Introduction

The event to establish a network with member associations of Organization of Professional Associations (OPA) was held with the coordination of Independent Medical Practiones Association (IMPA) and with the sponsorship of Country Coordinating Mechanism Sri Lanka (CCMSL). This was the first event of such nature which was funded through the CCMSL.

The event was taken place from 6.00 pm to 8.00 pm on 28th November 2024 at the Auditorium of OPA. There were nearly 60 participants from member organizations of the OPA as well as from professional groups who are closely associated with IMPA such as Primary Care Respiratory Group (PCRG) and Primary Care Diabetic Group (PCDG). This network members will function as the advocates and communicators in increasing the knowledge, inculcating favorable attitudes and bringing the sound practices in prevention of HIV/AIDS, Tuberculosis and Malaria among the other members of those associations.

Objectives

Main Objective of this event was to establish a network with member associations of Organization of Professional Associations (OPA) for prevention of AIDS, Tuberculosis and Malaria. Specific Objectives of the event were to establish a network with representatives of member associations of OPA, to create awareness on HIV/AIDS, Tuberculosis and Malaria among the representatives of member associations of OPA and to obtain the services of those representatives as advocates and as communicators in creating awareness among the members of respective organizations.

Resource Persons and Moderator

The resource persons were Dr Vindya Kumarapeli Director/National STD/AIDS Prevention Programme, Dr Pramitha Shanthilatha Director/National Programme for Tuberculosis Control and Chest Diseases and Dr Pubudu Chulasiri Consultant Community Physician/Anti Malaria Campaign. Dr Kanthi Ariyarathne Executive Secretary/Oversight Officer CCMSL and one of the Joint Secretaries of IMPA functioned as the moderator.

Summary of the presentations made

Tuberculosis Prevention

Dr Pramitha Shanthilatha speaking about the disease sated that Tuberculosis is an infectious disease caused by the bacterium called Mycobacterium tuberculosis. She further stated that 75% of all TB cases are pulmonary TB affecting the lungs whereas 25% of all TB cases are Extra Pulmonary TB affecting any other organs except hair and nail. She showed the categories of persons who are at higher risk of developing TB as contacts of pulmonary TB patients, healthcare workers, undernourished/malnourished personnel, immunocompromised patients and those who are on immunosuppressive therapy, patients with chronic diseases such as Diabetes and Chronic Kidney Diseases, elderly and institutionalized persons and displaced persons. She highlighted the TB situation in the country presenting the case distribution by districts including the Rifampicin Resistance (RR)  and Multi Drug Resistance (MDR) cases.

She highlighted the exciting strategies for ending TB and appealed the different professionals to contribute in increase case findings, prevent emergence of new cases, promote early treatment seeking and manage TB / TB with co morbidities targeting reduction of TB incidence and TB deaths.

HIV/AIDS Prevention

Dr Vindya Kumarapeli presenting the current trend and status of HIV/AIDS, priority areas in prevention & control and role of different professional groups in strengthening these activities highlighted that they are working to achieve the goal of ending the AIDS epidemic in Sri Lanka by 2030 as a public health burden. She further explained the difference between HIV and AIDS as there were professionals other than the medical professionals at the meeting. Talking about the Epidemiology of HIV and AIDS in Sri Lanka she further said that Sri Lanka is still a low-risk country for the spread of HIV of which the prevalence is <0.1% in the general population whereas Adult HIV incident rate <0.01%.She highlighted the trends of HIV cases in 2020-2023 and stressed the point that men in the age group of 15 years or more are at the most risk ,  majority of females have got the HIV through  heterosexual transmission (97%) while majority of males have go the HIV through  male-male sex (62% )whereas mother to child transmission has been kept in  zero  since 2019.  

Highlighting the National Response in prevention on HIV she presented the 95-95-95 targets  by 2025 and strategies they implement in celaboration with government, non-government and international stakeholders such as Family Health Bureau, Health Promotion Bureau, Directorate of Mental Health, Epidemiology Unit, Private Health Sector, Education and Higher Education Sectors including Vocational Training Centres, National Youth Service Council , National Youth Corps, Tri-forces, Sri Lanka Police, Sri Lanka Bureau  of Foreign Employment , Tourist industry, Social Service Department, Child protection Authority and  National Dangerous Drug Control Board.One of the important point stated was that as Sri Lanka is a low prevalence country  (< 0.1%) , most of the prevention activities are targeted on Key Population groups. Finally, she highlighted the preventive strategies and the existence of a network of institutions which provide the free of charge services to the citizens of Sri Lanka all over the country and requested to advocate for using these facilities by anyone who need the services. 

Malaria Prevention

Dr Pubudu Chulasiri paused two questions to the audience before starting his presentation as food for thoughts. They were two questions worth answering by everyone.  “Are we at risk of a Malaria outbreak?” and “Why we are talking on Malaria”.

Then he presented three case scenarios of two patients who had travelled to Malaria endemic countries for gem trading and one patient traveled as seaman who had returned back to the country. The first person had travelled to Cameroon (Central Africa, had got the symptoms of on and off fever and headache after one month of retuning back got admitted to a private hospital and diagnosed as having Malaria parasite and got the treatment and got cured. Second patient was also a gem trader who had travelled to Guinea, developed fever, body aches and weakness on the same day of arrival, got admitted to a private hospital Intensive Care Unit and undergone on many expensive investigations initially and got transferred to major private hospital, got done all the possible investigations except Malaria parasite. Finally, Malaria parasite microscopy had been done but it was available at the time of death only, reporting as the first death due to Malaria after the year 2007. Third case scenario he presented was Merchant Seamon who had also travelled to Guinea who had developed backache and lethargy one month prior to arrival, first contact was a General Practioner (GP) in the area, and gone to a second GP got admitted to one of the base hospitals in the area, transferred to a government teaching hospital, Malaria parasite testing was done at that hospital only at the terminal stages and patient had died. All three patients no history of taking Chemo Prophylaxis. By all these case scenarios he stressed the point that the people are travelling to the Malaria Endemic countries without taking Chemo Prophylaxis and once they travelled back when they get the symptoms, they go for medical advice but medical professionals tend to forget about doing the very simple test of Microscopy of Malaria parasite which is the lifesaving test.

With that introduction he presented the success story reduction of Malaria cases which is the public health achievement of historical significance.

He further presented the Malaria burden from 2012 to date highlighting the risk of Malaria insurgence and strategies adopted to prevent Malaria.

The Malaria Prevention strategies include

• Early diagnosis and treatment of malaria as per the guidelines
• Diagnosis by Malaria Parasite identification in the blood -Three consecutive samples needed to exclude
• Immediate Notification Hotline 0712841767 
• Routine Notification
• Malaria Chemo- Prophylaxis – Chemoprophylaxis for travelers visiting malaria endemic countries
• Mosquito bites prevention
• Avoid blood donation until 3 years of return from a malaria endemic country
• Awareness of Health staff and General Public
• Screening of risk groups

Finally, Dr Chulasiri requested the audience to create awareness among their colleagues, family members and relatives about the importance of getting Malaria Chemo Prophylaxis if someone is travelling to a Malaria endemic country during the prescribed periods. He stressed the point that divulging the history of travelling to such country when confronted with any minor symptoms such as fever, headache and backache after retuning back is equally important as well as even reminding the Medical Practiones to order a Microscopy for Malaria. 

The three presentations were followed by a very interactive Questions and Answers session of which many doubts of the audience were cleared. At the end of the proceedings the Token of Appreciations were presented to the three Resources Personnel and to the Moderator.The event was concluded happily offering a dinner to everyone present.