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Cross-Sectional Study to Assess Risk Factors for Leishmaniasis in an Endemic Region in Sri Lanka

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  • Department of Parasitology, Faculty of Medical Sciences, University of Sri Jayewardenepura, Gangodawila, Nugegoda, Sri Lanka; Department of Public Health, Faculty of Medicine, University of Kelaniya, Kelaniya, Sri Lanka; Regional Epidemiology Unit, Regional Director of Health Services Office, Anuradhapura, Sri Lanka; Dermatology Unit, Teaching Hospital, Anuradhapura, Sri Lanka; Geographic Information System Branch, Department of Surveys, Colombo, Sri Lanka; Office of the Medical Officer of Health, Thalawa, Sri Lanka; Department of Microbiology and Immunology, McGill University, Montreal, Quebec, Canada; Special Program for Research and Training in Tropical Diseases, World Health Organization, Geneva, Switzerland

Sri Lanka reports significantly more cutaneous leishmaniasis (CL) cases than visceral leishmaniasis (VL) cases, both of which are caused by Leishmania donovani MON-37. A cross-sectional study conducted in an area with a high prevalence of CL prevalent included 954 participants of an estimated population of 61,674 to estimate the number of CL cases, ascertain whether there is a pool of asymptomatic VL cases, and identify risk factors for transmission. A total of 31 cases of CL were identified, of whom 21 were previously diagnosed and 10 were new cases. Using rK39 rapid diagnostic test to detect antibodies against Leishmania spp., we found that only one person was seropositive but did not have clinical symptoms of CL or VL, which indicated low transmission of VL in this area. χ2 test, independent sample t-test, and multivariate analysis of sociodemographic and spatial distribution of environmental risk factors showed that living near paddy fields is associated with increased risk for transmission of CL (P ≤ 0.01).

Author Notes

* Address correspondence to Renu Wickremasinghe, Department of Parasitology, Faculty of Medical Sciences, University of Sri Jayewardenepura, Gangodawila, Nugegoda, Sri Lanka. E-mail: renuwickremasinghe@gmail.com† Co-senior authors.

Financial support: Shalindra Ranasinghe and Renu Wickremasinghe were supported by National Research Council (grant no. 09-24) and the Ministry of Technology and Research of Sri Lanka. Greg Matlashewski was supported by the Canadian Institutes of Health Research.

Authors' addresses: Shalindra Ranasinghe, Ositha Silva, Hasini Wackwella, and Renu Wickremasinghe, Department of Parasitology, Faculty of Medical Sciences, University of Sri Jayewardenepura, Gangodawila, Nugegoda, Sri Lanka, E-mails: shalindraran12@gmail.com, ositha18@gmail.com, hasini_wackwella@yahoo.co.uk, and renuwickremasinghe@gmail.com. Rajitha Wickremasinghe, Department of Public Health, Faculty of Medicine, University of Kelaniya, Kelaniya, Sri Lanka, E-mail: arwicks@sltnet.lk. Asoka Munasinghe, Regional Epidemiology Unit, Regional Director of Health Services Office, Anuradhapura, Sri Lanka, E-mail: reanuradhapura@gmail.com. Sanjeeva Hulangamuwa, Dermatology Unit, Teaching Hospital, Anuradhapura, Sri Lanka, E-mail: chamilsanjeeva@yahoo.com. Sundaramoorthy Sivanantharajah, Geographic Information System Branch, Department of Surveys, Colombo, Sri Lanka, E-mail: ssgis@sltnet.lk. Kamal Seneviratne and Samantha Bandara, Office of the Medical Officer of Health, Anuradhapura Road, Thewala, Sri Lanka, E-mails: vbkamals@gmail.com and samanthaban99@gmail.com. Indira Athauda, Department of Parasitology, Faculty of Medical Sciences, University of Sri Jayewardenepura, Gangodawila, Nugegoda, Sri Lanka, E-mail: indiraathauda@yahoo.com. Chaturi Navaratne, Department of Parasitology, Faculty of Medical Sciences, University of Sri Jayewardenepura, Gangodawila, Nugegoda, Sri Lanka, E-mail: chaturi_navaratne@yahoo.com. Greg Matlashewski, Department of Microbiology and Immunology, McGill University, Montreal, Quebec, Canada, and Special Program for Research and Training in Tropical Diseases, World Health Organization, Geneva, Switzerland, E-mail: greg.matlashewski@mcgill.ca.

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