Sri Lanka currently faces a ‘double burden’ of non‐communicable and communicable diseases. Public institutions geared primarily to care for communicable diseases struggled to meet demand for quality care in non‐communicable diseases. The World Health Organization has developed tools for implementing appropriate health care for long‐term problems.We piloted interventions in self‐management support, delivery system design, decision support and clinical information systems at sites in urban and rural Sri Lanka. This undertaking confirmed that interventions through adaptation of Sri Lanka's primary care infrastructure and establishment of innovative partnerships enable the effective implementation of care with existing resources in the short term. We demonstrated that media can be used as a powerful forum for educating the public, promoting new attitudes, providing skills for improving health status and influencing both planners and health care professionals. We also demonstrated that training and education of health care workers and research collaborations can influence policy makers. The collaboration to date has established a model for international collaboration providing both educational and technical support towards capacity building within the country. Collaborations with developing countries will enable the prevention and control of chronic disease in the developing world in keeping with the United Nations resolution regarding diabetes. Copyright © 2009 John Wiley & Sons, Ltd.
SUMMARYReaching entire populations with information relevant to the prevention of diabetes and its complications is a challenge wherever it is faced. However, given the complex issues of literacy, multi-ethnic communities, language differences and cultural variations, these problems are compounded in developing nations. In this article we describe a campaign co-funded by the World Diabetes Foundation, the Endocrine and Metabolic Diseases Trust of Sri Lanka, and the charitable Sri Lanka Education Fund held in Trust at Sherwood Forest Hospitals NHS Trust. This campaign has sought to reach a large part of the population of Sri Lanka with education intended to reduce the present explosion of diabetes and its complications in this developing nation.
Even though incidence of Hepatitis B is extremely low, it is recommended to continue hepatitis B vaccination which is currently included in the national immunization program. Screening for HCC in Sri Lankaa. Screening for HCC in cirrhotics i. Six-monthly ultrasound scanning is recommended in screening cirrhotic patients.Ÿ It is recommended to use a specially prepared request form within institutions indicating a clear clinical history.b. Screening of high risk NASH groups.i.Diabetics who are older than 40 years with elevated AST/ALT may be subjected to ultrasound scan screening.Ÿ Frequency of screening is to be decided by the clinician as firm data is not yet available. c. Hepatitis screening in Sri Lankan patients.Ÿ Considering the extremely low incidence, screening for hepatitis B and C is likely to yield negative results. Nonavailability or delay in these reports should not delay the management of HCC. d.Place of alpha feto protein (AFP)Ÿ Alpha feto protein has limited value in screening for HCC. Ÿ Alpha feto protein is useful as an adjunct for imaging. Ÿ Alpha feto protein is an important test in prognostication of HCC. Diagnosis of HCC a. Cirrhotic patients
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