Aim As the population ages, mental health issues among the elderly are becoming a major concern worldwide, including in Sri Lanka. With rapid globalization, the coping and adapting skills of elderly individuals are tested, potentially revealing predisposition to psychological disturbances. Previous studies have indicated a higher risk of depression among the elderly. The current study attempts to quantify the prevalence and associated factors of depression in a highly urbanized setting within Sri Lanka. Methods A community‐based, cross‐sectional analytical study was carried out in the urban areas of Colombo District. The subjects were young elders (60–74 years) who permanently reside in the area. Depression was assessed by the item Geriatric Depression Scale Sinhalese version (cut‐off score ≥8) among 1283 subjects. Logistic regression analysis was used to assess the association of depression with sociodemographic and health‐related variables. Results The prevalence of depression in the sample was 13.9% (mild depression: 11.2%; moderate to severe depression: 2.7%). Among the sociodemographic predictors, female sex (odds ratio (OR) = 10.60), being 60–64 years old (OR = 1.61), being unmarried, separated, divorced, or widowed (OR = 3.73), income ≤20 000 Sri Lankan rupees (OR = 2.27), and perceived financial burden (OR = 3.15) were significantly associated with clinically significant depression. Among the health‐related variables, smoking (OR = 2.18), alcohol use (OR = 7.58), presence of chronic disease (OR = 1.51), limitation in performing one or more instrumental activities of daily living (OR = 1.73), unsatisfactory partner relationship (OR = 2.94), perceived inadequate social support (OR = 2.47), experiencing abuse (OR = 3.90), and experiencing major life events (OR = 2.11) were significantly related with depression. Conclusion Depression is an important issue among the elderly living in an urbanized environment in Sri Lanka.

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Sri Lanka has faced two major catastrophes in recent history: the civil war (1983–2009) and the tsunami (2004). Furthermore, there is a continuously changing socioeconomic situation which is becoming ever more challenging. Nearly a quarter of the Sri Lankan population is a youth or adolescent, and this age group is particularly vulnerable to adversity. Over the past decade Sri Lanka has acknowledged the need to support these young people and embarked on developing adolescent mental health services, but they require further expansion. This article provides a critical review of the state of current adolescent mental health services in our country and makes suggestions for improvement.

Background: Identifying the prevailing intentions and practices related to fertility among females is important in promoting pre-pregnancy care service delivery to eligible families. Objective: To describe the fertility intentions regarding conception; awareness and current practices related to pregnancy preparedness; and factors associated with current fertility practices among fertile women in the district of Nuwara Eliya Methods: The current study was carried out as a community-based cross-sectional study among 476 cohabiting women in the reproductive age (15-44 years) living in the medical officer of health area, Ambagamuwa. Future and current pregnancy intentions were ascertained. Among the current intenders, their awareness and practices on pre-pregnancy fertility (rubella vaccination, folic acid use, adequate sexual exposure, nutritionally acceptable dietary habits) and factors associated with such practices were assessed. Those not intending a current pregnancy were assessed for family planning practices and associated factors. Results: Of the women, 300 (63.0%; 95% CI=58.5, 67.4) wanted a pregnancy. Current intention of child bearing was present among 142 (29.8%; 95% CI=25.8, 34.2) women. The awareness on rubella vaccine was observed to be higher (81.0%) compared to the awareness on healthy dietary habits during pre-pregnancy period (62.0%), on the use of folic acid (51.4%) and adequate level of sexual exposure for pregnancy (43.7%). The prevalence of related practices of vaccination with rubella (75.4%), pre-conceptional use of folic acid (12.7%), adequate sexual exposure for pregnancy (42.2%) and adherence to a healthy diet (21.8%) indicated a gap between awareness and practice. Certain socio-demographic factors were related to poor practices. Among those currently not intending to get pregnant, 264 (79.0%) were using a contraceptive method. Conclusions: The identified modifiable socio-demographic factors should be addressed in planning for improvement in pre-pregnancy care in the local setting.

Introduction: Apart from COVID-19, tuberculosis (TB) is the leading cause of death among infectious diseases globally and in Sri Lanka. It is known that the high-risk groups for developing TB are from lower socio-economic groups. Further, there is a close link between TB and nutrition. Objectives: To assess the prevalence and associated factors of undernutrition among TB patients in Sri Lanka Methods: A cross-sectional study was carried out using secondary data of a 2020 cohort of TB patients. Results: Out of 4566, the majority were males (65.2%). According to age groups, 55–64-year age group reported the highest proportion of patients (n=1018; 22.3%). According to the classification of body mass index (BMI), 46.3% were underweight. In bivariate analysis, gender (p=0.07), presence of comorbidities (p<0.001), site of TB (p<0.001), use of alcohol (p=0.01), site of TB (p<0.001), treatment category (p<0.001), smoking (p<0.001), alcohol use (p=0.04) and illicit drug use (p<0.001) were associated with patients being underweight. In multivariate analysis, only presence of comorbidities (p<0.001), site of TB (p<0.001), treatment category (p<0.001), smoking (p=0.04) and illicit drug use (p=0.02) were associated with patients being underweight. Conclusions & Recommendations: Creating awareness among clinicians and public health staff is important for them to be vigilant about TB patients with above associated factors. Proper nutritional counselling must be carried out for TB patients. Further, in implementing available nutritional interventions and patient awareness programmes, patients with lower BMI should be given priority although all TB patients are considered in need of nutritious diet.

Background Mental health is a neglected area within the healthcare systems in developing nations, including Sri Lanka. However, the rapid population aging and the resulting rise in psychological issues among the elderly are becoming major concerns within the country. Therefore, a proper assessment of distribution of mental healthcare facilities within the country is much needed in reducing the unmet need among people with psychological symptoms. In this study, the distribution of mental health services within the district of Colombo, which is the capital of the country, was assessed. Methods With this view, mapping of mental healthcare services within the district of Colombo was carried out using the Geographic Information System to assess service and human resource availability and physical accessibility to the elderly within the district. Results Certain deficiencies in availability and accessibility of the services were identified which were more significant toward eastern parts of the district. Conclusions Establishment of new mental healthcare facilities as well as upgrading of already available centres while ensuring availability of professional human resources to these centres is a timely need.