Abstracts of NCD & Prevalence of risk factors in Sri Lanka 1990 to 2012

[Type the
document
title]
Abstracts of Non Communicable Diseases and prevalence of risk
factors in Sri Lanka, published from 1990 – 2012
Abstracts of
Non Communicable
Diseases and prevalence
of risk factors
in Sri Lanka,
published fro m υύύτ – φτυφ
Non Communicable
Disease Unit,
Ministry of Health
Dr. Anura Jaysasinghe MD, MSc, MBBS

Acknowledgement
I should thanks for all stakeholders who contributed to accomplish this task. Especially, I
wish to express our deep sense of gratitude to the Japan International Cooperation Agency,
Sri Lanka for their invaluable support in providing us with necessary human resource to
complete this project.
It‘s my pleasure to thanks staff of Postgraduate Institute of Medicine library, Alcohol and
Drug Information Centre, Sri Lanka Medical Association Library, National Science
Foundation, World Health Organization library , University of Colombo and Ministry of Health
Library, who gave fullest support to carry out this task.
I would also take this opportunity to thank all the authors who made available their
publications to meet the requirement of this project. I would also like to express my gratitude
towards the colleagues of Ministry of Health Sri Lanka for their fullest support and
encouragement in completion of this important project.
Lastly on behalf of the NCD unit, my special thanks goes to the research assistant Sayuri
Nakandala, for her effort in making this project a success.
Dr. Anura Jayasinghe. MD, MSc, MBBS
Principal Investigator
Non Communicable Disease Unit
Ministry of Health
Sri Lanka.
υ Abstracts of Non Communicable Diseases and prevalence of risk factors in Sri Lanka,
published from 1990 – 2012

Contents
Acknowledgement ......................................................................................................................... 1
1. Introduction ........................................................................................................................... 3
2. Objective ............................................................................................................................... 3
3. Methodology ......................................................................................................................... 4
Key words*: ............................................................................................................................... 6
4. Results ................................................................................................................................... 7
5. Discussion .............................................................................................................................. 8
6. Limitations ............................................................................................................................. 9
7. Conclusion ............................................................................................................................. 9
References .................................................................................................................................... 9
Group A Publications (Studies which showed the prevalence of NCD’s and their risk factors in the
general population) ..................................................................................................................... 10
Group B Publications (Studies which found under the key words and carried out among specific
population) ................................................................................................................................ 101
Group C Publications (Studies found under the key words, but unable to meet the criteria for
Group A and B) .......................................................................................................................... 158
φ Abstracts of Non Communicable Diseases and prevalence of risk factors in Sri Lanka,

Abstracts of Non Communicable Diseases and prevalence of risk
factors in Sri Lanka, published from 1990 – 2012
1. Introduction
Sri Lanka faces escalating health care costs with rising rates of Non – Communicable
Diseases (NCD’s) such as Cardiovascular Diseases, Cancers, Chronic Respiratory
Diseases, and Diabetes as well as their risk factors such as Obesity, physical inactivity,
smoking, High sugar and salt intake, etc.
Due to rising levels of urbanization: sedentary lifestyles, unhealthy diet, excessive use of
alcohol and cigarettes, people are increasingly exposed to the risk factors of NCD’s and as a
result, create new burden for the health care system to cater for their health needs. The
effect of reducing risk factors such as cigarette use, alcohol consumption, promoting an
active lifestyle and eating balanced diets, will go a long way in reducing the prevalence of
NCD’s in Sri Lanka (1).
The Ministry of Health has introduced “The National Policy and Strategic Framework for
Prevention and Control of Chronic Non- Communicable Diseases” with the aim of reducing
the burden due to chronic NCD’s by promoting healthy lifestyles, reducing the prevalence of
common risk factors, and providing integrated evidence-based treatment options for
diagnosed NCD patients. The Ministry of Health has given priority to certain strategic areas
in the effort to achieve the goals such as to implement a cost-effective NCD screening
program at community level (2).
The aim of this project was to uncover the prevalence of NCD and their risk factors in Sri
Lanka, and to assess the socioeconomic burden they impart on the population. Findings of
studies conducted by other organizations regarding NCD’s would helpful to check the
reliability of routine survey of the Ministry. These valuable information will eventually be used
to plan and monitor prevention programme, which conduct by the Ministry of Health.
2. Objective
To compile studies and reports on prevalence of Non Communicable Diseases and their
risk factors in Sri Lanka published from 1990 – 2012.
χ Abstracts of Non Communicable Diseases and prevalence of risk factors in Sri Lanka,

3. Methodology
In order to achieve the objective of this project, there was a need to find the all physical and
electronic data published on the topic of NCD’s. However, there was no specific study
compiled for this purpose, and so a search was carried out to find the definite locations of
the publications on different directories such as “The Profile Partner in Health”, published by
WHO Sri Lanka.
Initially, the details of different organizations were obtained, which have libraries containing
the relevant publications on NCD, from several directories. Many online databases were also
looked into for studies carried out in Sri Lanka with regard to NCD’s. After preparing a list of
organizations, libraries, research institutions and websites which contained potential data for
this purpose, the relevant personnel in charge of the respective institutions were contacted,
either by visiting them personally or over the phone, and gained permission to use their
facilities. According to a schedule, they were visited during the August to November 2012. A
list of keywords was determined based on the risk factors and prevalence of NCD’s.
Permission was vested by the Ministry of Health to visit the particular institutions.
The first institution visited was the Post Graduate Institute of Medicine (PGIM) Library. The
PGIM is an institute attached to the University of Colombo, which is responsible for the
specialist training of medical officers. It is recognized internationally for its training
programmes, and works in close collaboration with the Ministry of Higher Education, Ministry
of Health, Faculties of Medicine and Professional Colleges. It is situated in Norris Canal
Road, Colombo 07. With help of the Senior Librarian, a list of references was found using
the keywords in their database. The publications identified were mainly theses and
dissertations compiled by the postgraduate trainees in Medicine to fulfill the requirement for
the Doctor of Medicine and Master of Science degrees in different fields (3). All of the
relevant publications were studied and the essential information was extracted and noted
down on a Microsoft Word document. The Word document was copied on to the software
program EndNote. Certain authors were contacted to obtain clarification on areas of the
publication and to gain further information.
Then, information collected from Alcohol and Drug Information Centre (ADIC). ADIC is a
well-recognized National Resource Centre, which works to reduce drug demand. It provides
a voluntary and charity service for the public by collecting and disseminating information,
conducting seminars, training, and workshops on the effects of substance abuse and
mobilizes communities through effective strategies. The institution also works in association
with many international networks such as the Global Alcohol Policy Alliance, etc.(4). The
ADIC conducts a variety of surveys designed to determine the trends of alcohol and tobacco
consumption on selected districts in order to support other programmes of ADIC and the
information needs of the country. The institution annually evaluates the activities of selected
programmes and donor funded projects in order to determine the impact and effectiveness
of the activities carried out.The ADIC library compiles data from spot surveys into reports.
These surveys along with research evaluations were extracted to the program EndNote and
scrutinized.
The Sri Lanka Medical Association (SLMA) was visited subsequently. The SLMA is the
national medical professional association in Sri Lanka, which brings together medical
ψ Abstracts of Non Communicable Diseases and prevalence of risk factors in Sri Lanka,

practitioners of all grades and all branches of medicine. It is in fact the oldest professional
medical association in Asia and Australasia, with a proud history dating from 1887 (5). Many
published journals such as Ceylon Medical Journal, Journal of Medical Sciences, British
Medical Journal and several other local and international journals were examined for
relevant publications. The online databases available at the SLMA library were also utilized
to find data relating to NCD’s and their risk factors.
The National Science Foundation (NSF) was visited next. The NSF is a state funded
organization under the Ministry of Technology and Research(6). It promotes research,
development and innovation to create knowledge based economy by building public-private,
institution-industry partnerships. National Science Library & Resource Centre (NSLRC) of
the National Science Foundation is the National Focal Point for the dissemination of Science
& Technology (S&T) Information in the country. The efficiency of the information service is
enhanced through a network (Sri Lanka Science & Technology Information Network)
operated among S&T libraries in the country. The NSLRC web site functions as a central
hub which links other S & T related information sources in the country for efficient exchange
of information among the scientific counterparts. NSLRC services extend to the reach &
accessibility of resources within & outside the country(7). Electronic online databases were
available within the NSF premises, some of which had limited access to the outside. NCD
relevant studies were also found in the studies done under the category of Anthropology and
Sociology. Eventually, all relevant publications were extracted and later placed onto the
software program EndNote.
The World Health Organization (WHO) was visited thereafter. The WHO is the directing and
coordinating authority for health within the United Nations system. It is responsible for
providing leadership on global health matters, shaping the health research agenda, setting
norms and standards, articulating evidence-based policy options, providing technical support
to countries and monitoring and assessing health trends(8). The publications and the online
databases were utilized to obtain the necessary data to accumulate the studies onto the
software program EndNote.
The Ministry of Health Library was also visited. Almost all available publications were in the
physical format, most of which had been previously encountered in prior institutions.
Previous publications were also verified as to the validity of the content of the publications, in
addition to gathering new data on publications.
Research groups of several universities were also contacted, such as University of Colombo,
University of Peradeniya, University of Sri Jayawardenapura, and a number of their
publications were included into this project.
The publications contained within each library were studied along with the key words*, and
the essential data were documented directly onto the software program EndNote.
ω Abstracts of Non Communicable Diseases and prevalence of risk factors in Sri Lanka,

Key words*:
Cardio vascular diseases
Stroke
Cerebrovascular diseases
Diabetes Mellitus
Peripheral vascular diseases
Cancer
Hyperglycemia
Hypertension
Myocardial Infarction
Heart failure
Smoking
Alcohol
Physical Inactivity/ activity
Hypercholesterolemia
Overweight
Obesity
Wasting
Asthma
Chronic non communicable diseases
The availability of publications on electronic databases was very helpful in recognizing
potential publications, but many of them were password restricted, so separate visits were
necessary to uncover these restricted electronic databases from their respective institutions.
EndNote is a software program which searches, organizes, and sharing researches and
bibliographies. Being an online search tool, it provides a simple way to search online
bibliographic databases and retrieve the references directly into EndNote. This software has
the capability to make bibliographies and manuscripts; it can format citations, figures, and
tables in Microsoft® Word with the Cite While You Write™ feature.
The reliability of individual publications was checked twice a week during the study period
and changes were made. After creating a library database on the EndNote software
program, which included all the probable publications relating to NCD’s, a grading system
was implemented on these publications in the order of their relevance to the risk factors and
prevalence of NCD’s, whether they were carried out as a community based study, etc. The
publications were placed into one of three categories “A”, “B”, or “C”, based on the following
features.
 Publications were graded “A”, if they contained data involving mentioned NCD risk
factors and prevalence rates, and if they were based on a general population.
 Publications were graded “B”, if they contained data involving mentioned risk factors
and prevalence rates, but they were from specific group or population which made it
difficult to infer the status of the general population.
 Publications were graded “C”, if they contained information matching the keywords,
but were unable to meet the criteria for Group A and B.
ϊ Abstracts of Non Communicable Diseases and prevalence of risk factors in Sri Lanka,

Some publications, despite matching the keywords, were excluded as they failed to address
the issue of NCD or any other component relevant to this project.
4. Results
During the period of four months, seven libraries/institutions were visited (PGIM Library,
ADIC, SLMA Library, NSF Library, WHO Library, University of Colombo and Ministry of
Health Library). Publications regarding NCD’s and published from January 1st 1990 -
November 30th 2012, referred from these libraries were found mainly in Journals of
Medicine and in dissertations and theses of Postgraduate trainees in preparation for their
Doctor of Medicine and Master of Science degrees.
The Journals referred were:
Ceylon Medical Journal
Journal of the Ceylon College of Physicians
Journal of the College of the Community Physicians of Sri Lanka
British Medical Journal
Sri Lanka Journal of Population Studies
International Journal of Public Health
Galle Medical Journal
Kandy Medical Journal
Anuradhapura Medical Journal
Sri Lanka Journal of Diabetes, Endocrinology and Metabolism
The electronic databases from which data were gathered included:
Sri Lanka Journals Online - http://www.sljol.info/
Hinari - www.who.int/hinari/
Scopus - www.scopus.com/scopus/home.url
EBSCO - www.ebsco.com/
SLSTINET - www.cmb.ac.lk/academic/Science/science-library/networks/slstinet
PubMed - www.ncbi.nlm.nih.gov/pubmed
Sciencedirect - www.sciencedirect.com/
From these data sources, after a period of 4 months, a total of 356 publications relating to
the topic of NCD’s were gathered. After analyzing and verifying their content, 241
publications were deemed to be appropriate for the need of this project.The publications
were categorized into Groups:
A (75 studies);Studies which showed the prevalence of NCD’s and their risk factors in the
general population,
ϋ Abstracts of Non Communicable Diseases and prevalence of risk factors in Sri Lanka,

B (74 studies); Studies which found under the key words and carried out among specific
population (e.g. hospital based or disease specific population) and
C (92 studies); Studies found under the key words, but unable to meet the criteria for Group
A and B.
Group A was further analyzed to identify the study method, study population, and the
prevalence of NCD related risk factors. There were 75 studies in group A, out of which
57.6% examined only a single risk factor relating to NCD’s and 42.4% studied multiple risk
factors. Table 1 shows the number of studies carried out to determine the prevalence of
each of NCD risk factors in the general population.
Table 1. Number of studies carried out to determine the prevalence of each of NCD risk
factors in the general population, published from January 1st 1990 - November 30th 2012.
NCD related risk factor Number of studies found
Smoking 25
Alcohol 14
Physical Inactivity/ activity 13
Hyperglycemia 19
Hypertension 17
Hypercholesterolemia 4
Overweight, Obesity, wasting 20
Asthma 4
The individual studies of Group A (studies which contain data involving risk factors and
prevalence rates, and which were based on the general population: published from January
1st 1990 –November 30th 2012) can be found Annexure 1.
Group B (studies which were based on a specific group or population which made it difficult
to infer the status of the general population) can be found in Annexure II and Group C
(studies which contain information matching the keywords, but were unable to meet the
criteria for Group A and B) can be found in Annexure III.
5. Discussion
Regarding the type of population studied in group A, most of smoking and alcohol related
studies have been carried out among the adolescent. Other NCD risk factors such as
hyperglycemia, hypertension and hypercholesterolemia were carried out among the adult
population.
A few studies were carried out among certain group of population such as estate community,
urban or rural population, school children and elderly population.
ό Abstracts of Non Communicable Diseases and prevalence of risk factors in Sri Lanka,

It was noticed that a large number of these studies targeted the adolescents and middle age
group ranging up to about 64 years, and relatively few were aimed at the elderly. Several
studies had not mentioned the age of study population, and most of them were abstracts
publication.
Among the 75 studies, it was observed that the majority were conducted within the Colombo
district, and other studies around other urban areas in Sri Lanka, while only a very few
studies were conducted in the rural areas. Among our study search, hardly any published
studies on prevalence of Type I DM were found.
6. Limitations
 A number of studies which were gathered had only the abstract, which limited the
amount of information extracted from those publications.
 In some instances, entering of key words by authors has not exactly reflected the
content of publication, so they are unable to find by using of our key words searching,
and a number of publications may have been missed out.
 Several authors had published pieces of same study in different journals. So one
study may be appeared in different publications.
7. Conclusion
This project was done in order to fill a large gap existing in the field of NCD’s. With the minor
limitation, this document is presented most of local studies (242) on NCD risk factors. While
taking possible effort to disseminate this document among needy people, it is suggested to
continue mapping up NCD researches/publication further more.
References
 (1)http://www.worldbank.org/en/news/2012/05/16/non-communicable-diseases-sri-lanka
 (2)http://203.94.76.60/NCD/temp/NCD%20Policy%20English.pdf
 (3) http://www.cmb.ac.lk/pgim/
 (4) http://www.adicsrilanka.org/Page_About%20Us.html
 (5) http://www.slmaonline.info/
 (6) http://www.nsf.ac.lk/index.php/the-nsf-/about-us
 (7) http://www.nsf.ac.lk/index.php/resources-and-publications/library-and-information-centre
 (8) http://www.who.int/about/en/
ύ Abstracts of Non Communicable Diseases and prevalence of risk factors in Sri Lanka,

Group A Publications (Studies which showed the prevalence of NCD’s and
their risk factors in the general population)
Alcohol and Drug Information Centre, (1995). Community Survey on substance on substance
abuse 1992/93 preliminary results of a research study carried out in 7 districts in Sri Lanka,
1995Colombo, Alcohol and Drug Information Centre (ADIC),
Objective:
To determine the prevalence and the socio-economic differentials of the use of tobacco, alcohol and
the other drugs (such as heroine)
Study method:
An interviewed administered questionnaire was used to obtain the data use to tobacco/alcohol and
other drugs types and quantity used, age of initiation and environment in which substances were
consumed.
Study Area:
The study was carried out in seven districts of Colombo, Gampaha, Kurunegala, Polonnaruwa,
Hambantota, Monaragala, and Nuwara-Eliya.
Study population:
Selected samples of both sexes, irrespective of their age from the seven districts
Study Instrument:
Interviewed administered questionnaires
Study type:
A cross sectional study
Sample size:
8257
Sampling method:
A multistage sampling technique
Risk Factors Investigated:
Alcohol
Tobacco
Drugs such as heroine
Results:
Prevalence rates (shown on table 1,2)
Ever use (substance was consumed at least once in their lifetime) rates for the three substances
varied from
•26% in Kurunegala to 34.8% in Moneragala for tobacco
•25.1% in Kurunagela to 33.8% in Gampaha for alcohol
•0.7% in Nuwara Eliya to 5.7% in Moneragala for other drugs
Thus it was seen that percentage of adults (including women) who had smoked, were slightly higher
than the corresponding rates for alcohol. In contrast, percentage of respondents who had tried an
illicit drug was very low, less than 4% in 5 of the 7 districts.
Current prevalence rates for the three substances varied from
•22.6% in Kurunegala to 31.8% in Moneragala for tobacco
•19.8% in Kurunegala to 31.4% in Gampaha for alcohol
•0.2% in Nuwara Eliya to 3.1% in Moneragala for other drugs
Male prevalence rate, both ever and current was higher than in women in all seven districts.
υτ Abstracts of Non Communicable Diseases and prevalence of risk factors in Sri Lanka,

Types of substances used
•Cigarettes were main types of tobacco smoked by males in all districts with over 70% of the
respondents in all 6 districts (except Nuwara Eliya), with beedi used (30%) to a lesser degree.
•Arrack was the most frequently mentioned type of alcohol used by the respondents (over 70% in
all districts).0n the other hand, 20% of the study population had used Kassipu, which includes 23.3%
Monaragala, 20.3% Kurunegala and 21.5% Polonnaruwa.
•Over 50% of the users of illicit drugs stated that they had used Ganja in 4 districts (Hambantota,
Monaragala, Polonnaruwa, and Kurunegala), with heroine being mentioned by 50% of the users only
in the Gampaha.
Age of Initiation
Age of initiation by 60%of smokers was 15 to 24 years with 35% being between 15 to 19 years
(except Colombo and Nuwara Eliya)
Over 50% of ever users (except in Nuwara Eliya) had initially taken alcohol between the ages of 15 to
24 years, with over 30% stating they started using between 20 to 24 years.
Of those who had used illicit drugs, over 30% in five districts had not mentioned the age of first use.
However in Polonnaruwa and Hambantota, of those who responded, 30% were between 20 to 24
years.
Enviroment in which substances were consumed
- Smoking occured mostly at home ( over 50%) of the respodents in all districts and either alone (
>70%) or with friends (45-70%)
- Alcohol was mostly consumed at functions (over 60% of users in 6 districts)and with friends (over
70% in most districts). In all the districts among 20-35% had consumed at home.
- Place of use of illicit drugs varied among the respondents as well as within the districts. At home
and while at travelling werethe places and instances mentioned by few of then drug users
commonly.
Alcohol and Drug Information Centre, A. (1995). Substance use among school children in 6
distiricts of Sri Lanka. Colombo, Alcohol and Drug Information Centre (ADIC)
Objective:
To assess the prevalence of smoking, alcohol and the use of other drugs ( such as heroine among
the the students
Study area:
Colombo, Hambantota , Badulla, Kandy , Anuradhapura and Puttalam
Study population:
School students of 33 different schools in year 7 and above with an age range between 12 to 20
years.
Type of study:
Study instrument:
Self administered questionnaire
Sampling method:
A multi stage cluster sampling
Sample size:
4843 males
3215 females
total 8058
Risk Factors investigated:
Alcohol
υυ Abstracts of Non Communicable Diseases and prevalence of risk factors in Sri Lanka,

tobacco
Illicit drugs
Results:
The number of student subjects in each district is given below-
Colombo, 2116
Kandy 834
Badulla 1332
Hambantota 1486
Anuradhapura 944
Puttalam 1344
According to the study, the substance use of the population was divided into ever users and current
users. Ever users are the students who had used alcohol , tobacco or other illicit drug at least once in
their life time and current users are the students who at present using one of the three substances.
The prevalence of the study population of both sexes is shown under table 1. It showed that among
the ever users highest percentage of alcohol and tobacco user were from Puttlam (38.6% and 19.3%
respectively.) and the highest other drug users were from Hambantota (4.6%). Among the current
users, highest tobacco users were from Colombo 6.0% and the highest alcohol and drug users were
from Hambantota, 8.0% and 2.8% respectively.
The study also revealed that the number of females who were currently using these three
substances were less than 10 for tobacco and other drugs and less than 20 for alcohol. Therefore
further detail analysis of the female population on the use of these three substances was not taken.
Regarding the type and the quantity of the substance currently used, it was observed that cigarettes
were the main type of tobacco smoked (over 85%) by the students in all districts. Moreover except
Hambantota, over 50% of the students smoked only 1 to 5 tobacco unit (refers to any unit of
smoking such as cigarette, beedi, cigar etc.) per month. While a regular smoker (a student who
smoked one unit a day or 30 units or more a month) ranged from 5% in Puttlam to 14% in
Hambantota.
Regarding the alcohol use among the study population it showed that, out of different types of
alcohol consumed, Beer was the most common alcohol drunk (35%) by the students in all six
districts, while arrack was drunk by 30% and kassipu by 10%.
Data of different types of drugs used was not mentioned and the study revealed that the drug used
was less than 12 % in eac district. The details of the type of alcohol used was not mentioned.
Alcohol and Drug Information Centre, A., Kandy Drug Prevention Project (Life), (1995). Survey of
substance use among a selected sample of households in an estate community Colombo, Alcohol
and Drug Information Centre (ADIC).
Objective:
To determine the knowledge, attitude and use of substances by workers on this estate, before the
interventions were carried out
Study method:
A small sample of the 60 estate workers in the four divisions of the estate was interviewed regarding
alcohol and tobacco use. Of the respondents 80% were males. Since the number of female
respondents were only 12 , the detailed analysis were confined to males.
Study Area:
In the 4 divisions of St. Claires Estate, Thalawakele, Nuwara Eliya District
υφ Abstracts of Non Communicable Diseases and prevalence of risk factors in Sri Lanka,

Study population:
Selected estate workers from the estate from various ages
Study Instrument:
Interviewer administered questionnaires
Study type:
Sample size:
48 males
12 females
Total 60
Sampling method:
Random sampling method
Alcohol
Tobacco
Results:
The respondents of this survey were mainly males (80%), Tamil (92%), 95% married and 81.7%
estate workers. Furthermore, the majority of the sample had not studied beyond grade 5 (73.4%).
Prevalence rate for tobacco and alcohol
Prevalence rate for tobacco was 56.7%. Consumption was comparatively higher among males. It was
revealed that 64.4% (31) males had and 33.3% (3) of the females have smoked
Cigarettes (32.3%) and beedi ( 29%) were the type of tobacco used by the estate workers . Majority
stated they smoked as a habit.(74.2%).
Prevalence rate for alcohol was 60%. Male prevalence rate was higher (65%) when compared to the
female rate (41.7%).
Reasons given for consuming alcohol were “ gives enjoyment” (54.8%), and “relieves tiredness”
(25.8%).
The frequency of the alcohol and tobacco use among the estate workers during 1995 is given under
table 1 and 2.
Attitudes regarding alcohol and tobacco
78% stated that use of alcohol and tobacco leads to relieving tiredness and 71% stated that it leads
to increased happiness.
Majority agreed with the statement that people are unware of their behavior when they are under
the influence of alcohol.(50%)
Impact of substance use
25% of the families who use substances had spent 20% of their total expenditure on alcohol and
tobacco.
Alcohol and Drug Information Centre, A. (2009). Trends in Alcohol use , spot survey. Colombo,
Alcohol and Drug Information Centre.
General objectives:
1.To find the prevailing alcohol trends in Sri Lanka
2.To compare the alcohol trends with the previous year
υχ Abstracts of Non Communicable Diseases and prevalence of risk factors in Sri Lanka,

Specific Objectives:
•To find the prevailing alcohol trends in the sampling districts
•To find the prevailing alcohol trends according to age groups
•To find the prevailing attitudes and reasons for alcohol use
•To find the age and initiation of alcohol use
•To find the trends in the alcohol brands according to age groups
Study Area:
The study was conducted in the following districts; Colombo, Gampaha, Galle, Kegalle,
Anuradhapura and Nuwara Eliya
Study population:
Male of age fifteen and above
Study Instrument:
Interviewer administered questionnaire
Study type:
Sample size:
1414
Sampling method:
Alcohol
Results:
The age distribution of the study sample population shows that 41.1% of the sample population
comprised of the age rand 15-24 years, 35.9% of the study sample population comprised of the age
range 25-39 years and 23.1% in the age range of 40 years and above. The mean age of the sample
population was 31 years. The minimum age was 15 years and maximum age was 85 years.
When considering the employment status, highest percentage of the study population consisted of
vendors (21.3%).
The current users (respondents who used alcohol within the previous month) of alcohol among the
study population was 46% in July 2009. The highest percentage of alcohol intake from the study area
was in the district of Colombo (49.6%) and the lowest percentage was on the district of Kegalle
(44.0%).
The study also revealed that most (54.5%) of the alcohol users were belonging to the age group 25-
39 years. Most (48%) of the users were occasional users and highest percentage of respondents who
were occasional users were in the age range 15-24 (52.5%) and this was mostly observed in the
district of Kegalle (58.1%).
Arrack (63.6%) was the most common type of alcohol used ( as shown below) among the study
subjects and it was more prominent among the subject s who belong the age group >/=40 years
(77.9%). The highest response on the use of arrack was from the district of Galle (70.6%).
The survey showed that the most of the subjects common reason for the use for consuming alcohol
was for ‘fun/enjoyment and to be happy’ (33%).
Regarding the age of initiation of alcohol use, most (55.6%) of the study population started using
alcohol at the age range 16-20 years of age. The initiation of alcohol was mostly at a ‘function’
(52.4%), and the commonest type of alcohol used was beer (51.7%).
In the comparison with the results of July 2009 spot survey and the July spot survey, the alcohol use
has decreased in comparison to the previous year (2008 July -48.6% to 46% in July 2009)
υψ Abstracts of Non Communicable Diseases and prevalence of risk factors in Sri Lanka,

Alcohol and Drug Information Centre, A. (2009). Trends in Tobacco use. Colombo, Alcohol and
Drug Information centre: 32.
General objective:
1.To find the prevailing tobacco trends in Sri Lanka
2.To compare the tobacco trends with the previous year
Specific Objective:
•To find the prevailing tobacco trends in the sampling districts
•To find the prevailing tobacco trends according to age groups
•To find the prevailing attitudes and reasons for tobacco use
•To find the age and initiation of tobacco use
•To find the trends in the tobacco brands according to age groups
Study Area:
Anuradhapura and Nuwara Eliya
Study population:
Male of age fifteen and above
Study Instrument:
Study type:
Sample size:
1414
Sampling method:
Tobacco
Results:
The age distribution of the study sample population shows that 41.1% of the sample population
comprised of the age rand 15-24 years, 35.9% of the study sample population comprised of the age
range 25-39 years and 23.1% in the age range of 40 years and above. The mean age of the sample
population was 31 years. The minimum age was 15 years and maximum age was 85 years.
When considering the employment status, highest percentage of the study population consisted of
vendors (21.3%).
37% of the sample population used tobacco. The highest percentage was recorded from the district
of Nuwara Eliya (44.6%) and lowest from the district of Kegalle (31.7%). The highest percentage of
tobacco users were found to be among those belonging to the age group of 25-39 years (42%) as
shown in table 1.
72% of the tobacco users of the study sample were daily users (used of tobacco at least one stick per
day). The highest percentage of daily users was from the district of Colombo (78%). The daily use
was mainly seen in the age group of 40 and above (90.1%) and the lowest in the age group 15-24.
The main reason for using tobacco in the study population was regarded as ‘Habit’ of using by 25.8%
of the study subject as give in the chart below.
The age of initiation of tobacco as told by the subjects was the age of 16-20 years 57.9%of the study
population. The highest percentage on the occasion of initiation of tobacco use was with the friends
(56.6%).
υω Abstracts of Non Communicable Diseases and prevalence of risk factors in Sri Lanka,

Alcohol and Drug Information Centre, R. a. I. p. (2008 ). Spot Survey 2008 December - Alcohol.
Colombo, Alcohol and drug Information centre
General objective:
To find the prevailing alcohol trends in Sri Lanka
Specific Objective:
•To find the prevailing alcohol trends in the sampling districts
•To find the prevailing alcohol trends according to age groups
•To find the prevailing attitudes and reasons for alcohol use
•To find the age and initiation of alcohol use
•To find the trends in the alcohol types according to age groups
•To find the t types of alcohol use according to the age groups
Study method:
Questionnaires
Study Area:
Anuradhapura and Monaragala
Study population:
Males of age fifteen and above
Study Instrument:
Interviewer administered Questionnaires
Study type:
Sample size:
1179
Sampling method:
Alcohol
Results:
The population distribution of the study sample among the districts studies is as follows:
Colombo 216
Gampaha 195
Galle 177
Kegalle 207
Anuradhapura 213
Monaragala 171
The age distribution of the study sample –
15-24 - 410
24-40 - 499
>40- 270
The alcohol use was based on the respondents alcohol used in the previous week of the study. The
study revealed that 48% of the overall study population was consuming alcohol as at December
2008. The results were further categorized in obtaining the alcohol use among the study population-
•Alcohol use – age basis
15-24 – 44.9%
24-40 - 50.8%
>40- 48.6%
The highest percentage of alcohol users were among the age group 25-40 (50%)
υϊ Abstracts of Non Communicable Diseases and prevalence of risk factors in Sri Lanka,

•Alcohol use – district basis
Colombo 51.9%
Kegalle 50.5%
Anuradhapura 49.8%
Gampaha 48.1%
Galle 47.9%
Monaragala 39.5%
The highest alcohol consumption was recorded was in Colombo 51.9% and the lowest from
Monaragala 39.5%
•Alcohol use (Ever used- whether they have ever used alcohol even once, in their life until now).
From analyzing the ever use of alcohol from the study population, it revealed that 29% of the study
subjects used alcohol at least once in their lifetime while 71 % did not. The ever used population was
further analyzed according to their district as follows-
Colombo 41%
Kegalle 21.8%
Anuradhapura 34.3%
Gampaha 27.7%
Galle 14.7%
Monaragala 29.7%
•Frequency of alcohol use
The frequency of the alcohol use was further analyzed according to daily use (at least a glass of
alcohol), monthly use and occasional basis-
The frequency of alcohol use among the overall study population was as follows-
Daily basis 11.5%
Few times per month 45.5%
On special occasion 42.9%
With regarding to the age group, highest percentage of daily users of alcohol was found among > 40
years (20.5%).
•Types of alcohol use
Arrack 68.2%
Beer 51.9%
Kassippu 11.1%
Other (whisky, Brandy, wine) 10%
With considering the age of the study population and the type of alcohol used 15-24 ,24-40 and >40,
Arrack was the most common type of alcohol used among all three age groups , 60%, 71.5% and
73.6% respectively.
•Reasons of using alcohol
“For partying, fun and feel happy” was the commonest reason to consume alcohol, given by the
study population 37.3%
•Age of initiation of alcohol
Among the alcohol users, 78% have initiated in consuming alcohol at the ages of 21-25 years.
<15 years – 2%
16-20 years- 11%
21-25 years- 78%
26-40 years -8%
The most common type of alcohol used at the time of initiation was Arrack (46.1%)
υϋ Abstracts of Non Communicable Diseases and prevalence of risk factors in Sri Lanka,

Arrack 46.1%
Beer 45%
Kassippu 3.7%
Other (whisky, Brandy, wine) 5.2%
Alcohol and Drug Intervention Centre, R. a. E. D. (1990 ). Research Project – Mirissankotuwa.
Colombo, Alcohol and Drug Intervention Centre
Objective:
1.To identify the present socio-economic level of the village
2.To evaluate the extent to which the inhabitants are involved in the production of illicit liquor
3.To recognize the attitudes , concepts and knowledge within the community regarding substance
abuse
4.To identify the present level of Alcohol and Drug consumption, and make an assessment of the
magnitude and characteristics of the drug problem in the community
Study method:
This survey was designed to investigate a population of special interest to those engaged in the
prevention of substance abuse. Two methods of data collection were employed in this survey –
1.By direct observation to elicit information pertaining to the illegal production of liquor in this
village.
2.A community survey using a interviewer administered questionnaire to find out the number of
people using alcohol and tobacco in Mirissankotuwa
Study Area:
North and South Mirissankotuwa
Study population:
A selected sample of both males and females, irrespective their age from both North and South
Mirissankotuwa
Study Instrument:
Study type:
Sample size:
Males 262
Female 250
Total 512
Sampling method:
Random sampling
Alcohol
Tobacco
Results:
A total of 512 people from this area were interviewed. The percentage of males in this population is
slightly higher than the percentage of females (51% are males). 67% of the population over 15 years
was married. 58% of the sample was below 30 years of age. Only 4% of the sample was above age
60. Only 23% of the population over the 16 years had studied beyond GCE (O/level). 6 people out of
the 396 had studied beyond GCE (A/Level).
When classifying according to the ethnicity, majority (98%) of them were Sinhalese and the rest
were Tamils. 96% of the sample was Roman Catholic. There were very few Buddhists (1%) and
Hindus (0.5%) in this village.
Prevalence of Tobacco
υό Abstracts of Non Communicable Diseases and prevalence of risk factors in Sri Lanka,

Of the 512 interviewed, 375 were above age 17. Among the 197 males of this group, 88 were current
smokers. 3 of the 178 females who came under the above stated category were current smokers.
Thus the prevalence of smoking for males over 17 years of age is 44.7% and the corresponding figure
for females is 1.7%.
Table 1 and 2 shows the age specific prevalence of smoking and the choice of tobacco products
among smokers.
There is no correlation between the incidence smoking and the level of education. When
considering the population over the age of 16 years, 24% of those studied up to GCE o/Level used
tobacco. The corresponding figure for those who had studied beyond GCE O/Level was 19%.
The study showed no significant relation P<0.05 between the use of tobacco and the level of income
in which the minimum income per month was Rs.200 and the maximum income of the study
population was Rs.59000 per month.
The degree of cigarette consumption was divides as light smoker (average of 1 cigarette per day),
moderate smokers (average of 5 cigarettes per day) and heavy smokers (average of 10 cigarettes per
day). Among the 91 smokers, twenty (22%) were light smokers, twenty nine (31%) were moderate
smokers and forty two (46%) were heavy smokers.
Prevalence of Alcohol
Of the 375 (all over 17 years of age) interviewed, 197 were males and 178 females. The users of
alcohol were defined as those who were occasional or habitual drinkers. The prevalence of alcohol
for males over 17 years of age was 61.4% (121) and the corresponding figure for females was 3.4% .
The age specific prevalence of Alcohol and the type of Alcoholic Beverages used are giving under the
table 3 and 4 respectively.
There is no significant relation between the use of alcohol and the level of education. Among those
who were above 16 years who studied less than GCE O/Level, 33% used alcohol and for those who
studied beyond GCE O/Level this figure was 29%.
Among those who use alcohol 69% belong to families which earn an income of less than Rs.2000/- .
Sixteen percent of them can be categorized as middle class (i.e. generating an income Rs.2000-
Rs.3000/-) while the rest (15%) had an income had an income greater than Rs.3000/-.
Arambepola C. Allender S. Ekanayake R. Fernando D (2008). "Urban living and obesity: is it
independent of its population and lifestyle characteristics?" Tropical Medicine and International
Health 13(4): pp 448–45.
Objective:
Living in an urban area influences obesity. However, little is known about whether this relationship is
truly independent of, or merely mediated through, the demographic, socio-economic and lifestyle
characteristics of urban populations. The objective of this study was to identify and quantify the
magnitude of this relationship in a Sri Lankan population.
Study method:
Cross-sectional study of adults aged 20–64 years representing the urban (n = 770) and rural (n = 630)
populations, in the district of Colombo in 2004. Obesity was measured as a continuous variable using
body mass index (BMI). Demographic, socio-economic and lifestyle factors were assessed.
Gender-specific multivariable regression models were developed to quantify the independent effect
of urban ⁄ rural living and other variables on increased BMI
υύ Abstracts of Non Communicable Diseases and prevalence of risk factors in Sri Lanka,

Study Area:
Colombo district
Study population:
Adults aged 20–64 years. Participants were those currently residing in urban or rural sectors in the
district of Colombo (estate sector was excluded as it represented only 0.3% of the total population
of Colombo) at least for a continued period of 1 year to ensure a stable lifestyle related to their
residence in the area. Those with pathological or iatrogenic obesity (e.g. hypothyroidism, Cushing
syndrome), ascites or pregnancy up to a postpartum period of 3 months were excluded by perusing
diagnosis cards and medical records of participants.
Study Instrument:
Pre-tested questionnaires
Height and weight measurements
Study type:
A community-based cross-sectional study
Sampling method:
Multi-stage, stratified, probability sampling method
Body mass index, Obesity
Results:
The BMI (mean; 95% confidence interval) differed significantly between urban (men: 23.3; 22.8–
23.8; women: 24.2; 23.7–24.7) and rural (men: 22.3; 21.9–22.7; women: 23.2; 22.7–23.7) sectors (P
< 0.01). The observed association remained stable independently of all other variables in the
regression models among both men (coefficient = 0.64) and women (coefficient = 0.95). These
coefficients equated to 2.2 kg weight for the average man and 1.7 kg for the average woman. Other
independent associations of BMI were with income (coefficient = 1.74), marital status (1.48), meal
size (1.53) and religion (1.20) among men, and with age (0.87), marital status (2.25) and physical
activity (0.96) among women.
Conclusions Urban living is associated with obesity independently of most other demographic,
socioeconomic and lifestyle characteristics of the population. Targeting urban populations may be
useful for consideration when developing strategies to reduce the prevalence of obesity.
Arambepola C. Ekanayake R. Fernando D (2007). "Gender differentials of abdominal obesity
among the adults in the district of Colombo, Sri Lanka." Preventive Medicine 44(2): 129-134.
Objective:
To assess the gender-specific prevalence and determinants of abdominal obesity (AO) within the
population and lifestyle diversity of an urban district in Sri Lanka.
Study Method:
Prevalence of AO (defined by waist circumference) was estimated in a cross-sectional study of 1400
adults aged 20-64, residing in the district of Colombo in 2004. Demographic, socio-economic and
lifestyle factors were assessed in gender-specific logistic regression models to identify determinants
of AO.
Study area:
Colombo district
Study population:
Adults aged 20-64
Type of study:
Cross-sectional study
Sample size:
1400
φτ Abstracts of Non Communicable Diseases and prevalence of risk factors in Sri Lanka,

Factors investigated:
Age, insufficient level of physical activity, frequent large meals, household income, increased
alcohol, moderately urban sector
Results:
Prevalence of AO was 44.7% (95% confidence interval (CI): 41.0, 48.5) in females and 25.7% (95% CI:
22.6, 29.0) in males. Significant determinants of AO were age 35-49 (adjusted odds ratio: 1.7; 95% CI:
1.2, 2.5), moderately urban sector (1.9; 1.3, 2.9) and insufficient level of physical activity (1.7; 1.1,
2.4) among females in contrast to household income > Rupees 10,000 (6.1; 2.7, 13.5), increased
alcohol (medium: 1.9; 1.2, 2.9; high: 2.1; 1.2, 3.5), low-fiber diet (1.6; 1.1, 2.4) and frequent large
meals (1.7; 1.0, 2.8) among males. Determinants common to males (M) and females (F) were age ≥
50 years (M: 2.5; 1.5, 4.2 and F: 2.9; 1.9, 4.4), most urban sector (M: 2.0; 1.3, 3.1 and F: 1.8; 1.2, 2.7)
and married status (M: 2.2; 1.3, 3.6 and F: 2.4; 1.6, 3.6).
Conclusion:
A distinct gender differential was observed in the prevalence and determinants of AO. It appears
vital that preventive strategies of AO be developed to be more 'gender-sensitive' in urban districts.
Arambepola C. Fernando D. Ekanayake R (2008). "A simple valid tool for measuring obesity-related-
CHD risk in Sri Lankan adults." Prevention and Control 3(1): 11-19.
Objective:
To compare waist circumference (WC) and body mass index (BMI) in identifying the "obesity-related-
CHD risk" among Sri Lankan adults.
Study Method:
A population-based cross-sectional study of 515 adults aged 20-64 years, residing in the district of
Colombo in 2004 was selected by a multi-stage, stratified, probability sampling method. WC, height
and weight were measured. Demographic, socio-economic and lifestyle characteristics, smoking and
obesity-related-CHD risk factors (hypertension, dyslipidaemia, diabetes) were assessed by
questionnaires, physical measurements and biochemical assessments. "Obesity-related CHD risk"
was defined by the presence of ≥1 obesity-related-CHD risk factors.
Study area:
Colombo
Study population:
Adults aged 20-64 years
Type of study:
Population-based cross-sectional study
Study instrument:
Questionnaires, physical measurements and biochemical assessments
Sampling method:
Multi-stage, stratified, probability sampling method
Sample size:
515
Waist Circumference (WC), height, weight, demographic, socio-economic and lifestyle
characteristics, smoking and obesity-related-CHD risk factors (hypertension, dyslipidaemia, diabetes)
Results:
Compared to BMI, WC was a stronger correlate of systolic and diastolic blood pressure, triglycerides
among both sexes and of plasma glucose among males. It was also an independent predictor of
obesity-related-CHD risk in both males (beta co-efficient = 0.046; standard error = 0.013) and
females (0.024; 0.012) in contrast to BMI, which was significant only among males (0.138; 0.037) in
the logistic regression models adjusted for confounders. At the same level of obesity-related-CHD
risk corresponding with BMI of 25 kg/m2 (OR = 1.7) and 30 kg/m2 (OR = 3.5), the corresponding WC
φυ Abstracts of Non Communicable Diseases and prevalence of risk factors in Sri Lanka,

values were 90.5 cm and 105.5 cm for males and 100 cm and 129 cm for females. The derived
optimal risk thresholds of WC for identifying obesity-related-CHD risk was 88.5 cm for males and 82
cm for females.
Conclusion:
WC with its sex-specific cutoff values can serve as a better screening tool than BMI in identifying
individuals at risk of obesity-related CHD in low-resource settings.
Athukorala LK. Kumarendran B. Kasturiratne A. Wickremasinghe AR (2012). "Negative health
effects of coconut - Are they real at the population level?" The Ceylon Medical Journal
57(Supplement 1): Page 19.
Objective:
The aim is to evaluate the impact of consumption of coconut products on CVD – Cardiovascular
death rates.
Study method:
Data from 1961 to 2006 were abstracted from different sources, coconut consumption from FAO
database, CVD death rates from reports of the Department of Census and Statistics , Population data
from the UN databases and per capita GDP from the World Bank database Correlation and
Regression analysis were carried out.
Results:
From 1961 to 2006, the average consumption of coconut including copra was 66.19 kg/ capita per
year, the average consumption of energy was 271.47 kcal/ capita/ day, the average fat supply was
24.46 g/ capita/ day. There was no increase in the per capita consumption of coconut production
from 1961 – 2006 in Sri Lanka (range 54.1 – 76.2 kg/ capita/ year)
The CVD death rates and the proportion mortality rate due to CVD have increased from 1961 -2006.
Consumption of coconut products was correlated with CVD death rates but no lags were seen. CVD
death rates were significantly associated with per capita GDP and percentage of urban population
but not consumption of coconut products after adjusting for the other variables (R2 = 0.865).
Athuraliya NTC. Abeysekera TDJ. Amerasinghe PH. Kumarasiri R. Bandara P. Karunaratne U. Milton
AH. Jones AL (2011). "Uncertain etiologies of proteinuric-chronic kidney disease in rural Sri Lanka."
Kidney International 80(11): 1212-1221.
Objective:
To describe the prevalence of proteinuric-CKD and disease characteristics of three rural populations
in the North Central, Central, and Southern Provinces of Sri Lanka.
Study Method:
Patients were selected using the random cluster sampling method and those older than 19 years of
age were screened for persistent dipstick proteinuria.
Study area:
North Central, Central, and Southern Provinces of Sri Lanka
Study population:
Adults older than 19 years of age
Study instrument:
Dipstick for proteinuria
Sampling method:
Random cluster sampling
Sample size:
6153
Diabetes, long-standing hypertension, age, farming
φφ Abstracts of Non Communicable Diseases and prevalence of risk factors in Sri Lanka,

Results:
The prevalence of proteinuric-CKD in the Medawachchiya region (North Central) was 130 of 2600
patients, 68 of 709 patients in the Yatinuwara region (Central), and 66 of 2844 patients in the
Hambantota region (Southern). The mean ages of these patients with CKD ranged from 44 to 52
years. Diabetes and long-standing hypertension were the main risk factors of CKD in the Yatinuwara
and Hambantota regions. Age, exceeding 60 years, and farming were strongly associated with
proteinuric-CKD in the Medawachchiya region; however, major risk factors were uncertain in 87% of
these patients. Of these patients, 26 underwent renal biopsy; histology indicated tubulointerstitial
disease.
Conclusion:
Proteinuric-CKD of uncertain etiology is prevalent in the North Central Province of Sri Lanka. In
contrast, known risk factors were associated with CKD in the Central and Southern Provinces.
Atukorala TM. Jayawardene MI (1991). "Lipid patterns and dietary habits of healthy subjects living
in urban, suburban and rural areas." Ceylon Med J 36(1): 9-16.
Lipid patterns were determined in 167 healthy subjects in the age group 28 to 50 years living in an
urban area, a suburban area and two rural areas to determine a possible relationship between their
serum lipid patterns and food habits. Total cholesterol, high density lipoprotein (HDL)-cholesterol,
and triglyceride concentrations were determined in the sera of fasting subjects, and low density
lipoprotein (LDL)-cholesterol concentration was calculated. Risk of coronary heart disease as
assessed by the body mass index, ratios of total cholesterol to HDL-cholesterol, and LDL-cholesterol
to HDL-cholesterol, was significantly lower in subjects in rural area 2, who were agricultural workers
with a high degree of physical activity, subsisting on a diet consisting mainly of plant food, despite a
higher consumption of coconut, a saturated fat. It is possible that the hypercholesterolaemic effect
of saturated fats was mitigated by the high fibre content of their diets.
Bandara KMGK (2008). Prevalence of Coronary Heart Disease risk factors among adolescents of
Kandy Municipal Council area and evaluation of effect of an intervention to reduce sedentary
lifestyle. Postgraduate Institute of Medicine. Colombo, University of Colombo. Doctor of Medicine
in Community Medicine:
Main objective:
To determine the prevalence of Coronary Heart Disease risk behaviors and biological risk factors
among adolescents of public schools in the Kandy Municipal Council area and to find out the effects
of an intervention program in reducing sedentary lifestyle among adolescents.
Specific objective:
1.To determine the prevalence of the following Coronary Heart Disease risk behaviors and
biological risk factors among adolescents:
 Unhealthy dietary habits
 Physical inactivity
 Smoking
 Psychological stress
 Overweight
 High blood pressure.
2.To assess the knowledge and attitudes towards the Coronary Heart Disease risk factors among
adolescent.
3.To determine the association between socioeconomic status and the prevalence of Coronary
Heart Disease risk behaviors and biological risk factors among the adolescents
4.To describe the plasma lipid profile and the plasma sugar levels in a subsample of adolescents
φχ Abstracts of Non Communicable Diseases and prevalence of risk factors in Sri Lanka,

5.To plan , implement and evaluate as intervention program to reduce sedentary lifestyle among
adolescents
Study method:
The study consisted of two phases
Phase 1-
Component 1: A school based cross sectional study among adolescents in public schools of Kandy
Municipal Council area. This component was planned to achieve the first three specific objectives of
the study
Component 2: A cross sectional study in a subsample of the study population included in component
1. The fourth specific objective of the study was achieved at the end of the component 2
Phase 2- A school based health promotion intervention trial and its evaluation among a subsample
of the study population in component 1 of phase 1.Phase 2 was planned to achieve the fifth specific
objective of the study.
Study area:
Public schools of Kandy Municipal Council area.
Study population:
Adolescents between 14 to 15 old, studying in Sinhala medium public schools of the Kandy Municipal
Council area
All adolescent with a diagnosis of any chronic illness, physical abnormality or mentally subnormal or
who were acutely ill at the time of the survey were excluded from the sample.
Type of study:
A school based cross sectional study school based intervention trial
Study instrument:
Self administered questionnaires
Anthropometric measurements
Blood pressure measurements
Sampling method:
A stratified cluster sampling method
Sample size:
3718
Smoking
Alcohol
Unhealthy dietary habits
Physical inactivity
Psychological stress
Overweight
High blood pressure
Results:
Smoking and Alcohol
As smoking and alcohol have been known risk factors for coronary heart disease, study revealed that
the overall ever smoking ( at least one puff during the lifetime) prevalence was 1.8% (95% CI: 1.4-
2.2) among the adolescents with a prevalence of 3.7% (95% CI:2.9-4.7) among males and 0.2% (95%
CI: 0.0-0.5) among the females while the overall prevalence of ever alcohol consumption (at least
one drink during their life time) was 3%(95% CI:2.5-3.6) among adolescents with a prevalence of
5.2%(95% CI: 4.2-6.3) among males and 1.3%(95% CI: 0.9-1.9) among females.
High blood pressure
Regarding elevated blood pressure hypertension was defined as an average Systolic Blood Pressure
(SBP) and / or Diastolic Blood Pressure (DBP) that is > 95th percentile for gender, age and height on
>3 occasions for this study..
φψ Abstracts of Non Communicable Diseases and prevalence of risk factors in Sri Lanka,

Pre hypertension in children was defined as average SBP or DBP levels that are >90th percentile but
<95th percentile.
Adolescents with BP levels greater than or equal to 120/80mmgh were considered as pre-hypertensive
(National Blood Pressure Education Program Working Group on High Blood Pressure in
Children and Adolescents 2004). The overall prevalence of prehypertension was 5.5 %( 95% CI: 4.8-
6.3) and elevated blood pressure was 0.1% in this study.
High blood pressure and overweight (Adults are defined as overweight if their BMI exceeds
25kg/m2) was significantly associated p=0.001 in the study.
Physical inactivity
The prevalence of insufficient physical activity was 33.6% (95% CI: 32.1-35.2) and it was higher
among the females 35.4% than the male 31.5% students. BMI levels and physically activities did not
show a relationship but hypertension was lower among the male and female students who were
physically active (p=0.042 and p=0.395 respectively).
Psychological stress
Psychological distress is another risk factor for coronary heart disease and it was significantly higher
among the male adolescents 12.5 %( 95% CI: 11.0-14.2) than female adolescents 7.1% ((95% CI: 6.1-
8.3). The study also revealed that stress was lower among the physically active adolescents that
those who are inactive.
Unhealthy dietary habits
The consumption of fruits was low among both males (44.9%) and females (42.1%) students. when
considering energy dense foods such as milk, diary products , eggs, commercially baked foods and
deep fried items etc, the consumption of deep fried foods (p=0.808) were higher among both the
sexes (>55%). Consumption of commercially baked foods were was also higher among the males
(33.8%) than females (25.9%) students with p<0.001. the consumption of sugar sweetened
beverages was also high among the both the sexes (males 31.2% and females 28% p=0.049)
In the present study, fasting blood sugar (FBS) was taken as high it exceeded more than 105mg/dL
and the lipid levels, total cholesterol >200 mg/dL , LDL (Low density lipoproteins) >130 mg/dL and
triglyceride levels >150 mg/dL were taken as High respectively. The mean FBS was significantly
higher (p<0.001) among the male students as shown in the table below. The mean triglyceride, total
cholesterol and LDL were higher among the female students. The difference of the mean total
triglycerides and cholesterol was significant (p=0.002) and the difference was not statistically
significant for triglyceride and LDL.
The mean FBS, total cholesterol and triglyceride and LDL was higher among the overweight students
than normal (BMI 18.5 - 25kg/m2) and underweight (<18.5kg/m2) students for both the sexes. The
study also revealed that the mean values of FBS and LDL were higher among the students with pre
hypertension and increased blood pressures than students with normal blood pressures for both the
sexes.
The knowledge on most coronary heart disease risk factors was satisfied among the adolescents. The
intervention programme was successful and it had an effect in decreasing physically inactivity and
further improvement of knowledge and attitudes toward coronary heart disease risk factors among
adolescents. But the sustainability of improve knowledge and attitudes and physical activity
decreased with time.
φω Abstracts of Non Communicable Diseases and prevalence of risk factors in Sri Lanka,

Beneragama APS (2002). An epidemiological study of type II diabetes mellitus in Kalutara district
in Sri Lanka. Postgraduate Institute of Medicine Colombo, University of Colombo. Doctor of
Medicine in Community Medicine:
General objective:
To determine the extent of the problem of type II diabetes mellitus among 30-64 year old population
in the Kalutara District of Sri Lanka and to develop and validate a screening tool that can be used by
PHC workers in identifying type II diabetes mellitus.
Specific Objective:
1.To estimate the prevalence rates of type II diabetes mellitus and IFG according to the new
WHO/ADA criteria.
2.To study the socio-demographic characteristics of the people with type II diabetes mellitus in the
sample.
3.To develop a simple screening tool which can be used by the PHC workers in the detection of
type II diabetes mellitus in the field setting.
4.To validate the screening tool with a reference test, Fasting Plasma Glucose (FPG) measurement
using Receiver Operating Characteristic (ROC) analysis.
Study method:
Fasting plasma glucose levels were measured after a minimum of10 hours of overnight fasting.
Structured pre coded questionnaire was used to collect information on socio-demographic
variables, symptoms and risk factors of type II DM. Anthropometric measurements height, weight
and waist circumference were measured using standard protocols. A screening tool was developed
following the standard procedure in developing of a new instrument.
Study Area:
Kalutara District in Sri Lanka
Study population:
All individuals aged 30-64 years who were in the voter’s list in the Kalutara District.
Study Instrument:
Electronic weighing scale
A microtoise 04116 steel tape for height measurement
Study type:
Community base cross sectional descriptive study for the prevalence study
Screening tool development
Screening tool validation.
Sample size:
3000
Sampling method:
A stratified cluster sampling method
Results:
There were 3000 selected study subjects out which 2865 participated in the study. There were 1391
males and 1474 female subjects in the study population. Mean age of the sample was 45.3 years
(S.D 9.76). Age standardized prevalence rate NIDDM for both sexes were 10.3 %( 95% C.I 6.92-
13.07). For females crude prevalence rate was 10.2% and for males it was 9.3%.
Prevalence of Impaired Fasting Glucose was 4.4% for males and 3.5% for Females.
Prevalence rate for Total Glucose Tolerance was (age adjusted) 14.02% indicating that Type II DM is
highly prevalent in this district.
Age was significantly associated with Type II DM status with a maximum prevalence in the age group
of 50-54 years. Prevalence rate among the females was a little higher than the males.
Urban people had significantly higher crude prevalence rate of 14.7% than their rural counterparts.
For each three known people with diabetes there were two persons with undiagnosed diabetes.
φϊ Abstracts of Non Communicable Diseases and prevalence of risk factors in Sri Lanka,

BMI levels correlated with NIDDM in both sexes.
Non occupational physical activity level was significantly (p<0.001) associated with NIDDM. Obesity
was more prevalent among Type II DM people.
In the screening tool, important risk factors found (p<0.05) were age more than 40 years, dryness of
the mouth, constipation, presence of family history of diabetes and nocturia.
Screening tool was validated with the FPG value and the ROC analysis showed that the screening
tool carries 53.3% sensitivity, 60.8 % specificity and positive predictive values of 6 %. It is concluded
that a questionnaire based on symptoms and risk factors is not suitable to screen for diabetes in the
field setting.
Chang T. Gajasinghe S. Arambepola C (2012). "Epidemiology of stroke in the district of Colombo,Sri
Lanka: a community -based study." The Ceylon Medical Journal 57(Supplement 1):
Objective:
To study the prevalence of stroke and its risk factors in an urban population
Study method:
The study was conducted among 2313 adults currently living in the district of Colombo. A multi stage
probability-proportionate-to-size cluster sampling technique was used to collect all eligible persons
in 46 administrative divisions. Data were collected using a questionnaire. ‘Ever diagnosis’ of stroke
confirmed by Pre-intern Medical Officers using a check list and documental evidence
Study Area:
Colombo District
Study Instrument:
An interviewer administered questionnaire
Study type:
Sample size:
2313
Sampling method:
A multi stage probability-proportionate-to-size cluster sampling
Disease Investigated:
Stroke
Results:
Of the total population (52% females; mean age 44.2 years, SD =16.6), the prevalence of stroke was
1.0% (95% CI: O.006, 0.014) with a 2:1 male to female ratio. The prevalence increased 6-fold
amongst males and two fold amongst females over the age of 65 years. There were none (92%)
developed hemi-paresis, 58.3% dysphasia, and 16.7% loss of balance. 58% sought Western medical
treatment, 4.2% indigenous medical treatment , and 37.5% both. Only 58.3% had CT brain scans, of
which 85.7% had ischemic strokes. Hypertension was the commonest risk factor (62.5%) followed by
smoking (50%), excess alcohol( 45.8%), diabetes (33%), transient ischemic attack ( 29.2%) and had a
family history (20.8%). 79.2%, mostly males , had two or more risk factors.
Conclusion:
The prevalence of stroke in urban Sri Lanka lies between high-income and low- and middle- income
countries. Increasing age remains the most important risk factor.
φϋ Abstracts of Non Communicable Diseases and prevalence of risk factors in Sri Lanka,

Danansuriya MN (2009). Prevalence and correlates of asthma among 12-14 year old school
children in a district and their quality of life. Postgraduate Institute of Medicine. Colombo,
University of Colombo. Doctor of Medicine in Community Medicine:
Main objective:
To determine the prevalence and correlates of asthma among 12-14 year old school children in a
selected district and to determine their general and asthma specific quality of life.
Specific objective:
1. To determine the prevalence and describe the correlates of asthma among 12-14 year old school
children.
2. To describe the sensitization pattern to common indoor allergens in a sub sample of asthmatc
students with with current asthma compared to their healthy siblings.
3.To describe the general quality of life among 12-14 years old school children and compare the
general quality of life (Qol) among student with asthma identified, with an age matched healthy
control group using the vallidated generic QOL questionnaire.
4. To describe the disease specific quality of life in the children with asthma using the vallidated
asthma specific QOL questionnaire.
Study area:
Gampaha District.
Study population:
For the translaton and vallidation of the study instruments- a healthy group of children selected
from randomly selected two schools age 12 to 14 years in the Ragama MOH area and a group of
asthmatic students from asthma amd medical clinics from LRH,North Colombo Teaching
Hospital,National Hospital and chest hospital Welisara of ages between 11years and 12 months to 14
years and 12 months.
Type of study:
For the prevalence study -A descriptive cross sectional study
To examine the correlates of asthma - A case control study
Study instrument:
For the prevalence study
1. A student questionnaire on respiratory diseases.
2. Teacher Information form
To examine the correlates of asthma-an interviewer administered questionnaire.
Sampling method:
The multi staged stratified cluster sampling method
Sample size:
For the prevalence study 1483
To examine the correlates of asthma - 158
Results:
The reported prevalence rates for current wheezing (having wheezing or whistling sound in the chest
during the last 12 months), ever wheezing (having wheezing or whistling sound in the chest at any
time in the past.), current asthma and physician diagnosed asthma were 16.7%, 19.4%,10.7% and
14.5% respectively as shown in the table given below.
One hundred and fifty eight students were identified as having current asthma (defined as those
with physician diagnosed asthma and having symptoms (wheezing) during the previous 12 months
)were enrolled for the case control study with two healthy controls- healthy students (as defined
below) per case from the same class. The study revealed that the following were predictors of
current asthma in the case control study-
§Being the only child (OR=4.2, 95% CI:1.7-9.9)
§Being the first born (OR=2.6, 95% CI:1.3-5.2)
φό Abstracts of Non Communicable Diseases and prevalence of risk factors in Sri Lanka,

§Presence of allergic rhinitis (OR=2.7, 95% CI:1.6-4.6)
§Family history of asthma (OR=1.8, 95% CI:1.1-3.2)
§Family history of allergic rhinitis (OR=1.9, 95% CI:1.1-3.2)
§Family history of eczema (OR=1.8, 95% CI:1.0-3.2)
§Exposure in-utero to tobacco smoke (OR=2.0, 95% CI:1.06-3.7)
§Skin prick testing, was done with 61 current asthma cases- healthy sibling pairs from which it
revealed that adolescents with asthma show 9,3 times risk of atopy and have a significant atopy
towards cockroaches (OR=5.3, 95% CI:-2.2-12.6), house dust mite (OR=13.0, 95% CI:3.08-54.7) and
blomia (OR=11.5, 95% CI:2.71-48.7)
The assessment of general quality of life among the school children was assessed using the validated
Pediatric Quality of Life InventoryTM (PedsQLTM ) Generic core scale. Based on the cut off value of
one standard deviation below the population mean (-1SD) , the study sample was stratified into
groups of “Poor QOL” ( total score less than 71.0) and “ better QOL” ( total score equal or more
than 71.0) based on QOL scores. There were 1236 (83.3%) with good QOL and 246 (16.6%) were
classified as having poor QOL.
Following factors were found to predictors of poor general QOL after accounting for cofounding –
§Living with person other than parents (OR=2.8, 95% CI:1.5-5.3)
§Studying in a low category school (OR=1.9, 95% CI:1.2-3.0)
§Presence of allergic rhinitis (OR=1.8, 95% CI:1.3-2.5)
§Presence of other allergies (OR=1.7, 95% CI:1.2-2.5)
§Presence of current asthma (OR=1.7, 95% CI:1.1-2.7)
§Poor academic performance (OR=0.98, 95% CI:0.97-0.99)
§Poor school attendance (OR=0.99, 95% CI:0.98-0.99) and
§Increasing BMI (OR=1.06, 95% CI:1.02-1.1)
The students with current asthma were found to have significantly lower general health related
quality of life compared to their healthy colleagues.
The presence of allergic rhinitis was significantly associated with poor asthma quality of life. The
students who perceived that their asthma was under control and those who were on regular
treatment had better asthma specific quality of life. There were significant correlations between the
academic performance, school absenteeism due to illness and general QOL with asthma specific QOL
scores.
Dassanayake AS. Kasturiratne A. Niriella MA. Kalubovila U. Rajindrajith S. De Silva AP. Kato N.
Wickremasinghe AR. De Silva HJ (2011). "Prevalence of Acanthosis Nigricans in an urban
population in Sri Lanka and its utility to detect metabolic syndrome." BioMed Central Research
Notes 4.
Objective:
To investigate the prevalence of AN among adults in an urban Sri Lankan community and describe its
utility to detect metabolic syndrome.
Study Method:
This study was part of a community based investigation - the Ragama Health Study (RHS), conducted
in the Ragama Medical Officer of Health area. This area has characteristics typical of an urban
community in Sri Lanka. Participants were a representative sample of 35-64 year old adults selected
by stratified random sampling from electoral lists. Ethical approval for the study was obtained from
the Ethics Review Committee of the Faculty of Medicine University of Kelaniya. The purpose of the
study, the procedures to be carried out with potential hazards and benefits were explained to the
individuals prior to obtaining informed written consent. Consenting adults were screened by a
structured interview, clinical examination, liver ultrasound (8 MHz probe, Toshiba ultrasound
φύ Abstracts of Non Communicable Diseases and prevalence of risk factors in Sri Lanka,

diagnostic systems SSA-51 OA, Toshiba Medical Systems Corporation, Otawara-city, Tochigi-prefecture,
Japan) and collection of 10 ml venous blood for biochemical tests. Metabolic syndrome
was diagnosed on revised ATP III criteria for Asian populations. AN was identified by the presence of
dark, thick, velvety, pigmented skin in the neck.
Statistical analysis
Data were entered in Epi Info 2000 (Centres for Disease Control and Prevention, Atlanta. GA) and
logical and random checks were done. Statistical analysis was done using SPSS version 16.0 (SPSS
Inc., Chicago, IL). Continuous and categorical data were described using mean and standard
deviations. Significance testing was done using the Student T test, Chi squared test and multiple
logistic regression. p < 0.05 was considered as significant. The sensitivity, specificity, positive
predictive value (PPV), and negative predictive value (NPV) of AN to detect metabolic syndrome
were calculated.
Study area:
Ragama Medical Officer of Health area
Study population:
35-64 year old adults
Type of study:
Community based investigation
Study instrument:
structured interview, clinical examination, liver ultrasound, biochemical tests
Sampling method:
Stratified random sampling
Sample size:
2957
Metabolic syndrome, Acanthosis Nigricans, type 2 diabetes mellitus
Results:
2957 subjects were included in this analysis. The prevalence of AN, metabolic syndrome and type 2
diabetes mellitus were 17.4%, 34.8% and 19.6%, respectively. There was a strong association
between AN and metabolic syndrome. The sensitivity, specificity, positive predictive value and
negative predictive value of AN to detect metabolic syndrome were 28.2%, 89.0%, 45.9% and 79.0%
for males, and 29.2%, 88.4%, 65.6% and 62.3% for females, respectively.
Conclusion:
AN was common in our study population, and although it did not have a high enough sensitivity to
be utilized as a screening test for metabolic syndrome, the presence of AN strongly predicts
metabolic syndrome.
De Lanerolle-Dias M. De Silva A. Lanerolle P. Arambepola C. Atukorala S (2011). "Body fat
assessment in Sri Lankan adolescent girls; development of a simple field tool." Annals of Human
Biology 38(3): 330–336.
Objective:
To determine percentage fat mass (%FM) of Sri Lankan adolescent girls using Fourier Transform
Infrared spectrometry (FTIR) as a reference method and develop a SFT-prediction equation to
estimate %FM.
Study Method:
Weight, height and SFT were measured and %FM determined by FTIR in 131 adolescent, post-menarcheal
girls (15–19 years). SFT-measurements were applied to available body composition
equations for validation in the population. A new equation for %FM was derived and validated.
χτ Abstracts of Non Communicable Diseases and prevalence of risk factors in Sri Lanka,

Study area:
Western Province of Sri Lanka
Study population:
Out-of-school adolescent girls aged 15–19 years
Study instrument:
Calibrated electronic scale, Stadiometer, Harpenden Caliper,
Sampling method:
Convenience sampling method
Sample size:
650
Weight, height, Biceps, triceps, sub-scapular and supra-iliac SFT, percentage fat mass
Results:
Mean %FM (FTIR) was 19.13 ^ 8.2.Selected body composition prediction equations over-estimated
%FM. The multiple regression procedure yielded a final equation consisting of two anthropometric
and one demographic variable, %FM = 9.701 -(0.460) x age + (0.640) x TricepsSFT + (0.583) x Supra-iliacSFT.
Conclusion:
Existing SFT prediction-equations are unsuitable for predicting %FM in this population. The new
equation utilizing one peripheral and one truncal skin-fold, is appropriate for prediction of %FM in
this population and may be applicable to other South Asian/Asian-Indian adolescents following
validation.
De Silva AP. Liyanage IK. De Silva STGR. Somatunga L. Bandara J. Sooriyarachchi U. Sooriyarachchi
K (2012). "National survey on tobacco use among 13 to 15 years school children in Sri Lanka." The
Ceylon Medical Journal 57(Supplement 1):
Objective:
To describe the prevalence and correlates of smoking among 13 to 15 years old school children in Sri
Lanka
Study method:
This study was done using a multi stage cluster sampling method to randomly selected thirty schools
from each of the school categories of 1AB, 1C and II. From each school a number of classes were
randomly selected using probability proportionate to size model. All students in selected classes
were enrolled. From 5891 students, 4963 (84.2%) participated. the final sample was weighted and
data was collected on their tobacco use.
Study Area:
Randomly selected thirty schools from each of the school categories of 1AB, 1C and II
Study population:
13 to 15 year old school children
Study Instrument:
A pre-tested self administered questionnaire
Study type:
Sample size:
4,963
Sampling method:
A multistage cluster Sampling Method
Tobacco use
χυ Abstracts of Non Communicable Diseases and prevalence of risk factors in Sri Lanka,

Results:
The prevalence of all time smoking was 6.5% (95% CI: 4.9-8.6) (Male: 11.9%, Females: 1.6%).
Prevalence of smoking during the past 30 days was 1.5% (95% CI: 1.0-2.5) and 42.5% (95% CI: 39.8-
45.1) was exposed to passive smoking. There were 3.4% (95% CI: 2.6-4.4) never smokers who were
considering to start smoking. Majority (88.9%, 95% CI: 86.8-90.6) believe that smoking should be
banned from public places .Among the current smokers 49.3 %( 95% CI: 20.4-78.7) were not refused
to sell cigarettes from the stores because of their age. Intention to quit smoking were observed
among 80.6% ((95% CI: 55.9-93.2) of current smokers and 79.4 %( 95% CI: 58.0-91.5) have tried to
quit during the past year.
Conclusion:
The prevalence of smoking was low. However the exposure to passive smoking in public was high.
Students who smoked have access to cigarettes from public shops in spite of being under age.
Intention to quit smoking is also high.
De Silva KSH. Wickramasinghe VP. Gooneratne INA (2006). "Metabolic consequences of childhood
obesity—a preliminary report." The Ceylon Medical Journal 51(3): 105-109.
Objective:
To document the presence of metabolic syndrome (MetS) and non-alcoholic steatohepatitis (NASH)
in obese Sri Lankan children, to correlate the fat mass (FM) with the waist circumference (WC) and
the body mass index (BMI), and to compare the association of the WC( waist circumference), BMI (
body mass index) and the WHR (waist-hip ratio) with the metabolic derangements
Study method:
Children attending the Obesity Clinic at Lady Ridgeway Hospital, Colombo, from November 2004 to
September 2005 were studied. The relevant sociodemographic data, anthropometric measurements
and examination findings were documented. After a 12-hour overnight fast, blood was taken for
estimation of lipid profile, serum insulin, liver enzymes and blood glucose. The oral glucose tolerance
test (OGTT) was done in children over 5 years of age. Fatty infiltration of the liver was assessed by
identifying specific features on ultrasonography and the degree of infiltration was given a score. The
International Diabetes Federation (IDF) 2004 guidelines was modified to define MetS. NASH was
defined as fatty infiltration of the liver associated with a raised serum ALT.
Study Area:
Obesity Clinic at Lady Ridgeway Hospital, Colombo
Study population:
Children attending the Obesity Clinic at Lady Ridgeway Hospital, Colombo
Study Instrument:
Sample size:
70
Sampling method:
Convenient sampling method
Metabolic syndrome, non-alcoholic steatohepatitis, obese Sri Lankan children, waist circumference
Results:
Of the 92 children seen in the clinic during the study period, 70 (76%) consented to participate in the
study. The demographic features of the study population are given in Table 1. The age of the
patients ranged from 25 to 177 months. The %FM (SD) of 47.5 (5.7) in boys and 48.6 (10.9) in girls
was far in excess of the values associated with adverse health outcomes (> 25% in boys and > 32% in
girls [15])
The mean (SD) age was 9.7 (2.5) and 9.3 (3.0) years for boys and girls respectively. Mean BMI was
25.9 in both groups. All patients had a WC>98th percentile. MetS was found in 13 of the 63 (21%)
χφ Abstracts of Non Communicable Diseases and prevalence of risk factors in Sri Lanka,

children on whom all criteria were assessed. Sixty children had ultrasonography and NASH was seen
in 11 (18%). The correlation of the percentage FM ( fat mass) was greater with the BMI (r=0.80; p<
0.001) than with the WC (r=0.56; p< 0.001), but the WC was more significantly associated with the
metabolic derangements than either BMI or WHR.
Demographic features of the study population
Boys mean (SD) Girls mean (SD)
Number 40 30
Age (years) 9.7 (2.5) 9.3 (3.0)
BMI (kg/m2) 25.9 (3.6) 25.9 (4.4)
WC 84.2(11.4) 84.0 (12.0)
HC 85.7(10.9) 90.1 (12.2)
WHR 0.98 (0.05) 0.93 (0.05)
FM(kg) 24.2(10.1) 26.7 (10.9)
%FM 47.5 (5.7) 48.6(10.9)
Components of the metabolic syndrome in the study population
Boys Girls Percentage (%)
WC
(>98l h percentile) 40 30 100
TG n=70
(> 95t h percentile) 18 9 39
HDL n=70
(< 5t h percentile) 1 1 3
HBPn=70
(^95'" percentile)
SBP 5 3 11
DBP 0 3 4
Abnormal glucose
homeostasis n=63 9 8 27
Metabolic syndrome
n=63 5 8 21
Conclusions:
Serious metabolic abnormalities are found in obese Sri Lankan children and the WC is a reliable
indicator of these derangements.
De Silva S (2008). "The Nutritional Status of Grade Eleven Students in the Medical Officer of Health
Area Kalutara." Journal of the College of Community Physicians of Sri Lanka 13(2).
objective:
To describe the nutritional status of grade eleven school children in the Medical Officer of Health
(MOH) area Kalutara.
χχ Abstracts of Non Communicable Diseases and prevalence of risk factors in Sri Lanka,

Study Method
A descriptive cross-sectional study was carried out among grade eleven school children in Type 1AB
and Type 1C state schools in the MOH area Kalutara. Eighteen classes from a total of 14 schools were
studied. Cluster sampling technique, probability proportionate to size was used to select the sample.
The heights and weights were measured, and the Body Mass Index (BMI) was calculated for each
child. The age and sex specific BMI charts developed by the National Centre for Health Statistics
2000 were used as standards. A structured, pre-tested self-administered questionnaire was used to
collect the socio-demographic characteristics.
Study area:
Type 1AB and Type 1C state schools in the MOH area Kalutara
Study population:
Grade eleven school children
Type of study:
A descriptive cross-sectional study
Study instrument:
A structured, pre-tested self-administered questionnaire
Height and Weight Measurements
Sampling method:
Cluster sampling method
Sample size:
639
Female 356 55.7 %
Male 283 44.3 %
Nutritional Status
Results:
The study included 639 school children where the great majority were Sinhalese (99.5%, n= 636),
Buddhists (95%, n=607). There were no Tamils or Hindus. Females accounted for 55.7% (n=356) of
the sample. Most (84.8%, n=542) of the students were residing in rural areas. The mean age of the
study sample was 16.1(SD±0.4) years. The age range was 15.5 to 18.5 years.
Seventy nine percent (n=502) of the children were able to record their monthly family income and
265 families had a monthly income of less than 10,000 rupees. Ninety eight percent [n=627] of the
students were residing in there own homes where as 12 (1.9%) were residing outside home.
The prevalence of thinness(<5th percentile) was 35.4% (n=226) and prevalence of being at risk of
overweight (≥85th percentile)was 6.7% (n=43). Out of the males 43.8% (n=124) were in the thinness
category compared to the girls (28.7%, n=102). Among those at risk of overweight, fe-males (8.7%,
n=31) had a higher prevalence than the males (4.3%, n=12). This finding was statisti-cally significant
(p=0.0001).
More of the rural children were in the thinness cate-gory (36.3%, n=197) and more urban students
were at risk of overweight (10.3%, n=10), yet not statisti-cally significant. Although there was no
statistically significant difference between the nutritional status and parental factors, a higher
proportion of thinness was observed when the mothers did not reside with the children and where
mothers‘ education was less than G.C.E. O/L
Conclusions:
Under-nutrition is a problem among grade eleven school children in the MOH area Kalutara. Almost
7% of them were at risk of overweight
χψ Abstracts of Non Communicable Diseases and prevalence of risk factors in Sri Lanka,

De Silva V. Samarasinghe D. Gunawardena N (2009). "Alcohol and tobacco use among males in
two districts in Sri Lanka." The Ceylon Medical Journal 54 (4).
Objective:
To investigate the prevalence and consumption of tobacco and alcohol among males in the Colombo
and Polonnaruwa districts
Study method:
A multistage cluster sampling was carried out in 4 Medical Officer of Health (MOH) areas in the
Colombo (urban) and Polonnaruwa (rural) districts to assess the prevalence of alcohol and tobacco
use in males over 18 years of age. Nugegoda and Moratuwa MOH areas located in the district of
Colombo are densely populated, suburban areas. Thamankaduwa and Elahara located in the district
of Polonnaruwa are rural agricultural areas in the north central part of Sri Lanka. Each MOH area has
a population of 80,000-90,000 and is divided into Public Health Midwife (PHM) areas for delivery of
community based healthcare services. Sixty five PHM areas were considered as primary clusters.
Roads within the primary clusters were considered as secondary clusters. All male occupants over 18
years of age in randomly selected houses were included in the study.
The data collection was carried out as part of a pre-intervention assessment in a programme to
reduce alcohol and tobacco use in selected MOH areas. The sample size was calculated to detect a
20% reduction in use. The study was conducted during May to August 2007. Information was
obtained using an interviewer administered questionnaire.
Alcohol consumption was quantified for each person using quantity-frequency estimation.
Consumption was recorded for the past 30 days through self report. The type of beverage
consumed, the average number of days per week alcohol was consumed and the average
consumption on each occasion was recorded for different beverage types. The reported
consumption was converted to units using average ethanol content of the different beverages. For
cigarettes, the brand and average consumption per day were recorded.
Study Area:
The study was conducted in 4 Medical Officer of Health (MOH) areas in the Colombo (urban) and
Polonnaruwa (rural) districts.
Study population:
All male occupants over 18 years of age in randomly selected houses were included in the study.
Study Instrument:
Interviewer administered questionnaire.
Study type:
A cross-sectional study
Sample size:
2684
Sampling method:
A multistage cluster sampling method
Alcohol
Results:
Study population
The study population consisted of 2684 males over 18 years. There were 1318 from the urban areas
and 1366 from the rural areas. There was no significant difference in mean age between urban and
rural males (p=0.41). Urban males had a significantly higher income (p<0.001). The ethnic
distribution (percentages) was Sinhalese 92.1, Tamils 2.7, Moor 4.5 and others 0.6. The percentage
distribution of the sample by religion was Buddhists 82.5, Christian 11.2, Muslim 4.5 and Hindu 1.8.
Distribution according to religion was significantly different between urban and rural groups
(p<0.001), but racial distribution was not (p=0.133).
χω Abstracts of Non Communicable Diseases and prevalence of risk factors in Sri Lanka,

Alcohol and tobacco use
Current drinkers were defined as those consuming one or more drinks during the past 30 days and
current smokers as those smoking one or more cigarettes during
the past 30 days. Those who did not consume alcohol during the past 12 months were classified as
abstainers.
There were significantly more abstainers in the rural areas (75.2%) than in urban areas (56.5%)
(p<0.001). Odds of current drinking was lowest among the Moor ethnic group (OR 0.40) and the
Muslim religious group (OR 0.43). The 45-54 year age group had the highest odds of being current
drinkers (OR 7.11) or current smokers (OR 4.84).
Overall, prevalence of current drinking was 27.8% and current smoking 27.6%.
The prevalence of current drinking in urban areas (32.9%) was significantly higher than in rural areas
(20.8%) (p<0.001). The prevalence of current smoking in urban areas (29.9%) was also higher than in
rural areas (24.4%) (p=0.052).
In both urban and rural areas the prevalence of alcohol use and smoking increased with age,
reaching a maximum in the 45-54 year category, and decreasing thereafter. In urban areas, the
prevalence of drinking and smoking were highest among the lowest income category (<Rs. 5000).
The mean consumption of alcohol in urban areas (33.1 units/week) was significantly higher than in
rural areas (20.9 units/week) (p=0.004). Mean number of cigarettes smoked in urban areas
(49.2/week) was higher than in rural areas (43.2/week) (p=0.21). From the age of 25 years tobacco
consumption increased with age and decreased after 65 years of age. There was no clear age related
pattern for amounts of alcohol consumed. The mean alcohol consumption in urban areas was
highest among the Rs. 8000-14999 income category and in rural areas was highest among the Rs.
15000-24999 income category.
Type of beverage used
When indicating the types of beverages used some men reported more than one type. The total
study population in the urban areas 16.9% drank beer, 26% drank arrack and 3.4% drank ‘kasippu’.
Of the rural population 5.1% drank beer, 16.1% drank arrack and 5.1% drank ‘kasippu’. The
consumption of imported beverages such as whisky, brandy, rum and gin was 3.3% in urban and
1.2% in rural areas.
High risk drinking
The rate of daily drinking of arrack or ‘kasippu’ was 51.6/1000 in urban and 14.6/1000 in rural areas.
14.8% (CI 12.5-17.3) of all urban males and 5.8% (CI 4.4-7.5) of all rural males consumed >14 units of
alcohol per week. Amongst alcohol users 27.7% of rural users (CI 22.0-34.3) and 44.9% of urban
users (CI 38.3-51.7) consumed >14units/week.
Dhanapala S (1994). Prevalence,Selected risk factors and Perception of hypertension in rural
community in the District of Matale. Postgraduate Institute of Medicine. Colombo, University of
Colombo. Master of Science in Community Medicine.
Main objective:
To study the prevalence, screening, knowledge, attitudes and practices and selected risk factors of
hypertension in an adult population of Matale District.
Specific objective:
1.To find out the extent of prevalence of hypertension in the adult Sinhala rural population in the
Divisional Secretary area of Matale.
2.To determine the extent to which the hypertensive persons were aware of their condition,
were under treatment and were controlling their blood pressures.
χϊ Abstracts of Non Communicable Diseases and prevalence of risk factors in Sri Lanka,

3.To assess the knowledge, attitudes and beliefs on hypertension.
4.To assess the prevalence and determine the association between some of the known risk
factors of hypertension
Study area:
Matale District
Study population:
All the Sinhalese population of ages 35 years or more from selected 5 Grama niladhari areas in the
Divisional Secretary area of Matale with all the pregnant mothers at the time were excluded
Type of study:
Descriptive cross sectional study
Study instrument:
-Structured questionnaires
-To measure the blood pressures –mercury blood pressure apparatuses
-Anthropometric data collection using the weight (bathroom weighing scales) and height(Stably
steel tapes)
Sampling method:
A multistage random sampling
Sample size:
Sample of 510 Sinhalese persons were selected out of which 97% participated
Males 193
Females 304
Total sample of 497
Elevated Blood pressure
Results:
The study population was categorized into normotensive, borderline hypertensive and hypertensive
persons according to their blood pressures.
Normal adult blood pressure is arbitrarily defined as systolic blood pressures (SBP) equal to or below
140 mmHg (18.7 kPa), together with a diastolic blood pressure (DBP)(fifth Korotkoff phase ) equal to
or below 90 mmHg (12.0 kPa).
Hypertension in adults is arbitrarily defined as systolic blood pressures (SBP) equal to or greater than
160 mmHg (21.3 kPa), together with a diastolic blood pressure (DBP) (fifth Korotkoff phase) equal to
or greater than 95 mmHg (12.7 kPa).
The term “borderline hypertension “ is used to denote the blood pressure values between the
normal and hypertensive ranges described above.
Distribution of Sample population by level of blood pressure is given below
Category Number Percentage
Definite hypertensive 86 17.3
Borderline hypertensive 94 18.9
Normotensive 317 63.8
Total 497 100.0
From the study population, based on sex, hypertension was higher among the male population
(19.7%) of persons aged >35 years compared to females (15.8%), out of which 23.8% were equal or
more than 50 years of age and 7.2% were between 35 to 49 years of age.
χϋ Abstracts of Non Communicable Diseases and prevalence of risk factors in Sri Lanka,

Abstracts of NCD & Prevalence of risk factors in Sri Lanka 1990 to 2012

Abstracts of NCD & Prevalence of risk factors in Sri Lanka 1990 to 2012

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