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Objectives To determine aetiology of illness among children and adults presenting during outbreak of severe respiratory illness in Southern Province, Sri Lanka, in 2018.Design Prospective, cross-sectional study.Setting 1600-bed, public, tertiary care hospital in Southern Province, Sri Lanka.Participants 410 consecutive patients, including 371 children and 39 adults, who were admitted with suspected viral pneumonia (passive surveillance) or who met case definition for acute respiratory illness (active surveillance) in May to June 2018.Results We found that cocirculation of influenza A (22.6% of cases), respiratory syncytial virus (27.8%) and adenovirus (AdV) (30.7%; type B3) was responsible for the outbreak. Mortality was noted in 4.5% of paediatric cases identified during active surveillance. Virus type and viral coinfection were not significantly associated with mortality.Conclusions This is the first report of intense cocirculation of multiple respiratory viruses as a cause of an outbreak of severe acute respiratory illness in Sri Lanka, and the first time that AdV has been documented as a cause of a respiratory outbreak in the country. Our results emphasise the need for continued vigilance in surveying for known and emerging respiratory viruses in the tropics.

Abstract Background Birth defects (BD) are considered a leading cause of childhood morbidity and mortality. Personal, cultural, and health care system barriers may increase the incidence of BD in low and middle income countries. In this study we assessed the knowledge of antenatal mothers on BD, associated factors, and prevention and management. Methods Three hundred and fifty (350) antenatal mothers were surveyed using a pretested, self-administered questionnaire. The knowledge on BD was evaluated under 3 categories; knowledge on BD, knowledge on associated factors, and knowledge on prevention and management. The total scores were calculated for each category and converted into percentages. A higher percentage score indicates a high level of knowledge. Descriptive statistics and regression models were used for data analysis. Level of significance was considered as p

Introduction: Congenital hypothyroidism is one of common disorders related to mental impairment and growth retardation in newborns. Hence, screening programs are performed for early diagnosis as most infants are with no clinical signs for recognition at birth. Objective: To evaluate key performance indicators of the congenital hypothyroidism screening programme in terms of coverage, effectiveness of detection and managing cases during the year 2016. Methods: The Newborn Screening Information System Database of the Faculty of Medicine, University of Ruhuna, Galle (www.nsisd.ruh.ac.lk) was retrospectively analyzed to assess performance indicators. . . . Results: In 2016, 126,341 samples were received, and 101 babies were confirmed as having congenital hypothyroidism with an annual incidence of 1 in 1250 live births. The coverage rate of 76% of births and sample rejection rate was < 0.01% The sample collection ages ranged from 6 hours to 49 days with median age of screening sampling was Conclusion: It has shown a good uptake of newborn screening with coverage of over 95% in areas for more than a year and overall 76% within months of inception. The laboratory and clinical services need to be improved to ensure that results are available and reviewed within the stipulated time frame. Liaison with the state public health department is important to promote community awareness and trace cases that required retesting. Periodic audits of the system are a necessity to identify any deficiency and improving the overall quality of the programme.

Introduction Galactosemia is a rare autosomal recessive metabolic disorder with the prevalence of 1;60000. Classical Galactosemia (CG) is the most common variant of Galactosemia and which is due to deficiency of Galactose-1-phosphate uridyltransferace enzyme. Fanconi Syndrome (FS) is a rare presentation of CG. Here we present a baby girl with CG presenting with FS. Case Report A 5-month old baby girl presents with recurrent non bilious vomiting since early neonatal period. She was the first baby born to second degree consanguineous parents. The baby was exclusively breast fed since birth and there was a history of feeding intolerance. Her weight gain was suboptimal. On admission, she looks ill, tachypneic and dehydrated and her anthropometric parameters were

Homocystinuria is an autosomal recessive disorder with the prevalence of 1;200000. It is due to the defect in the Methionine metabolism which results in accumulation of Homocysteine in the body. We report a series of patients with Homocystinuria followed up at university paediatric clinic Teaching Hospital Karapitiya. There were four children with Homocystinuria from 7 to 18 years, of them, 2 were males. None of them were born to consanguineous parents and two were siblings. The age at diagnosis ranged between 6 to 17 years. All children had delayed cognitive development with the IQ level between 40-77. The condition was suspected with the onset of opthalmic manifestations such as Ectopia lentis glaucoma and ptosis. Marfanoid body habitus (tall stature, high arch palate and arachnodactyly) and scoliosis were present in all four children. Three children had low bone mineral density and 2 of them had fractures. None of them had thromboembolic events. Serum Homocysteine and Methionine levels were high, ranged 145-373μmol/L (4.6-8.1) and 79-177 μmol/L (6-60) respectively. All had normal vitamin B12 levels between 150.0 and 216.0 pmol/L (140-650). It is well known that early detection and initiation of treatment would prevent most of the complications in Homocystinuria. However, in this case series, all children were diagnosed later. Therefore, it is important to suspect the condition in children with intellectual impairment, visual defects and marfanoid body habitus.