Dataset Information

Socioeconomic, demographic and landscape factors associated with cutaneous leishmaniasis in Kurunegala District, Sri Lanka.

ABSTRACT:

Background

Leishmaniasis is a neglected tropical disease that affects countries in the developing world. In Sri Lanka, cutaneous leishmaniasis is the most common form of the disease. It is prevalent in dry and intermediate zones, mostly associated with rural settings. Understanding basic risk factors is critical in the management of the disease with effective interventions. This study is focused on assessing the demographic, socioeconomic and landscape factors associated with leishmaniasis in Kurunegala District, Sri Lanka.

Methods

A descriptive cross-sectional study was conducted. Households of the past patients and randomly selected households, which had no history of leishmaniasis cases were interviewed. The clinical, socioeconomic, demographic, landscape and awareness-related data were obtained using a pre-tested, interviewer-administered questionnaire.

Results

A total of 101 patients and a similar number of controls were included in the study. All the patients had the cutaneous form of the disease. Housewives and personnel with monthly incomes less than Rs. 10,000 (56.76 USD) were 3.9- and 9.5-times more prone to the disease, respectively, according to multivariate analysis. Presence of decaying garbage, termite hills, unclear areas, wet soil and gardening areas were always associated with the increased odds of acquiring the disease.

Conclusions

Demographic factors do not play a pivotal role in the prevalence of leishmaniasis in the area. Housewives, inhabitants with low incomes and individuals who live in areas with conditions suitable for sand fly breeding and resting are major groups with a higher risk of infection. Special attention must be given in raising awareness and environmental management in control activities.

SUBMITTER: Wijerathna T

PROVIDER: S-EPMC7216469 | biostudies-literature | 2020 May

REPOSITORIES: biostudies-literature

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Publications

Socioeconomic, demographic and landscape factors associated with cutaneous leishmaniasis in Kurunegala District, Sri Lanka.

Wijerathna Tharaka T Gunathilaka Nayana N Gunawardena Kithsiri K Rodrigo Wasana W

Parasites & vectors 20200512 1

<h4>Background</h4>Leishmaniasis is a neglected tropical disease that affects countries in the developing world. In Sri Lanka, cutaneous leishmaniasis is the most common form of the disease. It is prevalent in dry and intermediate zones, mostly associated with rural settings. Understanding basic risk factors is critical in the management of the disease with effective interventions. This study is focused on assessing the demographic, socioeconomic and landscape factors associated with leishmanias ...[more]

PMID: 32398102

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Project description:BACKGROUND:Sand flies are responsible for the transmission of several disease pathogens including Leishmania. Sand flies breed in habitats with high levels of humidity and organic matter. They are nocturnal in nature and peak activity ranges from dusk to dawn. The scientific evidence on breeding ecology and diurnal resting sites of sand fly fauna are important aspects of planning and implementing vector control activities. However, such fundamental information is grossly inadequate in Sri Lanka to support the control efforts in the country. Therefore, the present study addresses some of the important aspects of sand fly breeding ecology and diurnal resting sites. METHODS:Potential resting sites were thoroughly observed, and sand flies were collected using a battery-operated aspirator and sticky papers when appropriate from three selected Medical Officer of Health (MOH) areas (Polpithigama, Maho and Galgamuwa) in Kurunegala district, Sri Lanka. Soil samples were collected from each potential breeding site. Half of each soil sample was incubated for 45 days. The other half was screened for immature stages. Adult sand flies collected from field and emerged adults at the insectary under confined incubation were identified using morphological characteristics. RESULTS:Pepper bushes and termite mounds were the most notable resting sites while, betel bushes, cattle huts, piles of coconut shells, latrines, manna bushes and tree holes were also positive for sand fly adults. Only two species, Phlebotomus argentipes and Sergentomyia punjabensis, were reported. Soil samples were collected from a total of 432 sites and 7 of them were positive for immature stages. Predominant breeding habitats identified during the present study were mud flats and moist soils of rice paddies, the soil below decaying hay, drying irrigational tank bottom moist soil, and the floors of cattle huts. CONCLUSION:This study demonstrates that the potential adult resting sites and breeding habitats are abundant in the Polpithigama, Maho and Galgamuwa MOH areas. Therefore, vector control activities targeting both adult and immature stages of sand flies are recommended.

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Project description:Sri Lanka records substantial numbers of snakebite annually. Primary rural hospitals are important contributors to health care. Health care planning requires a more detailed understanding of snakebite within this part of the health system. This study reports the management and epidemiology of all hospitalised snakebite in the Kurunegala district in Sri Lanka.The district has 44 peripheral/primary hospitals and a tertiary care hospital-Teaching Hospital, Kurunegala (THK). This prospective study was conducted over one year. All hospitals received copies of the current national guidelines on snakebite management. Clinical and demographic details of all snakebite admissions to primary hospitals were recorded by field researchers and validated by comparing with scanned copies of the medical record. Management including hospital transfers was independently assessed against the national guidelines recommendation. Population rates were calculated and compared with estimates derived from recent community based surveys.There were 2186 admissions of snakebites and no deaths in primary hospitals. An additional 401 patients from the district were admitted directly to the teaching hospital, 2 deaths were recorded in this group. The population incidence of hospitalized snakebite was 158/100,000 which was significantly lower than community survey estimates of 499/100,000. However there was no significant difference between the incidence of envenomation of 126/100,000 in hospitalised patients and 184/100,000 in the community survey. The utilisation of antivenom was appropriate and consistent with guidelines. Seventy patients received antivenom. Anaphylactic reactions to antivenom occurred in 22 patients, treatment reactions was considered to be outside the guidelines in 5 patients. Transfers from the primary hospital occurred in 399(18%) patients but the majority (341) did not meet the guideline criteria. A snake was identified in 978 cases; venomous snakebites included 823 hump-nosed viper (Hypnalespp), 61 Russell's viper, 14 cobra, 13 common krait, 03 saw scaled viper.Primary hospitals received a significant number of snakebites that would be missed in surveys conducted in tertiary hospitals. Adherence to guidelines was good for the use of antivenom but not for hospital transfer or treatment of anaphylaxis. The large difference in snakebite incidence between community and hospital studies could possibly be due to non-envenomed patients not presenting. As the majority of snakebite management occurs in primary hospitals education and clinical support should be focused on that part of the health system.

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Dataset Information

Socioeconomic, demographic and landscape factors associated with cutaneous leishmaniasis in Kurunegala District, Sri Lanka.

Background

Methods

Results

Conclusions

Publications

Socioeconomic, demographic and landscape factors associated with cutaneous leishmaniasis in Kurunegala District, Sri Lanka.

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