Knowledge, behaviour and attitudes on induced abortion and family planning among Sri Lankan women seeking termination of pregnancy.

INTRODUCTION: In Sri Lanka over 500 induced abortions are done daily in spite of restrictive legislation. Experiences in other countries show that liberal laws alone have not solved the issues of induced abortions which may harm a woman's physical and mental health. OBJECTIVE: To determine the socio-demographic features of women seeking termination of pregnancy, and their knowledge, attitude and behaviour with respect to induced abortion and family planning. METHODS: A prospective study on a randomly selected group of 210 women attending a clinic in Colombo requesting termination of pregnancy. A pre-tested interviewer-administered questionnaire was used for data collection. RESULTS: Over 80% of women seeking abortion were between 20 and 40 years of age. All religions were represented. 13% were single and 10% wanted to postpone a pregnancy. 38.6% had three or more children. In 90% the period of gestation was less than 10 weeks. Presence of a young child was the commonest reason for termination, followed by poverty. Only 0.9% were due to incest and foetal abnormality. 96% were not aware of adverse effects of abortion. 91% thought that induced abortion was immoral and 94% did not know that it was illegal. 29% had previous terminations and post-abortion contraception counselling was poor. Although 78% were knowledgeable on at least one method of contraception, only 16.3% were using it regularly. DISCUSSION: A majority used induced abortion as a family planning method. Improving accessibility and the quality of family planning services is of paramount importance. Every encounter of a woman with a health care worker should be an opportunity for counselling.

Varicella-zoster virus infection in the Infectious Diseases Hospital, Sri Lanka.

OBJECTIVES: To determine the morbidity and mortality patterns of varicella and risk factors affecting its outcome, and the facilities available at the Infectious Diseases Hospital (IDH), Sri Lanka. METHODS: A retrospective study on all patients admitted with varicella-zoster virus (VZV) infection to the IDH from August 2000 to July 2001. Data were collected from the hospital records. RESULTS: Among the 1690 patients admitted during the study period, 1090 (64.9%) were due to VZV infection. Nine hundred and eighty nine (90.7%) had varicella and 101 (9.3%) herpes zoster. Common complications were secondary bacterial infection (62.1%), neurological complications (3.4%), pneumonia (9.1%) and carditis (1.01%). They were significantly commoner in patients with coexisting diseases. Hospital stay was significantly shorter in patients who received early aciclovir, which was not available on a regular basis. Forty one patients died and mortality was highest in the elderly. The commonest cause of death was pneumonia. CONCLUSIONS: Varicella related complications are high in patients with coexisting diseases. Mortality rates are higher than reported elsewhere. Health care facilities available at IDH are quite inadequate, and should be improved.

Seroconversion after hepatitis B vaccination in healthy young adults, and the effect of a booster dose.

OBJECTIVE: Previous studies have shown that 5% to 15% of healthy people do not show a protective antibody response following hepatitis B vaccination. The study was done to determine the protective efficacy of vaccination in healthy young adults 1 to 4 years after the three dose vaccination series and to study the effect of a booster dose on non-responders and hypo-responders. DESIGN: Prospective intervention study. SETTING: From January to June 2000, Faculty of Medicine, University of Colombo. STUDY GROUP: 258 volunteers from five batches of medical students vaccinated with three doses of the recombinant vaccine at 0, 1 and 6 months. RESULTS: 9.5% were non-responders. Duration of vaccination, sex and body mass index were not significantly associated with anti-HBs levels. 28.6% had potential risk factors for acquiring HBV infection. 86.3% of non-responders developed protective anti-HBs titres after a booster dose. The persistent non-responders did not have a chronic illness or past HBV infection. CONCLUSIONS: A substantial number do not seroconvert after hepatitis B vaccination. Testing of blood for anti-HBs one month after vaccination is recommended to recognise non-responders as a booster dose will be beneficial in the majority of them.