Determinants of early cessation of exclusive breastfeeding practices among rural mothers from Jaffna District of Sri Lanka.

BACKGROUND: Sri Lanka is an upper-middle-income country with excellent health statistics. However, 2016 Demographic and Health Survey data have shown 82% and 64% of mothers exclusively breastfed infants aged 0-6 months and 4-5 months, respectively. The short duration of exclusive breastfeeding (EBF) has an impact on the growth and development of babies. Since no studies have been reported on EBF practices of the rural mothers in Jaffna District, an administrative district among 25 districts of Sri Lanka, this study aimed to assess the factors influencing the early cessation of EBF. METHODS: For this community-based cross-sectional study, 338 mother-child pairs were selected from 2013-14. EBF was defined as children not receiving any food or drink, including complementary foods, formula milk or milk products except for medicines and vitamins or mineral drops, other than breast milk since birth. Socio-economic and demographic factors, the influence of the mode of delivery, and knowledge on EBF were obtained using an interviewer-administered questionnaire. The details of EBF and reasons for the cessation of breastfeeding before six months were obtained from a subgroup of mothers (n = 208). Multivariate analysis was performed to explore the correlates of breastfeeding. RESULTS: In this study, 71.2% (95% CI 64.5, 77.2) had practiced EBF for six months. Early discontinuation of EBF was practiced by employed mothers (AOR 4.3; 95% CI 1.3, 13.9), mothers of low birth weight babies (AOR 3.6; 95% CI 1.6, 8.2) and those who experienced Cesarean section birth (AOR 2.9; 95% CI 1.2, 6.9). The EBF practiced by mothers of rural Jaffna was not associated with the gender of the babies, type of family, number of children in a family, religion of the household, knowledge on EBF, or family income. CONCLUSION: The prevalence of EBF up to six months was low in rural Jaffna, and it was influenced by employment, birthweight of the babies, and the mode of delivery. To enhance EBF, the Regional Directorate of Health Service, Jaffna, should take necessary action with policymakers to increase maternity leave for at least six months, reduce the Cesarean section rate, and provide nutritional support to pregnant mothers.

Factors influencing the iodine status of children aged 12 to 59 months from Jaffna District, Sri Lanka in the post-iodization era; a descriptive, cross-sectional study.

BACKGROUND: Iodine status, including Iodine Deficiency (ID) of the children aged 12-59 months of Jaffna District, Sri Lanka, have never been studied. This study thus aimed to assess ID among children aged 12-59 months by monitoring the Urinary Iodine Concentrations (UIC), the prevalence of goitre, and the factors causing ID. METHOD: A cross-sectional study was conducted among 846 children aged 12-59 months in Jaffna District, Sri Lanka. Sociodemographic characteristics and other factors were collected using an interviewer-administered questionnaire. Dietary pattern of children was obtained using semi-quantitative food frequency questionnaire. We performed urinary iodine estimation and physical examinations to detect the goitre, according to the World Health Organization criteria. A multivariate logistic linear regression model was used to identify the factors that causing ID. RESULT: The median UIC was 146.4 µg/L (interquartile range = 112.6-185.3 µg/L). Based on the UIC (<100 µg/L), 17.8% had ID, of which 15.7% and 2.1% had mild and moderate ID. The mean consumption of iodine from food was 128.7 (±20.2) µg/day. Gender variation had no influence on ID (p>0.05). Median UIC was significantly associated with living area, wealth status, type of drinking water, and method of iodized salt usage. A higher percentage of ID was significantly associated with younger age [AOR 2.32 (95% CI: 1.31-4.10)], urban area [AOR 1.94 (95% CI 1.27-2.96)], inland regions [AOR 3.20 (95% CI 1.85-5.55)], improper method of iodized salt usage [AOR 3.63 (95% CI: 1.38-9.56)], and low consumption of iodine-containing foods. The neck palpation revealed that only three children had goitre (0.4%). CONCLUSION: This study revealed that high ID among the children in Jaffna children was due to improper usage of iodized salt, even though the iodized salt is freely available in the region, living area, and age, while the prevalence of goitre was not significantly identified as a public health problem.

Maternal iodine status and the thyroid function of pregnant mothers and their neonates in Jaffna District of Sri Lanka.

INTRODUCTION: Iodine status of pregnant women and their newborns have not been studied in Jaffna District, Sri Lanka. This study was planned to assess the maternal iodine status and thyroid function at the third trimester of gestation and the thyrotrophin level of their neonate. METHODS: Four hundred and seventy-seven pregnant women and their newborns were randomly selected among six Medical Officers of Health Divisions out of 12 in Jaffna District, Sri Lanka. Maternal thyroid stimulating hormone (TSH), free thyroxine (fT4), thyroglobulin (Tg), urinary iodine levels, and the neonatal thyrotrophin (nTSH) level were assessed. RESULTS: In this study, mean age, weight, height, and gestational age of the mothers were 28.95 (±5.46) years, 63.02 (±11.56) kg, 154.39 (±6.00) cm, and 39.33 (±1.37) weeks, respectively. Maternal median urinary iodine concentration (UIC) was 140.0 µg/L (inter-quartile range 126.0-268.0 µg/L). Median values of the maternal serum TSH, fT4, and Tg were 1.9 mIU/L, 12.6 pmol/L, and 21.4 IU/L, respectively. Among the 477 newborns, 50.5% (n = 239) were males. Mean birth weight of newborn was 3.03 (±0.43) kg, while the mean length was 51.1 (±2.1) cm. Among the newborns, 18% (n = 86) had nTSH level > mIU/L and 37.7% (n = 180) within TSH level > mIU/L. nTSH level had positive but very weak correlations with maternal thyroid parameters, that is, UIC (r = 0.06, P = 0.13), fT4 (r = 0.01, P = 0.05), TSH (r = 0.09, P = 0.05), and Tg (r = 0.12, P = 0.03). CONCLUSION: On the basis of the World Health Organization criteria, the iodine status of pregnant women was inadequate in this region and also nTSH levels indicate moderate iodine deficiency during pregnancy. Therefore, the continuous education on adequate iodine intake during pregnancy and monitoring of iodine status are useful.

Metabolic syndrome among Jaffna Tamil community, Sri Lanka.

AIM: The prevalence and associated risk factors of metabolic syndrome (MS) among adults over 18 years old in Jaffna district. MATERIALS AND METHODS: It was community-based cross-sectional descriptive study. Multistage stratified cluster sampling technique was employed. An interviewer administered questionnaire was used to obtain the relevant information. Waist circumference (WC) and blood pressure (BP) measurements were recorded. Fasting plasma glucose (FPG), high-density lipoprotein (HDL), and triacylglycerols were analyzed by the enzymatic colorimetric assay using semi-automated analyzer (Teco Diagnostics TC-3300). International Diabetic Federation guideline for Asians was used to identify MS. RESULTS: Sample response rate was 95.3% and of them, 43.8% (n = 224) was male. The prevalence of central obesity (WC for male ≥90 cm, female ≥80 cm) was 23.9%. Raised FPG (≥100 mg/dL, or previously diagnosed diabetes mellitus), hypertriacylglycerolemia (≥150 mg/dl), low level of HDL cholesterol (<40 mg/dL in males, <50 mg/dL in females), and raised BP (systolic BP ≥130 or diastolic BP ≥85 mmHg or previously diagnosed hypertension) were found in 23.9%, 25%, 79.3%, and 36.6% of the participants. The prevalence of MS was 15.8% (95% confidence interval [CI]: 12.8-19.3) and it was 17.4% in males and 14.6% in females. Participants living in the urban area had a higher prevalence of MS when compared with participants in a rural area (P = 0.015). Older age (P < 0.001) was a risk factor for development of MS. Smoking (P = 0.005) was a risk factor for the development of MS. Participants having sedentary, moderately active, and highly active lifestyle had the prevalence of MS 20.6% (95% CI: 13.2-29.7), 14.7% (95% CI: 10.6-19.5), and 14.7% (95% CI: 9.3-21.6), respectively (P = 0.247). CONCLUSION: Older age, urban living, and smoking carry a higher risk for development of MS among Jaffna Tamil community.

Prevalence and factors associated with metabolic syndrome among Tamils aged over 18 years in Jaffna district, Sri Lanka.

BACKGROUND: 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. METHODS: This study was carried out as a community based cross sectional descriptive study in Jaffna district, Sri Lanka. Multistage stratified cluster sampling technique was employed. Total sample size was 544. An interviewer administrated questionnaire was used to gather data. Waist circumference (WC) and blood pressure (BP) measurements were recorded in standard method. Overnight fasting blood samples were obtained from all subjects. Fasting plasma glucose (FPG), high density lipoprotein (HDL), and triacylglycerols were analyzed by the enzymatic colorimetric assay (Semi Automated analyser Teco Diagnostics TC 3300). Modified National Cholesterol Education Program's Adult Treatment Panel III (NCEP ATP III) criterion was used to define the MS. RESULTS: Sample response rate was 95.3 %. Of them, 43.8 % (n = 224) was male. Prevalence of central obesity (WC for male ≥102 cm, female ≥88 cm) was 16.2 %. Prevalence of raised FPG (≥100 mg/dL), hypertriacylglycerolaemia (≥150 mg/dl), low level of HDL cholesterol (<40 mg/dL in males, <50 mg/dL in females) and raised BP (systolic BP ≥130 or diastolic BP ≥85 mmHg) were 23.9, 25, 79.3 and 36.6 % respectively. Prevalence of MS was 24.1 % (n = 123, 95 % CI: 20.4-28) and it was 26.8 and 21.9 % among males and females respectively. Participants living in urban area had higher prevalence of MS when compared with participants living in rural area (P = 0.015). Older age (P < 0.001) and smoking (P = 0.005) were risk factor for development of MS. Prevalence of MS among the participants with sedentary and active lifestyle was 29.9 and 23.7 % respectively. CONCLUSION: One out of four had MS. Old age, urban living and smoking carried higher risk for developing MS in Jaffna community.

Osmo-, thermo- and ethanol- tolerances of Saccharomyces cerevisiae S1

Saccharomyces cerevisiae S1, which is a locally isolated and improved strain showed viability at 40, 45 and 50ºC and produced ethanol at 40, 43 and 45ºC. When the cells were given heat shock at 45ºC for 30min and grown at 40ºC, 100% viability was observed for 60h, and addition of 200gl-1 ethanol has led to complete cell death at 30h. Heat shock given at 45ºC (for 30min) has improved the tolerance to temperature induced ethanol shock leading to 37% viability at 30h. when the cells were subjected to ethanol (200gl-1 for 30 min) and osmotic shock (sorbitol 300gl-1), trehalose contents in the cells were increased. The heat shocked cells showed better viability in presence of added ethanol. Soy flour supplementation has improved the viability of S. cerevisiae S1 to 80% in presence of 100gl-1 added ethanol and to 60% in presence of 300gl-1 sorbitol. In presence of sorbitol (200gl-1) and ethanol (50gl-1) at 40ºC, 46% viability was retained by S. cerevisiae S1 at 48h and it was improved to 80% by soy flour supplementation.

Osmo-, Thermo- and Ethanol- Tolerances of Saccharomyces cerevisiae S1.

Saccharomyces cerevisiae S1, which is a locally isolated and improved strain showed viability at 40, 45 and 50°C and produced ethanol at 40, 43 and 45°C. When the cells were given heat shock at 45°C for 30min and grown at 40°C, 100% viability was observed for 60h, and addition of 200gL(-1) ethanol has led to complete cell death at 30h. Heat shock given at 45°C (for 30min) has improved the tolerance to temperature induced ethanol shock leading to 37% viability at 30h. When the cells were subjected to ethanol (200gL(-1) for 30 min) and osmotic shock (sorbitol 300gL(-1)), trehalose contents in the cells were increased. The heat shocked cells showed better viability in presence of added ethanol. Soy flour supplementation has improved the viability of S. cerevisiae S1 to 80% in presence of 100gL(-1) added ethanol and to 60% in presence of 300gL(-1)sorbitol. In presence of sorbitol (200gL(-1)) and ethanol (50gL(-1)) at 40°C, 46% viability was retained by S. cerevisiae S1 at 48h and it was improved to 80% by soy flour supplementation.