
Article
Full-text available
The four serotypes of dengue virus (DENV-1, -2, -3, and -4) have had a rapidly expanding geographic range and are now endemic in over 100 tropical and subtropical countries. Sri Lanka has experienced periodic dengue outbreaks since the 1960s, but since 1989 epidemics have become progressively larger and associated with more severe disease. The domi...
Article
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Background Acute respiratory tract infections (ARTIs) are a common reason for antibiotic overuse worldwide. We previously showed that over 80% of outpatients presenting to a tertiary care hospital in Sri Lanka with influenza-like illness received antibiotic prescriptions, although almost half were later confirmed to have influenza. The purpose of t...
Article
Full-text available
Infective endocarditis (IE) carries significant mortality and morbidity and is mainly due to Streptococci and Staphylococci. Apart from the HACEK group (Haemophilus, Actinobacillus, Cardiobacterium, Eikenella and Kingella), IE due to other gram-negatives are rarely reported which may be attributed to the fact that they lack the ability to adhere to...
Article
Full-text available
Background Dengue is a frequent cause of acute febrile illness with an expanding global distribution. Since the 1960s, dengue in Sri Lanka has been documented primarily along the heavily urbanized western coast with periodic shifting of serotypes. Outbreaks from 2005–2008 were attributed to a new clade of DENV-3 and more recently to a newly introdu...
Article
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Background Extended-spectrum ß-lactamase-producing Enterobacteriaceae (ESBL-PE) are increasingly reported as pathogens in urinary tract infections (UTIs). However, in Sri Lanka, the clinical and molecular epidemiology of ESBL-PE implicated in UTIs has not been well described. Materials and Methods We conducted prospective, laboratory-based surveil...
Article
Introduction: Endocarditis is a rare complication of salmonellosis. The most frequently observed species is Salmonella typhi[1]. Endocarditis caused by Salmonella paratyphi is extremely rare with only few previous cases documented in the medical literature[2-7]. We report a case of endocarditis caused by Salmonella paratyphi A in an otherwise healt...
Article
Full-text available
Acute respiratory tract infections (ARTIs) are a common reason for unnecessary antibiotic prescriptions worldwide. Our objective was to determine if providing access to rapid influenza test results could reduce antibiotic prescriptions for ARTIs in a resource-limited setting. We conducted a prospective, pre-post study from March 2013 to October 201...
Article
Full-text available
Influenza accounts for a large burden of acute respiratory tract infections in high-income countries; data from lower-income settings are limited due to lack of confirmatory testing. Consecutive outpatients presenting to the largest tertiary care hospital in southern Sri Lanka were surveyed for influenza-like illness (ILI), defined as acute onset o...
Article
Full-text available
Pulmonary alveolar microlithiasis is a rare,chronic lung disease with bilateral intra-alveolar calcium and phosphate deposition throughout the lung parenchyma. This is a case history of a 40- year-old female with a family history of lung disease, presenting with progressive respiratory symptoms for 5 years. She had clinical and radiological feature...
Conference Paper
Background: Acute respiratory illnesses, including influenza, account for a large proportion of ambulatory care visits worldwide. In the developed world, these encounters commonly result in unwarranted antibiotic prescriptions; data from more resource-limited settings are lacking. Methods: Consecutive patients presenting to the Outpatient Dep...
Article
Full-text available
Chikungunya virus (CHIKV) re-emerged in Sri Lanka in late 2006 after a 40-year hiatus. We sought to identify and characterize acute chikungunya infection (CHIK) in patients presenting with acute undifferentiated febrile illness in unstudied rural and semi-urban southern Sri Lanka in 2007. We enrolled febrile patients ≥ 2 years of age, collected uni...
Article
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We studied rickettsioses in southern Sri Lanka. Of 883 febrile patients with paired serum samples, 156 (17.7%) had acute rickettsioses; rickettsioses were unsuspected at presentation. Additionally, 342 (38.7%) had exposure to spotted fever and/or typhus group rickettsioses and 121 (13.7%) scrub typhus. Increased awareness of rickettsioses and bette...
Article
Full-text available
Dengue virus (DENV), a globally emerging cause of undifferentiated fever, has been documented in the heavily urbanized western coast of Sri Lanka since the 1960s. New areas of Sri Lanka are now being affected, and the reported number and severity of cases have increased. To study emerging DENV in southern Sri Lanka, we obtained epidemiologic and cl...
Article
Full-text available
To determine the proportion of fevers caused by leptospirosis, we obtained serum specimens and epidemiologic and clinical data from patients in Galle, Sri Lanka, March-October 2007. Immunoglobulin M ELISA was performed on paired serum specimens to diagnose acute (seroconversion or 4-fold titer rise) or past (titer without rise) leptospirosis and se...
Conference Paper
Background: Rickettsial infections are re-emerging infections globally. In the tropics, they often manifest as fever without a focus and mimic agents such as dengue and leptospirosis. Under-recognition may lead to deaths, since regimens for acute febrile illness frequently do not treat rickettsiae. The historical gold standard for the diagnosis of...
Article
To document clinical features of propanil poisoning and discuss treatment. Five patients treated in the University medical unit at the Karapitiya teaching hospital over the past two years. Relevant laboratory investigations were done. The patients were treated on accepted lines. All had methaemoglobinaemia. The first patient died after severe poiso...

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