BACKGROUND & AIMS: :Invasive alien plants (IAPs) are a significant cause of socio-ecological change in Sri Lanka. Many studies have focused on the ecological dimensions of this problem, but few have addressed sociological factors such as the knowledge and perceptions of individuals and groups tasked with addressing IAPs. This study investigates how IAP issues are understood and perceived by professional forest and wildlife officers in Sri Lanka. The data analyzed were gathered using a questionnaire that covered three themes: the respondents' ability to identify IAPs, the impacts of IAPs and the threats they pose, and knowledge regarding control and mitigation. The questionnaire was completed by 186 field officers, and the resulting descriptive statistics and a probit regression analysis were used to analyze the data. The results show that almost all of the participating forest and wildlife officers were aware of the problems associated with IAPs but more than 75% of them lacked an accurate understanding of scientific means for controlling them and control policies established by the government of Sri Lanka. Generally, wildlife officers had a better understanding than forest officers. In addition, the analysis shows that officers' knowledge and perceptions of IAPs were positively correlated with their level of education and position within the organization. The analysis points to several recommendations for Sri Lankan officials when designing and implementing comprehensive policies and professional programs, particularly for lower-level field officers.

背景与目标： : 外来入侵植物 (iap) 是斯里兰卡社会生态变化的重要原因。许多研究都集中在这个问题的生态层面上，但很少有研究涉及社会学因素，例如负责解决iap的个人和群体的知识和看法。这项研究调查了斯里兰卡的专业森林和野生动植物官员如何理解和感知IAP问题。分析的数据是使用问卷收集的，问卷涵盖了三个主题: 受访者识别iap的能力，iap的影响及其构成的威胁以及有关控制和缓解的知识。问卷由186名现场官员完成，并使用结果的描述性统计和概率回归分析来分析数据。结果表明，几乎所有参与的森林和野生动物官员都知道与iap有关的问题，但其中75% 多名官员缺乏对控制它们的科学手段和斯里兰卡政府制定的控制政策的准确理解。一般来说，野生动物官员比森林官员有更好的理解。此外，分析表明，军官对iap的了解和看法与他们的教育水平和在组织中的地位呈正相关。分析指出，在设计和实施综合政策和专业方案时，特别是针对较低级别的外勤干事，对斯里兰卡官员提出了几项建议。

BACKGROUND & AIMS: BACKGROUND:Sri Lanka has reduced its overall suicide rate by 70% over the last two decades through means restriction, through a series of government regulations and bans removing highly hazardous pesticides from agriculture. We aimed to identify the key pesticide(s) now responsible for suicides in rural Sri Lanka to provide data for further pesticide regulation. METHODS:We performed a secondary analysis of data collected prospectively during a cluster randomized controlled trial in the Anuradhapura district of Sri Lanka from 2011 to 16. The identity of pesticides responsible for suicides were sought from medical or judicial medical notes, coroners' records, and the person's family. Trend analysis was done using a regression analysis with curve estimation to identify relative importance of key pesticides. RESULTS:We identified 337 suicidal deaths. Among them, the majority 193 (57.3%) were due to ingestion of pesticides while 82 (24.3%) were due to hanging. A specific pesticide was identified in 105 (54.4%) of the pesticide suicides. Ingestion of carbosulfan or profenofos was responsible for 59 (56.2%) of the suicides with a known pesticide and 17.5% of all suicides. The increasing trend of suicides due to carbosulfan and profenofos over time was statistically significant (R square 0.846, F 16.541, p 0.027). CONCLUSION:Ingestion of pesticides remains the most important means of suicides in rural Sri Lanka. The pesticides that were once responsible for most pesticide suicides have now been replaced by carbosulfan and profenofos. Their regulation and replacement in agriculture with less hazardous pesticides will further reduce the incidence of both pesticide and overall suicides in rural Sri Lanka.

背景与目标：

BACKGROUND & AIMS: :The saw-scaled viper (Echis carinatus carinatus) is a major venomous snake in Sri Lanka (SL) responsible for massive numbers of snakebites on the island; nevertheless, its venom proteome composition has never been explored. The proteome composition of SL E. c. carinatus venom (SL ECV), revealed by tandem mass spectrometry analysis, showed that it is composed of 42 enzymatic and nonenzymatic proteins belonging to 12 snake venom protein families. Snake venom metalloproteases (SVMP) and snaclec comprised the most abundant enzymatic and nonenzymatic proteins, respectively. When the composition of SL ECV was compared to the previously determined venom composition of Southern India ECV (SI ECV), 16 proteins were found in common. The SL ECV proteome composition was correlated with the clinical manifestations and pathophysiology of E. c. carinatus envenomation in SL. Polyvalent antivenom (PAV) raised in equine against the "Big Four" venomous snakes of India is typically exported to SL for snakebite treatment; however, the poor immunological cross-reactivity, partial in vitro neutralization of enzymatic activities, and some pharmacological properties, mostly shown by low molecular mass toxins (25 kDa) of SL ECV by Indian PAVs are major concerns for the effective treatment of ECV envenomation in SL.

背景与目标： : 锯鳞毒蛇 (Echis carinatus carinatus) 是斯里兰卡 (SL) 的一种主要毒蛇，负责岛上大量蛇咬; 尽管如此，它的毒液蛋白质组组成从未被探索过。通过串联质谱分析揭示了SL E. c. carinatus venom (SL ECV) 的蛋白质组组成，表明它由属于12个蛇毒蛋白家族的42种酶促和非酶促蛋白组成。蛇毒金属蛋白酶 (SVMP) 和snaclec分别包含最丰富的酶促和非酶促蛋白。将SL ECV的组成与先前确定的印度南部ECV (SI ECV) 的毒液组成进行比较时，发现共有16种蛋白质。SL ECV蛋白质组组成与SL中E. c. carinatus毒化的临床表现和病理生理相关。马中针对印度 “四大” 毒蛇饲养的多价抗蛇毒血清 (PAV) 通常出口到SL进行蛇咬治疗; 但是，较差的免疫交叉反应性，部分体外中和酶活性以及某些药理特性，印度PAVs的SL ECV的低分子量毒素 (25 kDa) 主要显示出有效治疗SL中ECV毒化的主要问题。

BACKGROUND & AIMS: :The mortality and morbidity of road traffic accidents (RTA) is increasing in the South Asian region, including Sri Lanka. Therefore, the demographic factors, types of vehicles involved, and the severity of injuries sustained in RTA was studied. Age, gender, and details of the incident of all patients admitted to hospital following a RTA, between January 2007 and August 2012, were obtained by interview. Following a medico-legal examination, the type and severity of injuries was categorized as, non-grievous, grievous, endangering life or fatal in the ordinary course of nature. Of the 579 RTA casualties examined, 72% were males, 28% females, and 26% were in the 20-29 year age group. There were 44% passengers, 32% drivers, and 20% pedestrians. Of the 440 vehicle occupants, 37% were on motor cycles, 28% in three wheelers, 13% in dual purpose vehicles and 11% in buses. Of the 114 pedestrians, 33% had been struck by motor cycles, 19% by three-wheelers and 17% by dual purpose vehicles. There was at least one soft tissue injury in 84%, whilst 45% had one or more fractures. In 85% of bicycle riders, the injuries were grievous, endangering life or fatal in the ordinary course of nature. A high proportion of young adults sustained grievous injuries due to RTA. Almost two thirds of the casualties resulted from motorcycle or three wheeler accidents. Laws limiting the number of passengers carried, installation of side doors, mandatory use of seat belts in three wheelers, and protective garments for motorcyclists are recommended.

背景与目标： : 在包括斯里兰卡在内的南亚地区，道路交通事故的死亡率和发病率正在上升。因此，研究了人口统计学因素，涉及的车辆类型以及RTA中受伤的严重程度。通过访谈获得了2007年1月和2012年8月之间的RTA后入院的所有患者的年龄，性别和事件的详细信息。经过医学法律检查后，伤害的类型和严重程度被归类为，非严重，严重，危及生命或在正常自然过程中致命。在所检查的579名RTA伤亡中，72% 名是男性，28% 名是女性，26% 名是20-29岁年龄组。有44% 名乘客、32% 名司机和20% 名行人。在440名车辆乘员中，有37% 人在摩托车上，28% 在三轮汽车上，13% 在两用车辆上，11% 在公共汽车上。在114名行人中，33% 人被摩托车击中，19% 人被三轮车击中，17% 人被两用车辆击中。84% 年至少有一个软组织损伤，而45% 有一个或多个骨折。在自行车骑手85%，伤害是严重的，危及生命或致命的自然过程。由于RTA，很大比例的年轻人遭受了严重伤害。几乎3分之2的人员伤亡是摩托车或三轮车事故造成的。建议限制载客人数的法律，安装侧门，在三轮汽车中强制使用安全带以及为摩托车手提供的防护服。

BACKGROUND & AIMS: :Colletotrichum is an important fungal genus with great diversity, which causes anthracnose of a variety of crop plants including rubber trees. Colletotrichum acutatum and Colletotrichum gloeosporioides have been identified as the major causative agents of Colletotrichum leaf disease of rubber trees in Sri Lanka based on morphology, pathogenicity, and the analysis of internally transcribed spacer sequences of the nuclear ribosomal DNA. This study has been conducted to investigate the members of the C. acutatum species complex causing rubber leaf disease using a morphological and multi gene approach. For the first time in Sri Lanka, Colletotrichum simmondsii, Colletotrichum laticiphilum, Colletotrichum nymphaeae, and Colletotrichum citri have been identified as causative agents of Colletotrichum leaf disease in addition to C. acutatum s. str. Among them, C. simmondsii has been recognized as the major causative agent.

背景与目标： : 炭疽菌是一种重要的真菌属，具有很大的多样性，会引起包括橡胶树在内的多种农作物的炭疽病。根据形态，致病性和核糖核糖体DNA内部转录的间隔区序列分析，已确定acutatum炭疽菌和gloeosporioides炭疽菌是斯里兰卡橡胶树炭疽菌叶病的主要病原体。进行了这项研究，以使用形态学和多基因方法研究引起橡胶叶病的C. acutatum物种复合体的成员。除C. acutatum.str外，在斯里兰卡，simmondsii炭疽菌，laticiphilum炭疽菌，nymphaeae炭疽菌和citri炭疽菌首次被确定为炭疽菌叶病的病原体。其中，C. simmondsii被认为是主要的病原体。

BACKGROUND & AIMS: BACKGROUND:Breast cancer (BC) is known to be the most common malignancy in females whereas colorectal cancer (CRC) incidence also higher in both genders in Sri Lanka. TP53 is an important tumour suppressor gene and its somatic mutations are reported in approximately 27% of BC and 43% of CRC cases. Analysis of TP53 gene variants not only provides clues for the aetiology of the tumour formation, but also has an impact on treatment efficacy. The current study was conducted to investigate the pattern of TP53 variants in patients with BC and CRC from Sri Lanka. METHODS:30 patients with BC, 21 patients with CRC and an equal number of healthy controls were screened for mutational status of TP53 by polymerase chain reaction (PCR) followed by direct sequencing. In addition, a subset of these samples were analysed for the protein expression of p53 and comparison made with the mutational status of TP53. We also analysed the protein expression of p21 and MDM2 as potential indicators of p53 functional status and compared it with the protein expression of p53. Additionally, hotspot codons of the KRAS, BRAF and PIK3CA genes were also analysed in a subset of CRC patients. RESULTS:Twenty seven sequence variants, including several novel variants in the TP53 gene were found. Nine BC and seven CRC tumour samples carried pathogenic TP53 variants. Pathogenic point missense variants were associated with strong and diffuse positive staining for p53 by immunohistochemistry (IHC), whereas, wild type TP53 showed complete absence of positive IHC staining or rare positive cells, regardless of the type of cancer. There was no direct correlation between p21 or MDM2 expression and p53 expression in either BCs or CRCs. Four of the CRC patients had pathogenic hotspot variants in KRAS; three of them were on codon 12 and one was on codon 61. CONCLUSION:The prevalence of pathogenic somatic TP53 variants was 31 and 33.33% in the studied BC and CRC cohorts respectively. All of them were located in exons 5-8 and the pathogenic missense variants were associated with strong immuno-positive staining for p53.

背景与目标：

BACKGROUND & AIMS: BACKGROUND:Gastroesophageal reflux disease (GORD) is a chronic and a common condition worldwide which causes mild to severe symptoms. Private tuition attendees are a group which could have potential risk factors for GORD. Therefore, we aimed to determine the prevalence, associated factors and medication for symptoms related to GORD among advanced level private-tuition attendees of Anuradhapura, Sri Lanka. METHODS:A descriptive cross-sectional study was conducted among students aged ≥18 years. A self-administered questionnaire was used to collect data. Students scoring ≥ eight on the Frequency Scale for Symptoms of GORD were categorised to have symptoms related to GORD. Logistic regression was performed to determine the significant association between the variables of interest and the presence of symptoms related to GORD (P < 0.05). RESULTS:Data of 1114 students were included for the analysis. A high prevalence of symptoms related to GORD (52% - 580/1114) was noted. Heartburn received the highest score among GORD symptoms. Biology students had the highest prevalence of GORD symptoms (63% - 127/201). Also, Biology students had the highest percentage for the utilisation of overall (17% - 35/201) and prescribed (13% - 27/201) medication for GORD symptoms. Presence of symptoms related to GORD was significantly associated with female sex [OR - 0.436 (95% CI 0.342-0.555)], being boarded [OR - 2.021 (95% CI 1.325-3.083)], chronic illness [OR - 2.632 (95% CI 1.439-4.813)], midnight snack [OR - 1.776 (95% CI 1.379-2.287)], frequent lack of breakfast [OR - 2.145 (95% CI 1.688, 2.725)], quick eating [OR - 1.394 (95% CI 1.091-1.780)] and inadequate sleep [OR - 2.077 (95% CI 1.624-2.655)]. CONCLUSION:A high prevalence of symptoms related to GORD in comparison to previous literature was found among private tuition attendees. Possible reasons for the above findings were discussed.

背景与目标：

BACKGROUND & AIMS: BACKGROUND AND PURPOSE:Speckle Reduction Imaging is a new algorithm that improves the image quality of B-mode scanning by reducing the reverberation artifacts. In the present study the value of this method for the characterization of atherosclerotic plaques in the internal carotid artery was investigated. METHODS:Two hundred and twenty two patients (161 men, 61 women; mean age 73 years) referred for carotid ultrasound evaluation were included in the study. Patients with plaques of the internal carotid artery as identified by conventional B-mode scanning were investigated also with the addition of Speckle Reduction Imaging (SRI) with the use of a 4-11-MHz wide band linear transducer. Plaque morphology was rated according to a standardized protocol by two independent observers. RESULTS:For the determination of plaque echogenicity, the reproducibility of SRI (kappa=0.83) was higher than that of conventional B-mode ultrasound (kappa=0.68). The interobserver agreement for plaque surface characterization was also higher for SRI (kappa=0.8) than for conventional B-mode (kappa=0.61). At the evaluation of the image quality through a semiquantitative analysis, SRI was rated superior in the plaque texture resolution, plaque borders determination, vessel wall demarcation and fibrous cap depiction. In addition, the level of "speckle" was reduced with the use of SRI. CONCLUSIONS:SRI is a technique that shows good general agreement with high-resolution B-mode and can be used for the characterization of atherosclerotic plaques in the carotid artery. Furthermore, because this advanced technique allows reduction of ultrasound artifacts, it improves the image quality allowing more precise visualization of plaque morphological details.

背景与目标：

BACKGROUND & AIMS: BACKGROUND:Gitelman syndrome (GS) is a rare autosomal recessively inherited salt-wasting tubulopathy associated with mutations in the SLC12A3 gene, which encodes for NaCl cotransporter (NCC) in the kidney. CASE PRESENTATION:In this report, we describe two siblings from a Sri Lankan non-consanguineous family presenting with hypokalaemia associated with renal potassium wasting, hypomagnesemia, hypocalciuria and hypereninemic hyperaldosteronism with normal blood pressure. Genetic testing showed that both were homozygotes for a novel missense mutation in exon 10 of the SLC12A3 gene [NM_000339.2, c.1276A > T; p.N426Y], which has not previously been reported in the literature in association with GS. Their mother was a heterozygous carrier for the same mutation. The father was not alive at the time of testing. This novel mutation extends the spectrum of known SLC12A3 gene mutations and further supports the allelic heterogeneity of GS. Interestingly both siblings had young onset Diabetes with strong family history. CONCLUSION:These findings have implications in providing appropriate genetic counseling to the family with regard to the risk associated with inbreeding, the detection of carrier/presymptomatic relatives. It further expands the known spectrum of genotypic and phenotypic characteristics of Gitelman syndrome.

背景与目标：

BACKGROUND & AIMS: BACKGROUND:Human toxocariasis, caused by Toxocara canis, T. cati, and T. vitulorum of dogs, cats and ruminants respectively, is recognized as an important zoonotic infection worldwide. The typical clinical syndromes of toxocariasis in humans are ocular larva migrans (OLM) and visceral larva migrans (VLM). The most commonly affected sites of OLM are the peripheral retina and/or vitreous humor. In Sri Lanka, there is a dearth of information on prevalence of ocular infection in our population. Therefore, the present study was carried out to determine the prevalence of Toxocara antibodies in suspected OLM patients and to describe demographic factors and clinical manifestations of seropositive patients. A total of 250 clinically suspected ocular toxocariasis cases referred by consultant eye surgeons to the Department of Parasitology, University of Peradeniya were studied between the years 1995 to April 2015. METHODS:Data (age, sex, fundoscopic findings) were gathered from the referral letters. Each serum sample was subjected to Toxocara excretory - secretory antigen ELISA (TES - ELISA). RESULTS:Out of the 250 cases, 155 (62%) were seropositive. The age range of the seropositive cases was 1 to 78 years with the mean age of 27 years. The highest seropositivity (25/155) was observed within the age group of 10 to 14 years. The most frequent clinical presentation of seropositive OLM cases were unilateral reduced vision and red eye. The other symptoms include tearing, photophobia and leukokoria. A high proportion of seropositive OLM cases had uveitis (34.19%) followed by reduced vision (21.94%), vitritis (12.9%) and choroiditis (7.74%). However none of these clinical manifestations were significantly associated with TES-ELISA seropositivity except vitreits (X2 = 8.557, p = 0.003). CONCLUSION:In conclusion, the results of this study showed high seroprevalence of toxocariasis among clinically suspected OLM cases confirming the toxoplasmic etiology. This high rate of Toxocara seropositivity in ocular patients should alert ophthalmologists in Sri Lanka to include toxocariasis in the differential diagnosis of ocular diseases presented with the symptoms and signs stated above.

背景与目标：

BACKGROUND & AIMS: :Interpretation of scars of torture is not an easy task as our understanding of evolution of scars of different methods of torture is still in its infancy. The objectives of this study were to produce the features of a typical scar of a few selected methods of torture and determine their characteristic distribution. To achieve this, 100 medico-legal records of victims of torture examined at the Judicial Medical Officer's Office, Colombo between 1998 and 2001 were perused. Scars caused by seven selected methods of torture were taken into consideration. They were, assault with both non-pliable and pliable blunt objects, cigarette burns, burns with heated solid objects and molten plastic, ligature application with different forms of suspension and cuts with sharp objects. Total number of scars analyzed in this study was 1846, which included 740 scars of non-pliable blunt weapons, 182 of pliable blunt weapons, 102 of ligature, 59 of molten polythene, 55 of heated objects and 82 of razor blades and knives. Typical scars of each method of torture and their characteristic distribution were determined.

背景与目标： : 解释酷刑伤疤并非易事，因为我们对不同酷刑方法伤疤演变的理解仍处于起步阶段。这项研究的目的是产生几种选定的酷刑方法的典型疤痕的特征，并确定其特征分布。为此，我们仔细阅读了司法医务干事办公室、科伦坡1998年和2001检查的100份酷刑受害者的医疗法律记录。考虑了由七种选定的酷刑方法造成的伤疤。它们是，用非柔韧和柔韧的钝器攻击，香烟烧伤，用加热的固体物体和熔融塑料烧伤，用不同形式的悬吊绑扎和用尖锐物体切割。在这项研究中分析的疤痕总数为1846，其中包括非柔韧钝器的740个疤痕，柔韧钝器的182个疤痕，结扎线的102个，熔融聚乙烯的59个，加热物体的55个以及剃刀刀片和刀具的82个。确定了每种酷刑方法的典型疤痕及其特征分布。

BACKGROUND & AIMS: BACKGROUND:The consequences of war violence and natural disasters on the mental health of children as well as on family dynamics remain poorly understood. Aim of the present investigation was to establish the prevalence and predictors of traumatic stress related to war, family violence and the recent Tsunami experience in children living in a region affected by a long-lasting violent conflict. In addition, the study looked at whether higher levels of war violence would be related to higher levels of violence within the family and whether this would result in higher rates of psychological problems in the affected children. METHODS:296 Tamil school children in Sri Lanka's North-Eastern provinces were randomly selected for the survey. Diagnostic interviews were carried out by extensively trained local Master level counselors. PTSD symptoms were established by means of a validated Tamil version of the UCLA PTSD Index. Additionally, participants completed a detailed checklist of event types related to organized and family violence. RESULTS:82.4% of the children had experienced at least one war-related event. 95.6% reported at least one aversive experience out of the family violence spectrum. The consequences are reflected in a 30.4% PTSD and a 19.6% Major Depression prevalence. Linear regression analyses showed that fathers' alcohol intake and previous exposure to war were significantly linked to the amount of maltreatment reported by the child. A clear dose-effect relationship between exposure to various stressful experiences and PTSD was found in the examined children. CONCLUSION:Data argue for a relationship between war violence and violent behavior inflicted on children in their families. Both of these factors, together with the experience of the recent Tsunami, resulted as significant predictors of PTSD in children, thus highlighting the detrimental effect that the experience of cumulative stress can have on children's mental health.

背景与目标：

BACKGROUND & AIMS: BACKGROUND:Although 21% of the population of Sri Lanka consists of adolescents, studies of nutritional status among this group are limited. OBJECTIVE:To assess nutritional problems and dietary and activity patterns among adolescents in Sri Lanka. METHODS:A nationally representative cross-sectional study was conducted on 6,264 adolescents 10 to 15 years of age. All subjects were clinically examined for Bitot's spots, and their weights and heights were measured. The subjects were interviewed during regular class time. Hemoglobin concentration and dietary and activity patterns were assessed among a subsample (n = 787) of 1,521 adolescents. The World Health Organization age- and sex-specific references for body-mass index and height-for-age were used to estimate the prevalence of underweight and stunting, respectively. The International Obesity Task Force age- and sex-specific reference for body-mass index was used to estimate the prevalence of overweight. Age-specific WHO-defined cut off points were used to estimate the prevalence of anemia. RESULTS:The prevalence rates of underweight, stunting, and overweight were 47.2%, 28.5%, and 2.2%, respectively. The prevalence rates of anemia and vitamin A deficiency were 11.1% and 0.4%, respectively. During the previous 6 months, 10.4% of the subjects had usually not eaten breakfast before going to school. During the week before the interview, 24.4% of the children had not consumed green leafy vegetables, 26.6% had not consumed fruit, 19.0% had not participated in physical activities, and 27.5% had watched television for more than 2 hours per day. CONCLUSIONS:The nutritional problems of adolescents aged 10 to 15 years should be addressed through the schools. Specific policies should be developed in collaboration with the Ministry of Health and Education to control nutritional problems among adolescents.

背景与目标：

BACKGROUND & AIMS: INTRODUCTION:To facilitate introduction of live attenuated SA 14-14-2 Japanese encephalitis vaccine (LJEV) into the National Immunization Programme of Sri Lanka, we evaluated the safety and immunogenicity of co-administration of LJEV and measles vaccine at 9 months of age. Serum immune responses were evaluated post-vaccination on days 28, 180, and 365 using JE neutralization test and anti-measles IgG ELISA. RESULTS:278 infants received one dose of LJEV and measles vaccine. Of these, 257 were eligible for the per-protocol analysis. On Day 0, 14 infants (5.5%) were seropositive for JE, but none were seropositive for measles. At Day 28, seropositivity rates were 90.7% (95% CI, 86.4-93.9%) for JE and 84.8% (95% CI, 79.8-89.0%) for measles. The geometric mean titer for JE neutralizing antibodies was 111 (95% CI, 90-135), and the geometric mean concentration (GMC) for anti-measles IgG was 375 mI U/mL (95% CI, 351-400 mI U/mL). Over the next year, JE neutralizing antibody responses declined only slightly, with seropositivity at 87.4% (95% CI, 82.6-91.2%) at Day 365. In contrast, measles antibody levels continued to increase over time. Seropositivity for anti-measles IgG reached 97.2% (95% CI, 94.4-98.9%) at Day 365, and the GMC rose to 1202 mI U/mL (95% CI, 1077-1341 mI U/mL). Co-administration of LJEV and measles vaccine was also safe. Most adverse reactions were mild, and no serious adverse events were related to study vaccinations. CONCLUSION:The safety and immunogenicity of LJEV co-administered with measles vaccine in Sri Lankan infants is similar to that seen in other populations, and our results support use of LJEV at 9 months of age. Live SA 14-14-2 vaccine is now prequalified by the WHO for use in infants in Asia, and other countries may wish to introduce LJEV to combat this devastating disease.

背景与目标：

BACKGROUND & AIMS: OBJECTIVE:We examined the association between frailty and disability in rural community-dwelling older adults in Kegalle district of Sri Lanka. DESIGN:A population-based cross-sectional study. PARTICIPANTS:A total of 746 community-dwelling adults aged ≥60 years. PRIMARY AND SECONDARY OUTCOME MEASURES:Frailty was assessed using the Fried phenotype. Disability was operationalised in terms of having one or more activity limitation/s in instrumental activities of daily living (IADL) and basic activities of daily living (BADL). RESULTS:The median age of the sample was (median 68; IQR 64-75) years and 56.7% were female. 15.2% were frail and 48.5% were prefrail. The prevalence of ≥1 IADL limitations was high, 84.4% among frail adults. 38.7% of frail adults reported ≥1 BADL limitations. Over half of frail older adults (58.3%) reported both ≥1 physical and cognitive IADL limitations. Being frail decreased the odds of having no IADL limitations, and was associated with a higher count of IADL limitations. No significant association was found between prefrailty and number of IADL limitations. CONCLUSIONS:The prevalence of ≥1 IADL limitations was high among rural community-dwelling frail older adults. Findings imply the greater support and care required for rural Sri Lankan frail older adults to live independently in the community.

背景与目标：