An investigation of a new cutaneous leishmaniasis endemic area in Western Sri Lanka

• Published in: Transactions of the Royal Society of Tropical Medicine and Hygiene 2021-11, Vol.115 (11), p.1288-1297
• Main Authors: Mallawarachchi, Chandana H, Chandrasena, Nilmini, Wijerathna, Tharaka, Dalpadado, Rasika, Mallawarachchi, Maleesha S M N S, Gunarathna, Dinesh G A M, Gunathilaka, Nayana
• Format: Article
• Language: English
• Subjects: Animals; Cattle; Disease Vectors; Humans; Leishmaniasis, Cutaneous - epidemiology; Leishmaniasis, Cutaneous - therapy; Male; Phlebotomus; Psychodidae; Sri Lanka - epidemiology
• ISSN: 0035-9203; 1878-3503
• DOI: 10.1093/trstmh/trab141

Abstract Background The aim was to investigate an emerging focus of cutaneous leishmaniasis (CL) in Gampaha district, Western Sri Lanka. Methods Sociodemographics of CL patients in Mirigama, Gampaha district, were compared with controls using a structured questionnaire. Clinical data and geographic positioning system coordinates of patients were recorded. Sandflies collections were performed in four selected sites using indoor hand collection (162 units) and cattle-baited net traps (n=3). Results Of 73 patients (mean age 43.6 y; SD 20), 58.9% were males. Lesions consisted of nodules (52.1%) and ulcers (47.9%). Single lesions were seen in 69.9% of patients, while 30.1% had multiple lesions. Except for one mucosal lesion, all the others were cutaneous. Treatment consisted of sodium stibogluconate and cryotherapy (46.6%), sodium stibogluconate (45.2%) or cryotherapy (8.2%). Multiple lesions were more likely to receive combination therapy (p=0.013). The majority of those employed (81.1%; 27/33) were engaged in outdoor work. Male gender, low education attainment and poor disease awareness were significant risk factors for CL (p