Body image perception and body dissatisfaction among rural Sri Lankan adolescents; do they have a better understanding about their weight?

Introduction: Adolescents have high vulnerability for body image distortions which may result in many psychological and physical problems. Objectives: This study aimed to determine body image perception and dissatisfaction among rural schooling adolescents in Sri Lanka. Methods: Adolescents (aged 13-16 years) were selected using probability-based sampling framework. Self-administered figure rating scale was used to assess perceived current (PCBS) and ideal (IBS) body size and body discrepancy score (BDS = PCBS ­ IBS). Pubertal stage was assessed with pubertal development scale. Anthropometry was done according to WHO guidelines. Results: Of 3128 students studied, 47.8% were boys. Median PCBS was 4 (inter quartile range 1) for boys and 4 (2) for girls. Boys aspire a larger body size compared to girls and the respective median IBS were 5 (0) and 4 (1). More boys (70.4%, n = 1053) than girls (66.4%, n = 1084) were dissatisfied about their current body size; χ2 = 5.5, df = 1, p < 0.05. Overweight students recorded higher PCBS and were more dissatisfied with their body size when compared to others. Nearly half of boys and 29.6% girls wanted to have a larger body size than their current. The main influencing factor of body dissatisfaction was body mass index. Conclusions: Body dissatisfaction is evident even among rural adolescents, affecting boys more than girls. Many students show a desire to have a larger body size than their current. This study also provides valid and reliable tools to assess body dissatisfaction and pubertal development in Sinhala speaking adolescents.

Evaluation of surveillance case definition in the diagnosis of leptospirosis, using the Microscopic Agglutination Test: a validation study.

BACKGROUND: Leptospirosis is endemic in both urban and rural areas of Sri Lanka and there had been many out breaks in the recent past. This study was aimed at validating the leptospirosis surveillance case definition, using the Microscopic Agglutination Test (MAT). METHODS: The study population consisted of patients with undiagnosed acute febrile illness who were admitted to the medical wards of the Teaching Hospital Kandy, from 1st July 2007 to 31st July 2008. The subjects were screened to diagnose leptospirosis according to the leptospirosis case definition. MAT was performed on blood samples taken from each patient on the 7th day of fever. Leptospirosis case definition was evaluated in regard to sensitivity, specificity and predictive values, using a MAT titre >or= 1:800 for confirming leptospirosis. RESULTS: A total of 123 patients were initially recruited of which 73 had clinical features compatible with the surveillance case definition. Out of the 73 only 57 had a positive MAT result (true positives) leaving 16 as false positives. Out of the 50 who didn't have clinical features compatible with the case definition 45 had a negative MAT as well (true negatives), therefore 5 were false negatives. Total number of MAT positives was 62 out of 123. According to these results the test sensitivity was 91.94%, specificity 73.77%, positive predictive value and negative predictive values were 78.08% and 90% respectively. Diagnostic accuracy of the test was 82.93%. CONCLUSION: This study confirms that the surveillance case definition has a very high sensitivity and negative predictive value with an average specificity in diagnosing leptospirosis, based on a MAT titre of >or= 1: 800.