Locally aquired visceral leishmaniasis in Sri Lanka

Abeygunasekara, PH; Costa, Y Pallás; Seneviratne, N; Ratnatunga, Neelakanthi; Wijesundera, M. de S.

doi:10.4038/cmj.v52i1.1047

Cited by 45 publications

(42 citation statements)

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“…The Thalawa MOH area reported the second highest CL case incidence in 2010 and 2011 (Regional Epidemiology Unit, Anuradhapura District, unpublished data) and is the area of residence of the first VL and ML cases reported in the country. 13,15 The Thalawa MOH area is a semi-dry and has an annual average rainfall of 1,205 mm. The highest rainfall in this area is the northeast monsoonal rains, which last from December through February.…”

Section: Methodsmentioning

confidence: 99%

“…9 Two cases of indigenous VL and one case of mucosal leishmaniasis (ML) have been reported from the Anuradhapura District. [13][14][15] The first indigenous case of CL in Sri Lanka was reported in 1992 in the Hambantota District in Southern Province, and to date, more than 2,000 CL cases have been reported. 12,16 The parasite strain causing CL and VL in Sri Lanka was identified as Leishmania donovani MON-37 6,17 a strain known to cause VL in India and Kenya.…”

Section: Introductionmentioning

confidence: 99%

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Cross-Sectional Study to Assess Risk Factors for Leishmaniasis in an Endemic Region in Sri Lanka

Ranasinghe¹,

Wickremasinghe

Munasinghe³

et al. 2013

The American Society of Tropical Medicine and Hygiene

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Abstract. Sri Lanka reports significantly more cutaneous leishmaniasis (CL) cases than visceral leishmaniasis (VL) cases, both of which are caused by Leishmania donovani MON-37. A cross-sectional study conducted in an area with a high prevalence of CL prevalent included 954 participants of an estimated population of 61,674 to estimate the number of CL cases, ascertain whether there is a pool of asymptomatic VL cases, and identify risk factors for transmission. A total of 31 cases of CL were identified, of whom 21 were previously diagnosed and 10 were new cases. Using rK39 rapid diagnostic test to detect antibodies against Leishmania spp., we found that only one person was seropositive but did not have clinical symptoms of CL or VL, which indicated low transmission of VL in this area. χ 2 test, independent sample t-test, and multivariate analysis of sociodemographic and spatial distribution of environmental risk factors showed that living near paddy fields is associated with increased risk for transmission of CL (P 0.01).

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Section: Methodsmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Cross-Sectional Study to Assess Risk Factors for Leishmaniasis in an Endemic Region in Sri Lanka

Ranasinghe¹,

Wickremasinghe

Munasinghe³

et al. 2013

The American Society of Tropical Medicine and Hygiene

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“…A range of atypical manifestations have also been reported later on in some studies. 16,18 Increasing the complexity of this picture, MCL was first reported in 2005, 19 followed by the first report of VL two years later. 20 Soon after, a second case of MCL with lip, buccal mucosal and nasal septum lesions was reported from Northern Sri Lanka.…”

Section: What Is Known So Far?mentioning

confidence: 99%

Leishmaniasis in Sri Lanka: a decade old story

Siriwardana

Chandrawansa

Sirimanna

et al. 2012

Sri Lankan J Infec Dis

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Visceral leishmaniasis is a vector-borne protozoan disease targeted for elimination from the Indian subcontinent by year 2020. Sri Lanka is a new focus of human leishmaniasis caused by a genetically distinct variant of Leishmania donovani, which is the species more widely known to cause visceral leishmaniasis (VL). The clinical entity that is most frequent in Sri Lanka is cutaneous leishmaniasis (CL), though a few cases of muco-cutaneous (MCL) and VL have also been reported in the recent past. In CL, papules, nodules, ulcerating nodules and ulcers occur mainly as single lesions on exposed body areas of affected individuals. A wide age range is affected including both sexes. The potential for visceralization in the cutaneous variant of L. donovani in Sri Lanka is not known. There is no evidence for a serological response in CL patients who have demonstrated negative for rK 39 antibodies in sera, (rk39 test being the recommended test for VL detection), while MCL and VL cases have been rK39 positive.Phlebotomus argentipes, the vector of L. donovani in other parts of the world is a widely prevalent insect in almost all parts of Sri Lanka. Studies are underway for vector identification. L.donovani is transmitted between this vector and the human host, the only known host for this species. However, domestic dogs have shown the presence of Leishmania parasites and also the presence of anti -L. donovani antibodies in their sera, providing primary evidence for the likely presence of an animal reservoir in Sri Lanka. Field-based risk factor studies have shown that there is peri-domestic as well as zoonotic/outdoor transmission cycles in different parts of the country.At present patients are detected mainly passively based on self referrals. Only a proportion of these patients proceed for pre-treatment laboratory confirmation due to the lack of freely available investigation facilities. Leishmaniasis was made a notifiable disease in Sri Lanka in 2008. Action plan for its control was drawn up with primary involvement of the Ministry of Health and other stake holders in 2008. Preventive and control activities are required to be put in place sooner rather than later. Enhanced case detection and active treatment are of prime value in controlling L.donovani infections. Availability of cost effective and field friendly diagnostic services in a decentralized manner, timely case management and vector control using appropriate protocols are necessary. To achieve this, a considerable amount of information is already available, and further research is needed to fill in the essential gaps.

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“…[10][11][12] L. donovani, the usually visceralizing species, is known to cause CL in Sri Lanka. 13,14 More virulent clinical forms such as VL and MCL have also emerged, [15][16][17][18] calling for urgent preventive and control measures. Hence, disease control activities and scientific research leading towards such activities have been identified as priorities in the recently updated national action plan for leishmaniasis control in Sri Lanka.…”

Section: Introductionmentioning

confidence: 99%

Characterisation of cutaneous leishmaniasis in Matara district, southern Sri Lanka: evidence for case clustering

Kariyawasam

Edirisuriya

Senerath

et al. 2015

Pathogens and Global Health

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Leishmaniasis is a neglected tropical disease transmitted by Phlebotomus spp. sand flies. Cutaneous leishmaniasis (CL) in Sri Lanka is caused by Leishmania donovani. Transmission patterns are different in Southern and Northern Sri Lanka. Current study examined the prevalence, risk factors and distribution of CL in Matara District, Southern Sri Lanka. Total of 2260 individuals from four District Secretariat divisions (DSDs) were screened by house to house surveys using an interviewer administered questionnaire. The study population had an age range of 1-90 years (median 5 43 + 17.31), low monthly income (v20 000 LKR, 52.8%) and a male to female ratio of 1 : 2. Thirty eight patients were diagnosed by light microscopy, culture and/or PCR with a disease prevalence of 1.68%. Spatial mapping provided evidence for significant case clustering, which tended to be more prominent with proximity to forest areas. The risk factors identified were un-plastered brick walls, absence or low usage of protective measures against insect bites, low income and excessive time (w4 hours/day) spent outdoors. However, exposure of limbs while outdoors, unawareness about the disease, type of occupation, common water source as the mode of water supply and presence of animal shelters within 200 m were not associated with the risk of acquiring the disease. Peri-domestic transmission is likely to contribute to the observed case clustering with all age groups at risk of acquiring the infection. Human behavioural habits coinciding with that of the vector, sand fly are likely to enable host-vector contact promoting its spread. Appropriate vector control measures, improvement of housing conditions, public education regarding preventive measures are required to contain the spread of disease.

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Locally aquired visceral leishmaniasis in Sri Lanka

Cited by 45 publications

References 0 publications

Cross-Sectional Study to Assess Risk Factors for Leishmaniasis in an Endemic Region in Sri Lanka

Cross-Sectional Study to Assess Risk Factors for Leishmaniasis in an Endemic Region in Sri Lanka

Leishmaniasis in Sri Lanka: a decade old story

Characterisation of cutaneous leishmaniasis in Matara district, southern Sri Lanka: evidence for case clustering

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