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Concept: Jaffna

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Located only a short distance off the southernmost shore of the Greater Indian subcontinent, the island of Sri Lanka has long been inhabited by various ethnic populations. Mainly comprising the Vedda, Sinhalese (Up- and Low-country) and Tamil (Sri Lankan and Indian); their history of settlements on the island and the biological relationships among them have remained obscure. It has been hypothesized that the Vedda was probably the earliest inhabitants of the area, followed by Sinhalese and Tamil from the Indian mainland. This study, in which 271 individuals, representing the Sri Lankan ethnic populations mentioned, were typed for their mitochondrial DNA (mtDNA) hypervariable segment 1 (HVS-1) and part of hypervariable segment 2 (HVS-2), provides implications for their settlement history on the island. From the phylogenetic, principal coordinate and analysis of molecular variance results, the Vedda occupied a position separated from all other ethnic people of the island, who formed relatively close affiliations among themselves, suggesting a separate origin of the former. The haplotypes and analysis of molecular variance revealed that Vedda people’s mitochondrial sequences are more related to the Sinhalese and Sri Lankan Tamils' than the Indian Tamils' sequences. MtDNA haplogroup analysis revealed that several West Eurasian haplogroups as well as Indian-specific mtDNA clades were found amongst the Sri Lankan populations. Through a comparison with the mtDNA HVS-1 and part of HVS-2 of Indian database, both Tamils and Sinhalese clusters were affiliated with Indian subcontinent populations than Vedda people who are believed to be the native population of the island of Sri Lanka.Journal of Human Genetics advance online publication, 7 November 2013; doi:10.1038/jhg.2013.112.

Concepts: DNA, Indian subcontinent, Sri Lanka, Maldives, Tamil language, Tamil people, Jaffna, Sinhalese people

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Hemoprotozoan parasites are responsible for significant economic losses in cattle. We screened Sri Lankan cattle populations for the presence of Babesia bovis, Babesia bigemina, Theileria annulata, and Theileria orientalis, using species-specific PCR assays. Out of 316 samples collected from animals in four different districts of Sri Lanka (Nuwara Eliya, Polonnaruwa, Ampara, and Jaffna), 231 (73.1%) were positive for at least one parasite species. All four parasite species were detected among the study groups from all of the districts surveyed. The first and second commonest hemoprotozoan parasites identified were T. orientalis (53.5%) and B. bigemina (30.1%), respectively. We found that the dry zones (Polonnaruwa, Ampara, and Jaffna) had more Babesia-positive animals than the hill country wet zone (Nuwara Eliya). In contrast, T. orientalis was the predominant species detected in Nuwara Eliya, while infection with T. annulata was more common in the dry zones. In addition, 81 (35.1%) of the 231 positive samples were infected with more than one parasite species. The presence of multiple parasite species among the different cattle populations is of clinical and economic significance. Therefore, island-wide control and prevention programs against bovine babesiosis and theileriosis are needed to minimize the financial burden caused by these parasites.

Concepts: Sri Lanka, Babesiosis, Tamil language, Tamil people, Babesia, Lanka, Northern Province, Sri Lanka, Jaffna

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Clinically diagnosed amoebic liver abscess (ALA) caused by Entamoeba histolytica has been an important public health problem in Jaffna district, northern Sri Lanka for last three decades. In order to draw up a control strategy for elimination of this condition, knowledge of its epidemiology and factors associated with this condition in the local context is vital.

Concepts: Public health, Health, Sri Lanka, Entamoeba histolytica, Tamil language, Northern Province, Sri Lanka, Jaffna, Liver abscess

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We conducted a 12-month follow-up of a population sample of adults from districts (Mannar, Killinochi, Mullaitivu and Jaffna) exposed to high levels of mass conflict in Sri Lanka, the aim of the present analysis being to identify trajectories of depression and anxiety symptoms and their associations with exposure to psychological trauma and ongoing living adversities. The cohort of 1275 adults (response 86%) followed-up in 2015 was a structured subsample drawn from the baseline nationally representative survey conducted in 2014 across 25 districts in Sri Lanka. Interviews were conducted using electronic tablets by field workers applying contextually adapted indices of trauma exposure, ongoing adversities and symptoms of depression and anxiety. Latent transition analysis revealed a three-class longitudinal model from which four composite trajectories were derived, comprising a persistent symptom trajectory (n=555, 43.5%), an incident or new onset trajectory (n=170, 13.3%), a recovery trajectory (n=299, 23.5%) and a persistently low-symptom trajectory (n=251, 19.7%). Factors associated with both the persistent symptom and incident trajectories were female gender, past trauma exposure and lack of access to health services. Loss of a job was uniquely associated with the persisting trajectory at follow-up. The recovery trajectory comprised a higher proportion of men, older persons and those without risk factors. Our findings assist in translating epidemiologic data into public policy and practice by indicating the importance of stable employment and the provision of healthcare as key factors that may act to reduce anxiety and depressive symptoms in the post-conflict phase. The findings also confirm that women are at high risk of mental distress. Brief screening for trauma exposure in populations with high levels of exposure to mass conflict may assist in defining those at risk of ongoing symptoms of anxiety and depression.

Concepts: Anxiety, Epidemiology, Symptoms, Psychological trauma, Sri Lanka, Tamil language, Northern Province, Sri Lanka, Jaffna

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In recent decades diabetes mellitus has become a considerable health problem in countries like Sri Lanka and results in an increasing economic burden hampering the social and economic development of these countries. About 60 to 70 % of the rural population in Sri Lanka rely on indigenous medicinal systems as their main source for primary health care. Siddha (Tamil) Medicine is one of the four Sri Lankan traditional medicinal systems and it is practised mostly in the eastern and northern provinces of Sri Lanka where the majority of Tamils reside.

Concepts: Health care, Medicine, Sri Lanka, Tamil language, Tamil people, Malaysia, Jaffna

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HLA-B(∗)1502 is known as a biomarker for carbamazepine (CBZ) induced Steven-Johnson Syndrome and Toxic Epidermal Necrolysis (SJS/TEN) in some Asian populations. Hence United States Federal Drug Administration (USFDA) recommends HLA-B(∗)1502 screening for Asian and other populations with a high prevalence of HLA-B(∗)1502, prior to the administration of carbamazepine. This study was conducted to estimate the prevalence of HLA-B(*)1502 in a cohort of Sri Lankans. We observed an overall prevalence of 4.3% (4/93) among 93 Sri Lankans comprised of 32 Sinhalese, 30 Sri Lankan Tamils and 31 Moors. The allele was detected in 3 [9.3%; 3/32] Sinhalese, 0 [0%; 0/30] Sri Lankan Tamils and in 1 [3%; 1/31] Moor. The overall prevalence of HLA-B(*)1502 in this population was close to that of other populations where the USFDA has recommended HLA-B(*)1502 screening. A larger study is required to confirm these findings, especially among the Sinhalese where the frequency appears to be high.

Concepts: Sri Lanka, Tamil Nadu, South India, Tamil language, Tamil people, Jaffna, Toxic epidermal necrolysis, Sinhalese people

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Groundwater in Miocene karstic aquifers in the Jaffna Peninsula of Sri Lanka is an important resource since no other fresh water sources are available in the region. The subsurface is characterized by highly productive limestone aquifers that are used for drinking and agriculture purposes. A comprehensive hydrogeochemical study was carried out to reveal the processes affecting the groundwater quality in this region. Major and trace element composition and environmental isotope ratios of oxygen and hydrogen (δ(18)OH2O and δ(2)HH2O) were determined in 35 groundwater samples for this investigation. The ion abundance of groundwater in the region was characterized by an anion sequence order with HCO3->Cl->SO4->NO3-. For cations, average Na(+)+K(+) contents in groundwater exceeded those of Ca(2+)+Mg(2+) in most cases. Ionic relationships of major solutes indicated open system calcite dissolution while seawater intrusions are also evident but only close to the coast. The solute contents are enriched by agricultural irrigation returns and associated evaporation. This was confirmed by the stable isotope composition of groundwater that deviated from the local meteoric water line (LMWL) and formed its own regression line denoted as the local evaporation line (LEL). The latter can be described by δ(2)HH2O=5.8×δ(18)OH2O – 2.9. Increased contents of nitrate-N (up to 5mg/L), sulfate (up to 430mg/L) and fluoride (up to 1.5mg/L) provided evidences for anthropogenic inputs of solutes, most likely from agriculture activities. Among trace elements Ba, Sr, As and Se levels in the Jaffna groundwater were higher compared to that of the dry zone metamorphic aquifers in Sri Lanka. Solute geochemistry and stable isotope evidences from the region indicates that groundwater in the area is mainly derived from local modern precipitation but modified heavily by progressive evaporative concentration rather than seawater intrusion.

Concepts: Water, Aquifer, Groundwater, Ion, Sri Lanka, Irrigation, Isotopes, Jaffna

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This study looks at the groundwater issues in the dry zone of Sri Lanka and shows how the use of remote sensing with high-resolution images can help in groundwater management. A new approach is developed for automatic extraction of the location of agro-wells using high-spatial-resolution satellite imageries. As an example, three pilot sites in three different aquifer systems in the country are considered, and their high-resolution images are analyzed over two temporal time periods. The analysis suggests that the well density in all three regions has increased over the last few years, indicating higher levels of groundwater extraction. Using the well inventory developed by this new approach, the water budgeting was prepared for the mainland of Jaffna Peninsula. The analysis shows a wide variation in well density in the Jaffna Peninsula, ranging from (as little as) less than 15 wells per square kilometer to (as high as) more than 200 wells per square kilometer. Calculations made for the maximum allowable water extraction in each administrative division of Jaffna show that less than 3 h of daily extraction per well is possible in some districts. This points to an increasing pressure on groundwater resources in the region and thus highlights the importance of understanding groundwater budgets for sustainable development of the aquifers.

Concepts: Water, Aquifer, Groundwater, Hydrogeology, Sri Lanka, Water well, Jaffna, Jaffna Peninsula

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The aim was to determine the prevalence and factors associated with Metabolic Syndrome (MS) among adults aged over 18 years in Jaffna district, Sri Lanka.

Concepts: Sri Lanka, Tamil language, Tamil people, Sri, Northern Province, Sri Lanka, Jaffna, Jaffna Peninsula, United National Party

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In recent years, stings of a lethal scorpion species were recorded from Jaffna Peninsula in the northern dry zone of Sri Lanka. This species was identified as Hottentotta tamulus (Scorpiones: Buthidae) which is the Indian red scorpion commonly found in Maharashtra, India. The Teaching Hospital, Jaffna recorded 84 H. tamulus stings over a year in 2012 and of them, 23 cases provided offending scorpions (proven cases). Three localities in Jaffna were recorded as hotspots of scorpion stings namely Palali, Achchuvali and Karainagar. Of the proven cases, 13 (57%) and 10 (43%) were males and females respectively and had a mean age of 30 years (SD ± 20 years). Among them, 5 (22%) were children below 12 years. In 13 (57%) patients stings occurred inside their houses including two children (40%). Six (26%) stings occurred at night when the victims were in sleep. Median time taken to arrive at the hospital from the time of stinging was 58 min (range 8-550 min). Signs of over activation of autonomic nervous system predominated the clinical picture-tachycardia in 14 (61%), high blood pressure in 11 (48%), excessive sweating in 9 (39%), excessive salivation in 5 (22%), hypotension in 4 (17%) and piloerection in 3 (13%). Children showed higher predilection to develop tachycardia - 4 (80%) and excessive salivation - 3 (60%). Priapism was not observed and 17 (74%) patients have developed intense pain at the site of sting. The commonest ECG change was tachycardia (73%) and occasional T wave inversion. Prazosin as a treatment was given to 22 (96%) patients. All patients made recovery and 13 (57%) patients left the hospital within two days. In future, there is a potential risk of spreading this species to elsewhere in the country and may disturb the ecological balance.

Concepts: Hypertension, Sri Lanka, Scorpion, Jaffna, Jaffna Peninsula, STING, Jaffna District