Situation of Sri Lanka, where autochthonous malaria is no longer a problem, and other infections dominate, such as dengue, leptospirosis and rickettsioses

Agampodi, Suneth; Wijerathne, Buddhika; Weerakoon, Kosala

doi:10.1097/qco.0000000000000303

Cited by 2 publications

(3 citation statements)

References 50 publications

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“…Therefore, CKDu in Sri Lanka is suspected to be preceded by an acute episode of tubulointerstitial nephritis indicating infection of a particular cause [38]. For the past decades in Sri Lanka, reduction of malaria was associated with concurrent increase of several tropical diseases including dengue, leptospirosis, and rickettsioses [39]. In 2008, a leptospirosis outbreak occurred near the dry zone, and in 2011, another outbreak of leptospirosis came to attention in the relatively dry district of Anuradhapura [14].…”

Section: Sri Lankamentioning

confidence: 99%

Leptospirosis Renal Disease: Emerging Culprit of Chronic Kidney Disease Unknown Etiology

Yang¹

2017

Nephron

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Leptospirosis is the most prevalent zoonosis affecting more than 1 million populations worldwide. Interestingly, leptospirosis endemic regions coincide with chronic kidney disease (CKD) hotspots largely due to flooding and agricultural overlaps. Acute leptospirosis induces multiple organ dysfunction including acute kidney injury and may predispose to CKD and end-stage renal disease, if not treated timely. Asymptomatic infection may carry the bacteria in the kidney and CKD progresses insidiously. Histologic finding of leptospirosis renal disease includes tubulointerstitial nephritis, interstitial fibrosis, and tubular atrophy. Proximal tubule dysfunction and hypokalemia are observed in adult male workers with leptospirosis, a characteristic similarity to CKD unknown etiology (CKDu). CKDu is a form of CKD that is not attributable to traditional risk factors clustering in agricultural communities affecting young male farmers. Kidney pathology shows a chronic tubulointerstitial disease. CKDu is being reported as an endemic nephropathy across the globe. Recent surveys suggest that asymptomatic leptospira renal colonization is an overlooked risk for renal fibrosis and CKDu. Population with anti-leptospira seropositivity is associated with lower estimated glomerular filtration rate in endemic regions and carrier may progress to CKD. Leptospirosis has been considered as a risk factor for CKDu in Sri Lanka and in Mesoamerican area. Sugarcane workers in Nicaragua showed increased anti-leptospira seropositivity and higher urinary biomarkers for kidney injury. Emerging evidence with signs of infection were reported in these endemic population, indicating that leptospira exposure could play a role in CKDu as a cause of primary kidney disease or a susceptible factor when secondary injury such as heat stress or dehydration aggravates kidney disease. Therefore, leptospirosis as an emerging culprit of CKDu deserves further in-depth investigation.

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Section: Sri Lankamentioning

confidence: 99%

Leptospirosis Renal Disease: Emerging Culprit of Chronic Kidney Disease Unknown Etiology

Yang¹

2017

Nephron

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“…However, in 2012, Sri Lanka reported a zero incidence of autochthonous malaria and received WHO certification of its malaria-free status in 2016. 2,3 This situation shifted the predominance of vector-borne and zoonotic diseases of concern within the country, resulting in additional attention to the diagnosis of dengue, leptospirosis, and rickettsioses. 2 The recognition of scrub typhus, caused by Orientia tsutsugamushi and transmitted by Leptotrombidium mites, in Sri Lanka dates to World War II; it is known to occur in both the hill country and lowlands.…”

Section: Introductionmentioning

confidence: 99%

“…2,3 This situation shifted the predominance of vector-borne and zoonotic diseases of concern within the country, resulting in additional attention to the diagnosis of dengue, leptospirosis, and rickettsioses. 2 The recognition of scrub typhus, caused by Orientia tsutsugamushi and transmitted by Leptotrombidium mites, in Sri Lanka dates to World War II; it is known to occur in both the hill country and lowlands. 4,5 More recently, the frequent occurrence of spotted fever rickettsioses has been demonstrated serologically in both ecozones in Sri Lanka, but particularly in the central hill country.…”

Section: Introductionmentioning

confidence: 99%

Molecular Characterization of Rickettsial Agents in Ticks (Acari: Ixodidae) from Sri Lanka

Dasch

Eremeeva

Zambrano

et al. 2022

The American Journal of Tropical Medicine and Hygiene

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Because the majority of spotted fever group rickettsiae are transmitted to humans by tick bites, it is important to understand which ticks might play a role in transmission of rickettsial pathogens in Sri Lanka. The purpose of our study was to conduct molecular surveillance of 847 ticks collected in different locations in central Sri Lanka to determine which were infected with Rickettsia and Anaplasmataceae. Molecular methods were used to identify the ticks and the agents detected. Most ticks (Amblyomma, Haemaphysalis, and Rhipicephalus) were collected by flagging, and lower number was collected from dogs, cattle, pigs, a pangolin, and tortoises. Five spotted fever genotypes were identified: a Rickettsia africae-like agent in Amblyomma larvae, Rhipicephalus massiliae and a related genotype identified in association with the tropical type of Rhipicephalus sanguineus from dogs and Rhipicephalus haemaphysaloides from dogs and cattle, and Candidatus R. kellyi and another novel genotype (SL94) in R. haemaphysaloides. Twenty-three ticks were positive for Anaplasmataceae, including one Anaplasma and two Ehrlichia genotypes. Because the sequence database for both ticks and rickettsial agents from Sri Lanka and southern India is not extensive, additional molecular characterization of the tick species of Sri Lanka and their rickettsial agents is required to understand their pathogenic potential more completely. However, several of the agents we identified in this survey may well be pathogenic for humans and domestic animals, and should be considered as a part of epidemiological surveillance and patient management.

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Situation of Sri Lanka, where autochthonous malaria is no longer a problem, and other infections dominate, such as dengue, leptospirosis and rickettsioses

Abstract: The communicable disease control programme in Sri Lanka should be further strengthened with availability of proper and rapid diagnostic facilities. Malaria control could not be considered as a great achievement due to the fact that other emerging infectious diseases are replacing malaria.

Cited by 2 publications

References 50 publications

Leptospirosis Renal Disease: Emerging Culprit of Chronic Kidney Disease Unknown Etiology

Leptospirosis Renal Disease: Emerging Culprit of Chronic Kidney Disease Unknown Etiology

Molecular Characterization of Rickettsial Agents in Ticks (Acari: Ixodidae) from Sri Lanka

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