Pujitha Wickramasinghe

• Bachelor of Medicine
• Professor (Full) at University of Colombo

Introduction: Previous Sri Lankan studies have shown an increase in diabetes and pre-diabetes prevalence. Therefore, we aimed to determine their prevalence and correlates among adults in the Western province. Methods: Between 2018 and 2020, a cross-sectional sample of 1800 aged ≥20 years was recruited by a multi-stage stratified random cluster sa...

Background and objective Valid and cost-effective approaches are essential to assess physical activity and sedentary behaviours in individuals of all ages. This study aimed to validate a physical activity recall questionnaire (PAR-Q) and a physical activity log against the doubly labelled water (DLW) technique in 11-13-year-old Sri Lankan children....

Background Accurate assessment of body composition during infancy is an important marker of early growth. This study aimed to develop anthropometric models to predict body composition in 3–24-month-old infants from diverse socioeconomic settings and ethnic groups. Methods An observational, longitudinal, prospective, multi-country study of infants...

Background Insufficient physical activity, excessive screen time and short sleep duration among young children are global public health concerns; however, data on prevalence of meeting World Health Organisation 24‐h movement behaviour guidelines for 3–4‐year‐old children in low‐ and middle‐income countries (LMICs) are limited, and it is unknown whe...

Purpose This paper aims to describe the study design and baseline characteristics of the Sri Lanka Child Growth Cohort (SLCGC), which was established to assess the timing, pattern and determinants of growth faltering in infants and young children in Sri Lanka. Participants A retrospective cohort study was conducted among term-born babies (≥37-week...

Background Outbreaks of dengue can overburden hospital systems, drastically reducing capacity for other care. The 2017 dengue serotype 2 (DENV-2) outbreak in Sri Lanka coincided with vaccination in an ongoing phase 3 efficacy trial of a tetravalent dengue vaccine, TAK-003 (NCT02747927). Here, we present data on the efficacy of TAK-003 following two...

Introduction: Promoting healthy parenting practices is considered to be a part of public health midwives' (PHMs) job in Sri Lanka. However, they do not undergo specific training to impart parenting skills to parents. Objectives: Objectives of this study was to evaluate the relationship between the advocacy of PHMs on parenting and its correlation w...

Introduction: Promoting healthy parenting practices is considered to be a part of public health midwives’ (PHMs) job in Sri Lanka. However, they do not undergo specific training to impart parenting skills to parents.Objectives: Objectives of this study was to evaluate the relationship between the advocacy of PHMs on parenting and its correlation wi...

BACKGROUND Prevailing childhood obesity in Asia adds risk for future adult burden of obesity and non-communicable diseases. Weak policies across most Asian countries enables unrestricted marketing of obesogenic foods and beverages directly to children. Television is the common medium for food marketing to reach this audience. OBJECTIVE This study...

Background Rising childhood obesity rates in Asia are adding risk for the future adult burden of obesity and noncommunicable diseases. Weak policies across most Asian countries enable unrestricted marketing of obesogenic foods and beverages to children. Television is the common medium for food marketing to reach this audience. Objective This study...

Background and objective: Valid and cost-effective approaches are essential to assess physical activity and sedentary behaviors in individuals of all ages. This study aimed to validate a physical activity recall questionnaire (PAR-Q) and a physical activity log against the doubly labelled water (DLW) technique in 11-13-year-old Sri Lankan children....

Background: About half of the world's population lives in dengue endemic areas. We aimed to evaluate the long-term efficacy and safety of two doses of the tetravalent dengue vaccine TAK-003 in preventing symptomatic dengue disease of any severity and due to any dengue virus (DENV) serotypes in children and adolescents. Methods: In this ongoing doub...

Congenital mesoblastic nephroma is considered a tumour with favourable clinical behaviour with only few reported cases of metastases. We report an infant who underwent complete resection and later developed pulmonary metastasis. Ten-month-old baby girl initially presented at 3 weeks of age with macroscopic haematuria, hypertension and a lumbar mass...

A left shift of weight, height and BMI of 5- 15 year old Sri Lanka children compared to WHO data

Introduction: Nomophobia is becoming an increasing concern as a result of inappropriate use of electronic communication devices. Objectives: To describe the pattern of use of electronic communication devices and the prevalence of nomophobia among General Certificate of Education (GCE) Advanced Level (A/L) students in Colombo Educational Zone. Metho...

Introduction and objectives: Multimorbidity affects 37% of adults globally. It increases mortality and healthcare expenses. We aimed to determine its prevalence and associations among Sri Lankan adults. Methods: A descriptive cross-sectional survey was conducted in the Western province of Sri Lanka during 2018-2020. Adults (age > 20 years) were rec...

Background Accurate assessment of body composition during infancy is important, especially for understanding the effects of early growth on later health. This study aimed to develop an anthropometry-based approach to predict body composition in 3–24 month old infants from diverse socioeconomic settings and ethnic groups. Methods An observational, l...

Background: Body composition assessment in the first 2 y of life provides important insights into child nutrition and health. The application and interpretation of body composition data in infants and young children have been challenged by a lack of global reference data. Objectives: We aimed to develop body composition reference charts of infant...

Measuring growth provides the opportunity to assess an individual’s health and nutritional status as well as reflect the quality of life and social wellbeing. Global standards and references for child and adolescent growth have been adopted by many countries including Sri Lanka, but it is questionable whether these charts are appropriate. They are...

Background Given the importance of infancy for establishing growth trajectories, with later-life health consequences, we investigated longitudinal body composition among infants from six economically and ethnically diverse countries. Methods We recruited mother-infant dyads using the WHO Multicenter Growth Reference Study criteria. We measured fat...

This study aimed to develop a regression equation to predict physical activity energy expenditure (PAEE) using accelerometry. Children aged 11–13 years were recruited and randomly assigned to validation (n = 54) and cross-validation (n = 25) groups. The doubly labelled water (DLW) technique was used to assess energy expenditure and accelerometers w...

Background Previous studies have shown that delayed prenatal growth followed by accelerated postnatal growth plays a significant role on the onset of adult metabolic diseases. The present study aimed to identify the effects of intrauterine and later growth on metabolic derangements among children in Colombo, Sri Lanka. Methods A school-based cross...

Dietary fat exerts a significant risk of coronary heart disease (CHD) and obesity, which is on the rise in children. Television marketing of food and non-alcoholic beverages (FNAB) influences the dietary choices of children. There is a global interest in reducing fat, particularly trans-fat, contents in food and in regulating unhealthy FNAB marke...

The high prevalence of obesity, as well as growth failure among children, is of great concern, especially in developing countries. Environmental factors, especially familial factors, have a strong influence on the food intake of preschool-aged children, and this has led to the development of psychometric scales to measure parents’ feeding practices...

Background Early childhood is a vital period for development and growth. Promoting beneficial lifestyle behaviours in early childhood can help optimise children's health, development and learning, shape their behaviours in adulthood and offer the best protection against future non-communicable diseases (NCDs). In the Asia-Pacific region, NCDs are s...

Restricting children's exposure to the marketing of unhealthy FNAB is a priority for preventing global obesity and diet-related non-communicable diseases. This study focused on assessing the extent and nature of FNAB marketing on television targeting children and adolescents in Sri Lanka. The analysis included FNAB advertisements streamed over 11...

INTRODUCTION: Prevention of childhood obesity needs focus on primary and primordial prevention. The aim of our study is to identify the role of maternal obesity on offspring adiposity and the effect of lifestyle modification on infant weight gain. MATERIALS AND METHODS: Study component 1 is a prospective cohort study of 1537 mother‐infant pairs. Mo...

Background Early childhood is a vital period for development and growth. Promoting beneficial lifestyle behaviours in early childhood can help optimise children's health, development and learning, shape their behaviours in adulthood and offer the best protection against future non-communicable diseases (NCDs). In the Asia–Pacific region, NCDs are s...

Association of maternal BMI andGestational Weight Gain (GWG) with offspring anthropometry, cord blood DNAmethylations, adipokine levels and the effect of life style modification on growth during infancy: a randomized control trial‐Study protocol

Objective: To evaluate the performance of a UK based prediction model for estimating fat-free mass (and indirectly fat mass) in children and adolescents in non-UK settings. Design: Individual participant data meta-analysis. Setting: 19 countries. Participants: 5693 children and adolescents (49.7% boys) aged 4 to 15 years with complete data o...

Aims To assess the relationship between placental size and infant body composition, maternal characteristics and cord leptin, adiponectin, IGF-1 and insulin Methods This is part of a descriptive longitudinal study, 2015-2019, at Professorial Unit, De Soysa Hospital for Women, Colombo, Sri Lanka. Body composition [fat mass (FM) and fat free mass (F...

Background Iron overload (IO) is a complication in transfusion dependent beta thalassaemia (TDT). Pathogenic variants in genes involving iron metabolism may confer increased risk of IO. The objective of this study was to determine the magnitude of the cardiac and hepatic IO and determine whether pathogenic variants in HFE, SLC40A1 and TFR2 genes in...

Abstract Background Growth faltering is commonly encountered in breastfed infants during 4—6 months of age in low socioeconomic communities. The objective of this study was to describe the changes of growth indices with age, timing of growth faltering and its association with the feeding practices in children up-to 18 months of age. Methods A cross...

Purpose: There is a paucity of global data on sedentary behaviour during early childhood. The purpose of this study was to examine how device-measured sedentary behaviour in young children differed across geographically, economically, and socio-demographically diverse populations, in an international sample. Methods: This multinational, cross-se...

Background and objectives: Adiposity at birth is a predictor of childhood obesity. Abdominal circumference (AC) at birth has been shown to correlate well with visceral adipose tissue and abdominal subcutaneous adipose tissue. Adiposity differs according to ethnicity and geography. The aim of this study was to describe the anthropometry derived adi...

Background: Socio-demographic and lifestyle factors have an impact on the prevalence of obesity. Therefore, the present study aimed to identify the sociodemographic and lifestyle predictors associated with high body fat in 8 to 9-year-old primary school children.Methods: Data used in the present analysis were derived from a case-control study, wher...

Background Obesity rates are rising rapidly in low-middle-income-countries (LMICs). School-based interventions have shown moderate efficacy in improving diet and lifestyle associated with obesity in high-income countries. However, there is little data available on effective interventions suitable for LMICs. We devised a novel program for primary sc...

Background: Childhood obesity is a global problem associated with metabolic abnormalities. The gut-liver axis is thought to play a major role in its pathogenesis. Probiotics are known to alter the gut microbiota and, therefore, could be a therapeutic option in the management of childhood obesity-related complications. Purpose: This double-blind...

The significance of parenting on child development has been recognized as early as the 17th century. Baumrind recognized authoritative, authoritarian, and permissive parenting styles in 1971. After the recognition of responsiveness and demanding dimensions of parenting, a 4th entity called neglectful parenting also emerged. The implications of pare...

Introduction and Objectives: Absence of disease may give a higher perception of being well. We aimed to evaluate the effect of common indices of non-communicable diseases (NCDs) with HRQOL. Methodology: Preliminary data from Sri Lanka Non-Communicable Diseases Survey (SLNCDS) in Western Province were used for this study. The participants not report...

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...

Background Physical inactivity is a major contributor to overweight, obesity and death. Early childhood is a critical time to promote healthy lifestyle behaviours. World Health Organisation (WHO, 2019) recommends 1. ≥180 minutes of total physical activity (TPA), including ≥60 minutes of moderate-to-vigorous physical activity (MVPA), 2. ≤1 hour of r...

Introduction 24-hour movement behaviours (physical activity, sedentary behaviour and sleep) during the early years are associated with health and developmental outcomes, prompting the WHO to develop Global guidelines for physical activity, sedentary behaviour and sleep for children under 5 years of age. Prevalence data on 24-hour movement behaviour...

Childhood obesity-related metabolic derangements are increasing among South Asian populations. Most of these changes persist to adulthood. This study aims to describe the distribution of metabolic abnormalities among 7- to 17-year-old overweight and obese children in the Gampaha District of Sri Lanka. Overweight children (age- and gender-adapted BM...

Pathogenesis of dengue haemorrhagic fever is not fully understood, but it is thought that there is antibody enhancement during the secondary infection, which causes severe dengue haemorrhagic fever (DHF). Therefore, patients who have DHF should have a documented history of symptomatic dengue infection in the past. A retrospective descriptive-analyt...

Background. Iron overload (IO) is a complication in transfusion dependent beta thalassaemmia (TDT). Pathogenic variants in genes involving iron metabolism may confer increased risk of IO. The objective of this study was to determine the magnitude of the cardiac and hepatic IO and determine whether pathogenic variants in HFE, SLC40A1 and TFR2 genes...

Background The restrictions associated with the 2020 COVID-19 pandemic has resulted in changes to young children’s daily routines and habits. The impact on their participation in movement behaviours (physical activity, sedentary screen time and sleep) is unknown. This international longitudinal study compared young children’s movement behaviours be...

Background: Disciplining refers to teaching and nurturing children to achieve competence, self-control, self-direction and caring attitudes. Healthy parenting builds positive relationships and healthy personality in children. Punishments express the anger or desperation of caregiver. Objectives: The objective of the study was to explore the inten...

Background: Early childhood is a period of rapid brain development that paves the way for growth of self-regulation skills. This is the perfect time for caregivers to actively teach and coach skills like decision making and problem-solving. Parental warmth, responsiveness, and sensitivity support to self-regulation development of the children. Obj...

PurposeWe evaluated the effectiveness of iron supplementation in relation to baseline iron and inflammatory status of pregnant women and their offspring in Sri Lanka.Methods Apparently healthy women aged 18–36 years at < 12 weeks of gestation prior to receiving any supplementation were randomly recruited at the antenatal clinics. They received 60 m...

INTRODUCTION Use of ether to dissolve urinary catheter bulb is an accepted treatment when there is a difficulty in removing latex catheters due to inability to deflate the catheter bulb. We present a case of chemical haemorrhagic cystitis following the use of ether to deflate the catheter bulb. CASE REPORT A 19-month-old boy was treated for dengue...

Resting metabolic rate (RMR) is the key determinant of the energy requirement of an individual. Measurement of RMR by indirect calorimetry is not feasible in field settings and therefore equation-based calculations are used. Since a valid equation is not available for Sri Lankans, it is important to develop a new population-specific equation for fi...

Abstract Background Nutritional status is an important indicator for measuring quality of life in children. A region that is recovering from war will face many problems related to nutrition. Very few studies have addressed the nutritional problems in school children. This study was undertaken to identify the prevalence of wasting, stunting and obes...

Abstract Background The prevalence of obesity and associated risk of chronic diseases are increasing among the paediatric population. The effectiveness of preventive measures and interventions are likely to improve when all factors which associate with obesity in a specific target group are considered. Currently such comprehensive data is unavailab...

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...

Abstract Background Asthma is a disease characterised by hyper responsiveness and bronchoconstriction of airways, and is a major health burden globally. A dysfunction of the oxidant-antioxidant balance, termed oxidative stress, has been implicated in the pathophysiology of asthma. The present study aims to assess the changes in oxidative stress mar...

Background: The 2020 COVID-19 pandemic has placed unprecedented restrictions on children’s ability to participate in adequate movement behaviours. This international longitudinal study compared young children’s physical activity, sedentary behaviour and sleep behaviours before and during the COVID-19 pandemic. Methods: Parents of children aged 3-5...

INTRODUCTION Failure to expectorate mucus resulting in progressive airway damage is the hallmark of bronchiectasis. Therefore effective Airway Clearance Techniques (ACT) is the key step in its management. The aim of this study was to evaluate the efficacy of 3% Hypertonic Saline (HS) pre‐medication in ACT in children with non CysticFibrosis (non‐CF...

Background South Asian adults have higher prevalence of obesity comorbidities than other ethnic groups. Whether this also is true for Sri Lankan children with obesity has rarely been investigated. Objective To investigate prevalence of glucose intolerance and other comorbidities in Sri Lankan children with obesity and compare them with Swedish chi...

Background: Micronutrient deficiencies are identified among obese individuals. Vitamin D deficiency (VDD) is prevalent in obese children, and is hypothesized to cause insulin resistance and metabolic abnormalities. This study aimed to determine the effect of vitamin D supplementation on obesity and related metabolic abnormalities among obese Sri L...

Obesity is defined as an abnormal/excessive accumulation of body fat, associated with health consequences. Although overall obesity does confer a significant threat to the health of individuals, the distribution of body fat, especially abdominal/central obesity is of greater importance. For practical reasons, proxy anthropometric measurements have...

Background Studies have shown that accelerated postnatal growth plays a significant role on the onset of adult metabolic diseases. The aim of this study was to identify the effects of intrauterine and later growth on metabolic derangements among children in Colombo, Sri Lanka Materials A school-based cross-sectional study was conducted among 5–15...

Bioelectrical impedance analysis (BIA) is a simple and quick method used for assessment of body composition (BC). Present study aims to develop and validate a BIA prediction equation for Sri Lankan adults. Healthy adults (≥18 years) were randomly selected for development and validation of the equation. BIA was performed using the Inbody 230 multifr...

Background: The foundation for lifelong good health is laid in childhood. Schools can play a pivotal role in preventing obesity/type 2 diabetes with effective interventions. Methods: We devised a novel school-based program using a sticker based food diary (FD) and colorful 12-page story book to motivate young school children to adopt a healthier di...

Background Nutritional status is an important indicator for measuring quality of life in children. A region that is recovering from war will face many problems related to nutrition. Very few studies have addressed the nutritional problems in school-going children. This study was undertaken to identify the prevalence of various nutritional problems...

Background Nutritional status is an important indicator for measuring quality of life in children. A region that is recovering from war will face many problems related to nutrition. Very few studies have addressed the nutritional problems in school-going children.. This study was undertaken to identify the prevalence of nutritional status of school...

Background Nutritional status is an important indicator for measuring quality of life in children. A region that is recovering from war will face many problems related to nutrition. Very few studies have addressed the nutritional problems in school-going children. This study was undertaken to identify the prevalence of wasting, stunting and obesity...

Background Nutritional status is an important indicator for measuring quality of life in children. A region that is recovering from war will face many problems related to nutrition. Very few studies have addressed the nutritional problems in school children. This study was undertaken to identify the prevalence of wasting, stunting and obesity among...

Early growth pattern is increasingly recognized as a determinant of later obesity. This study aimed to identify the association between weight gain in early life and anthropometry, adiposity, leptin, and fasting insulin levels in adolescence. A cross-sectional study was conducted in 366 school children aged 11–13 years. Weight, height, and waist ci...

Background Micronutrient deficiencies are identified among obese individuals. Vitamin D deficiency is prevalent in obese children, and is hypothesized to cause insulin resistance and metabolic abnormalities. This study aimed to determine the effect of vitamin D supplementation on obesity and related metabolic abnormalities among obese Sri Lankan ch...

Introduction : Non-communicable diseases (NCD) are emerging in all ages, with cardio-metabolic diseases being a leading cause of morbidity and mortality. OBJECTIVE: To determine the prevalence of cardio-metabolic risk among medical students of a selected Faculty of Medicine in Colombo. METHOD: A cross-sectional study was conducted among medical stu...

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...

Resting metabolic rate (RMR) is a key determinant of daily energy requirement. Facilities for the measurement of RMR by indirect calorimetry (IC), (reference method) may not be accessible in routine settings. Existing RMR prediction equations were found to be inaccurate in Sri Lankans. Therefore, development of a new population-specific equation wa...