Potential Challenges of Controlling Leishmaniasis in Sri Lanka at a Disease Outbreak

Abstract

The present works reviewed the existing information on leishmaniasis in Sri Lanka and in other countries, focusing on challenges of controlling leishmaniasis in the country, in an outbreak. Evidence from recent studies suggests that there is a possibility of a leishmaniasis outbreak in Sri Lanka in the near future. Difficulty of early diagnosis due to lack of awareness and unavailability or inadequacy of sensitive tests are two of the main challenges for effective case management. Furthermore, the absence of a proper drug for treatment and lack of knowledge about vector biology, distribution, taxonomy and bionomics, and reservoir hosts make the problem serious. The evident potential for visceralization in the cutaneous variant of L. donovani in Sri Lanka may also complicate the issue. Lack of knowledge among local communities also reduces the effectiveness of vector and reservoir host control programs. Immediate actions need to be taken in order to increase scientific knowledge about the disease and a higher effectiveness of the patient management and control programs must be achieved through increased awareness about the disease among general public and active participation of local community in control activities.

The Economic Impact of Cutaneous Leishmaniasis in Sri Lanka

“…Of these forms, the VL is considered to be the most virulent disease orientation. In Sri Lanka, CL is the predominant form of disease [ 6 ]. More than 2,000 cases have been identified from 2000 to 2009 [ 7 ].…”

Leishmaniasis in Sri Lanka: The need for effective targeting of island-specific issues through strategic implementation of global management plans for disease detection and control

“…17 In relation to housing, mud or thatched walls, damp earthen floors and peridomestic vegetation each act to promote vector resting and breeding sites. 18 Longterm changes in meteorological conditions, notably global warming, have facilitated the incremental northward expansion of mosquito-borne tropical diseases such as dengue and malaria from more equatorial latitudes. 19 Environmental conditions including altitude, precipitation and humidity also influence the abundance of sandflies, 3 and there is justified concern that the distribution of phlebotomine vectors of Leishmania transmission may increase with climate change.…”

“…38 Nevertheless, the exact number of species that are capable of transmitting leishmaniasis in Sri Lanka is still not known, while the possibility of disease transmission by other potential vectors such as biting midges is yet to be established. 18 In a detailed nationwide entomological trapping study, the highest number of sandflies collected was from the south-west coastal area of Kathaluwa, located in the Galle District. 39 This is part of the Southern Province, which experiences a hot and humid tropical rainforest climate.…”

“…However, a clear picture of the population dynamics is not yet established due to a lack of survey data from the whole island. 18 On the other hand, the development of insecticide resistance in sandflies, predominantly to DDT and occasionally to Malathion and Pyrethroids, 40 will be associated directly with the epidemiology of leishmaniasis. Therefore, implementation of national vector control measures for malaria could explain the increasing rate of leishmaniasis over the last two decades.…”

Establishment of a Colony of Phlebotomus argentipes under Laboratory Conditions and Morphometric Variation between Wild-Caught and Laboratory-Reared Populations

“…Although a total of 20 species have been recorded in Sri Lanka, the only confirmed vector for disease transmission is Phlebotomus argentipes, which has been reported from almost all the endemic regions for the disease [3][4][5][6][7][8][9]. Many studies have reported that this species is the main vector for visceral leishmaniasis (VL) caused by Leishmania donovani in Indian subcontinent [10][11][12].…”