Dermotropic<i>Leishmania donovani</i>in Sri Lanka: visceralizing potential in clinical and preclinical studies

Kariyawasam, Udeshika; Selvapandiyan, Angamuthu; Siriwardana, H. V. Y. D.; Dube, Anuradha; Karunanayake, Panduka; Senanayake, Sanath; Dey, Ranadhir; Gannavaram, Sreenivas; Nakhasi, Hira L.; Karunaweera, Nadira D.

doi:10.1017/s003118201700169x

Cited by 28 publications

(28 citation statements)

References 54 publications

(73 reference statements)

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“…Clustering of cases within the MOH area with multiple cases occurring within the same household is in support of established transmission within the locality with the possibility of peri-domestic or domestic transmission as reported in the Southern province [32].…”

Section: Discussionsupporting

confidence: 60%

Epidemiology of cutaneous leishmaniasis in a newly emerging focus in Gampaha district, Western province of Sri Lanka

Mallawarachchi

Chandrasena²,

Wijerathna

et al. 2020

Preprint

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Background Cutaneous leishmaniasis (CL) appears to be spreading to previously non-endemic regions of Sri Lanka. The aim of this study was to describe a newly emerging focus of CL in the district of Gampaha, in Western Sri Lanka. Methods A case based descriptive study was carried out from January 2018 to April 2019 in the Mirigama Medical Officer of Health (MOH) area, which reported the highest number of CL cases in Gampaha District. Laboratory confirmed cases were traced and socio-demographic and clinical data were collected via a validated questionnaire and clinic records respectively. The quality of life (QOL) of study participants was measured using the Dermatology Life Quality Index (DLQI). Global Positioning System (GPS) coordinates of patient residences were recorded using handheld GPS receivers. Sand-flies were collected from four selected sites, using Indoor Hand Collection (IHC) (162 units) and Cattle Baited Net Traps (CBNT) (n=3) and a battery-operated aspirator. Results Of 73 patients identified in this study, 58.9% were males, with a mean age of 43.6 years (SD 20.1). The lesions included nodules (52.05%) and ulcers (47.9%). Single lesions were seen in 69.86%, while 30.1% had multiple. Except for one mucosal lesion, all others were on skin. Treatment varied from sodium stibogluconate (SSG) + cryotherapy (46.57%), SSG (45.2%) and cryotherapy (8.2%). Patients with multiple lesions were more likely to be treated with combined SSG + cryotherapy (p< 0.05). The mean DLQI score was 8.14 (SD=7). Most patients engaged in outdoor activities that exposed them to the risk of sand-fly bites Workplaces of 81.1% (27/33) were located within the district. Housing conditions of study participants were of moderate (59%), good (35.6%) and poor (5%) quality. Four households reported multiple cases. Spatial distribution of cases indicated notable clustering in seven adjacently located Public Health Inspector (PHI) areas. Phlebotomus argentipes was detected in all CBNTs and 35.28% of IHC units surveyed. Conclusions CL is emerging in Gamapha district with Mirigama MOH area being the epicentre of infection. The disease had a moderately negative impact on QOL of patients. Minimal migration of cases, clustering of cases within households and in the locality indicates local transmission with P. argentipes as the probable vector.

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Section: Discussionsupporting

confidence: 60%

Epidemiology of cutaneous leishmaniasis in a newly emerging focus in Gampaha district, Western province of Sri Lanka

Mallawarachchi

Chandrasena²,

Wijerathna

et al. 2020

Preprint

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“…However, the majority of our study population had minimal travel to areas outside the district. Clustering of cases within the MOH area with multiple cases occurring within the same household is in support of established transmission within the locality with the possibility of peri-domestic or domestic transmission as reported in the Southern province[32].…”

supporting

confidence: 60%

Epidemiology of cutaneous leishmaniasis in a newly emerging focus in Gampaha district, Western province of Sri Lanka

Mallawarachchi¹,

Chandrasena²,

Wijerathna³

et al. 2020

Preprint

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Background: Cutaneous leishmaniasis (CL) appears to be spreading to previously non-endemic regions of Sri Lanka. The aim of this study was to describe a newly emerging focus of CL in the district of Gampaha, in Western Sri Lanka. Methods: A case based descriptive study was carried out from January 2018 to April 2019 in the Mirigama Medical Officer of Health (MOH) area, which reported the highest number of CL cases in Gampaha District. Laboratory confirmed cases were traced and socio-demographic and clinical data were collected via a validated questionnaire and clinic records respectively. The quality of life (QOL) of study participants was measured using the Dermatology Life Quality Index (DLQI). Global Positioning System (GPS) coordinates of patient residences were recorded using handheld GPS receivers. Sand-flies were collected from four selected sites, using Indoor Hand Collection (IHC) (162 units) and Cattle Baited Net Traps (CBNT) (n = 3) and a battery-operated aspirator. Results: Of 73 patients identified in this study, 58.9% were males, with a mean age of 43.6 years (SD 20.1). The lesions included nodules (52.05%) and ulcers (47.9%). Single lesions were seen in 69.86%, while 30.1% had multiple. Except for one mucosal lesion, all others were on skin. Treatment varied from sodium stibogluconate (SSG) + cryotherapy (46.57%), SSG (45.2%) and cryotherapy (8.2%). Patients with multiple lesions were more likely to be treated with combined SSG + cryotherapy (p < 0.05). The mean DLQI score was 8.14 (SD = 7). Most patients engaged in outdoor activities that exposed them to the risk of sand-fly bites Workplaces of 81.1% (27/33) were located within the district. Housing conditions of study participants were of moderate (59%), good (35.6%) and poor (5%) quality. Four households reported multiple cases. Spatial distribution of cases indicated notable clustering in seven adjacently located Public Health Inspector (PHI) areas. Phlebotomus argentipes was detected in all CBNTs and 35.28% of IHC units surveyed. Conclusions: CL is emerging in Gamapha district with Mirigama MOH area being the epicentre of infection. The disease had a moderately negative impact on QOL of patients. Minimal migration of cases, clustering of cases within households and in the locality indicates local transmission with P. argentipes as the probable vector.

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“…The potential for visceralization in the cutaneous variant of L. donovani in Sri Lanka is not known until recently [ 9 ]. However, some recent studies have indicated that there is no visceralizing potential in L. donovani strain found from Sri Lanka [ 10 ].…”

Section: Introductionmentioning

confidence: 99%

The Economic Impact of Cutaneous Leishmaniasis in Sri Lanka

Wijerathna

Gunathilaka

Gunawardena

2018

BioMed Research International

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Cutaneous leishmaniasis (CL) is a neglected tropical disease which affects mainly the poorest communities in developing countries. Considering the limited published information on economic impact of CL in Sri Lanka, the current study was conducted with the objective of revealing the nature and magnitude of the economic impact of CL in three selected disease endemic regions in Kurunegala District, Sri Lanka. The patient records of CL notified of relevant Medical Officer of Health (MOH) office during 2013- 2016 were obtained. Patient households were visited and data collection was done using an interviewed administered questionnaire. The majority of patients (57%) were economically active at the time of infection. Of them, 65% were the only contributors to household economy. Total median costs including both direct and indirect costs were 66.85 USD (Rs. 10,831) (IQR = 57.26 - 86.78 USD), while total median economic loss to households was 61.27 USD (Rs. 9,927) (IQR= 49.61- 75.04 USD). From provider perspective, total median cost per patient was 22.83 USD (Rs. 3,696). The mean total economic loss was denoted as 65.26 USD (Rs. 10,572) which is about 5.4% of the annual household income and 20.9% of the mean annual per capita income of the study population. Although economic impact of CL infection is not catastrophic according to current interpretation, the infection may have significant economic impacts on households when considering the mean economic loss to household as a percentage of the mean annual per capita income of the population.

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DermotropicLeishmania donovaniin Sri Lanka: visceralizing potential in clinical and preclinical studies

Cited by 28 publications

References 54 publications

Epidemiology of cutaneous leishmaniasis in a newly emerging focus in Gampaha district, Western province of Sri Lanka

Epidemiology of cutaneous leishmaniasis in a newly emerging focus in Gampaha district, Western province of Sri Lanka

Epidemiology of cutaneous leishmaniasis in a newly emerging focus in Gampaha district, Western province of Sri Lanka

The Economic Impact of Cutaneous Leishmaniasis in Sri Lanka

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