Lakkumar Fernando

Centre for Clinical Management of Dengue & Dengue Haemorrhagic Fever, Negombo, Sri Lanka

In the pivotal phase 3 efficacy trial (NCT02747927) of the TAK-003 dengue vaccine, 5 of 13,380 TAK-003 recipients and 13 of 6,687 placebo recipients experienced two episodes of symptomatic dengue between the first dose and the end of the study, ∼57 months later (patients received the second dose 3 months after the first dose). Two of these particip...

Background: Takeda's live attenuated tetravalent dengue vaccine candidate (TAK-003) is under evaluation in a long-term clinical trial across eight dengue-endemic countries. Previously, we have reported its efficacy and safety in both seronegative and seropositive participants and that its performance varies by serotype, with some decline in effica...

genetic variations in dengue virus

Genetic variations in dengue virus (DENV) play a distinct role in epidemic emergence. The DENV 3′ UTR has become a recent interest in research. The objective of the study was to examine the genetic variation in the domain II, 3′ UTR region of human and mosquito-derived DENV. DENV-infected human sera were orally infected to laboratory reared Aedes a...

Background: Dengue, a devastating public health problem has clinical entities dengue fever (DF) and dengue haemorrhagic fever (DHF) differentiated by plasma leaking in latter. Most guidelines have introduced a total fluid volume [maintenance with added 5% (50 ml/kg body weight up to maximum of 50 kg)] given over 48 hours as standard fluid quota (SF...

Background Takeda’s dengue vaccine is under evaluation in an ongoing Phase 3 efficacy study; we present an update after 2 years. Methods 20,099 children (4–16 years old) were randomized to receive two doses of TAK-003 or placebo three months apart and are under long-term febrile surveillance to detect dengue by serotype-specific RT-PCR. (NCT027479...

Background: Rectal route of paracetamol is preferred to the commonly used oral route in some instances. Yet there is no previous documented study comparing the two routes in the local setting. Methods: Single-centre, balanced randomized [1:1], two arms, parallel-group clinical trial was conducted in single Paediatric ward at the Gampaha District Ge...

Background: More than 80,000 dengue cases including 215 deaths were reported nationally in less than 7 months between 2016 and 2017, a fourfold increase in the number of reported cases compared to the average number over 2010-2016. The region of Negombo, located in the Western province, experienced the greatest number of dengue cases in the countr...

Background A substantial unmet need remains for safe and effective vaccines against dengue virus disease, particularly for individuals who are dengue-naive and those younger than 9 years. We aimed to assess the efficacy, safety, and immunogenicity of a live attenuated tetravalent dengue vaccine (TAK-003) in healthy children aged 4–16 years. Method...

Background: Dengue, a mosquito-borne viral disease, was designated a World Health Organization top 10 threat to global health in 2019. Methods: We present primary efficacy data from part 1 of an ongoing phase 3 randomized trial of a tetravalent dengue vaccine candidate (TAK-003) in regions of Asia and Latin America in which the disease is endemi...

Presented Poster at RCPCH 2019 Sessions at Birmingham, U.K.

Background Dengue haemorrhagic fever (DHF) is a major public health concern responsible for significant morbidity in both adult and paediatric populations in Sri Lanka. The detection of non-structural protein 1 (NS1) antigen in the serum at the early stage of the disease is effective in diagnosing dengue infection. This has been assessed and proven...

Objective Dengue haemorrhagic fever (DHF) is a major public health concern responsible for significant morbidity in both adult and paediatric populations in Sri Lanka. This study examined if persistent non structural protein 1 (NS1) antigen positivity beyond day 3 was predictive of the occurrence of dengue haemorrhagic fever. The patients were foll...

New Insights in to the clinical management of Dengue & Dengue Haemorrhagic Fever ; Experience from a centre of excellence in Sri Lanka, Centre for Clinical Management of Dengue & Dengue Haemorrhagic Fever, Negombo, Sri Lanka

Background More than 80,000 dengue cases including 215 deaths were reported nationally in less than seven months between 2016-2017, a fourfold increase in the number of reported cases compared to the average number over 2010-2016. The region of Negombo, located in the Western province, experienced the greatest number of dengue cases in the country...

Predictive value of NS1 Ag Rapid test for DHF

Background: Foot drop is a disabling clinical condition with multiplicity of causes, which requires detailed evaluation to identify the exact aetiology. Here, we report an extremely rare cause of foot drop in a child, which if not recognized early, could lead to multiple complications. Case presentation: A 6-year-old girl presented with difficul...

Ultrasound as an Aid to Predict the Onset of Leaking in Dengue Haemorrhagic Fever: Experience of a Dengue Treatment Facility in South Asia Authors : Hasn Perera, Is Almeida, Hnk Perera, Mzf Mohammed, Ade Silva, H. Wijesinghe, Ajal Fernando Abstract : Introduction: Dengue is a major Public Health burden of two clinical entities, Dengue Fever & Dengu...

The objectives of the study were to compare the DENV NS1 and nucleic acid positivity in dengue fever (DF) and dengue haemorrhagic fever (DHF) patients and to evaluate the usefulness of these parameters in severe dengue. Blood samples were collected from 91 patients with DF or DHF (fever days 3–9) from Gampaha and Negombo General Hospitals, Sri Lank...

Dengue is one of the major hurdles to the public health in Sri Lanka, causing high morbidity and mortality. The present study focuses on the use of geographical information systems (GIS) to map and evaluate the spatial and temporal distribution of dengue in Sri Lanka from 2009 to 2014 and to elucidate the association of climatic factors with dengue...

Host, vector, virus and environmental factors for effective dengue control (Curtsey: Sri Lankan Journal of Infectious Diseases. 2016;6(1):2–16). (TIF)

Distribution of DF/DHF cases in Sri Lanka from 2010–2015 (Curtsey: Sri Lankan Journal of Infectious Diseases. 2016;6(1):2–16). (TIF)

Objective: Dengue fever (DF) is one of the most common public health problems in Sri Lanka. A pilot study was undertaken to investigate the clinical profiles of DF and dengue haemorrhagic fever (DHF) in patients admitted to two hospitals from July 2011 to July 2012. The objective of the study was to evaluate clinical patterns to improve pattern rec...

Five failures of postexposure treatment of rabies in small children with multiple severe bites on the face and head are discussed. All had received rabies immune globulin and a potent tissue-culture vaccine. However, not all wounds had been infiltrated with immune globulin. Surgical closure prior to wound injection with immune globulin was performe...