Browse > Article
http://dx.doi.org/10.3347/kjp.2017.55.1.1

Clinico-Epidemiological Patterns of Cutaneous Leishmaniasis Patients Attending the Anuradhapura Teaching Hospital, Sri Lanka  

Galgamuwa, Lahiru Sandaruwan (Department of Basic Sciences, Faculty of Allied Health Sciences, General Sir John Kotelawala Defence University)
Sumanasena, Buthsiri (Teaching Hospital)
Iddawela, Devika (Department of Parasitology, Faculty of Medicine, University of Peradeniya)
Yatawara, Lalani (Department of Medical Laboratory Science, Faculty of Allied Health Sciences, University of Peradeniya)
Wickramasinghe, Susiji (Department of Parasitology, Faculty of Medicine, University of Peradeniya)
Publication Information
Parasites, Hosts and Diseases / v.55, no.1, 2017 , pp. 1-7 More about this Journal
Abstract
Cutaneous leishmaniasis (CL) caused by Leishmania donovani is an endemic vector-borne disease in Sri Lanka. Over 2,500 cases have been reported since 2000 and the number of CL cases has dramatically increased annually. Total 57 clinically suspected CL patients attending the dermatology clinic in Anuradhapura Teaching Hospital were recruited from January to June 2015. Slit skin smears and skin biopsies were taken from each of the subjects. Clinical and epidemiological data were obtained using interviewer administered questionnaire. Forty-three (75.4%) patients among 57 were confirmed positive for L. donovani. The majority (77%) of infected patients was males, and the most affected age group was 21-40 years. Soldiers in security forces, farmers, and housewives were identified as high risk groups. The presence of scrub jungles around the residence or places of occupation (P=0.003), the presence of sandflies (P=0.021), and working outsides more than 6 hr per day (P=0.001) were significantly associated with CL. The number of lesions ranged from 1-3, and the majority (76%) of the patients had a single lesion. Upper and lower extremities were the prominent places of lesions, while the wet type of lesions were more prevalent in females (P=0.022). A nodular-ulcerative type lesion was common in both sexes. The presence of sandflies, scrub jungles, and outdoor activities contributed to spread of Leishmania parasites in an endemic pattern. Implementation of vector control programs together with health education with regard to transmission and prevention of CL are necessary to control the spread of this infection.
Keywords
Leishmania donovani; cutaneous leishmaniasis; clinico-epidemiological pattern; Sri Lanka;
Citations & Related Records
Times Cited By KSCI : 1  (Citation Analysis)
연도 인용수 순위
1 Bari AU. Clinical spectrum of cutaneous leishmaniasis: an overview from Pakistan. Dermatol Online J 2012; 18: 4.
2 Athukorale DN, Seneviratne JK, Ihalamulla RL, Premaratne UN. Locally acquired leishmaniasis in Sri Lanka. J Trop Med Hyg 1992; 95: 432-433.
3 Siriwardana HV, Thalagala N, Karunaweera ND. Clinical and epidemiological studies on the cutaneous leishmaniasis caused by Leishmania donovani in Sri Lanka. Ann Trop Med Parasitol 2010; 104: 213-223.   DOI
4 Piarroux R, Fontes M, Perasso R, Gambarelli F, Joblet C, Dumon H, Quilici M. Phylogenetic relationship between old world Leishmania strains revealed by analysis of a repetitive DNA sequence. Mol Biochem Parasitol 1995; 73: 249-252.   DOI
5 Ranasinghe S, Wickremasinghe R, Munasinghe A, Hulangamuwa S, Sivanantharajah S, Seneviratne K, Bandara S, Athauda I, Navaratne C, Silva O, Wackwella H, Matlashewski G, Wickremasinghe R. Cross-sectional study to assess risk factors for leishmaniasis in an endemic region in Sri Lanka. Am J Trop Med Hyg 2013; 89: 742-749.   DOI
6 Nawaratna SS, Weilgama DJ, Wijekoon CJ, Dissanayake M, Rajapaksha K. Cutaneous leishmaniasis, Sri Lanka. Emerg Infect Dis 2007; 13: 1068-1070.   DOI
7 Sandanayaka R, Kahawita I, Gamage A, Siribaddana S, Agampodi S. Emergence of cutaneous leishmaniasis in Polonnaruwa, Sri Lanka 2008-2011. Trop Med Int Health 2014; 19: 140-145.   DOI
8 Sharma NL, Mahajan VK, Kanga A, Sood A, Katoch VM, Mauricio I, Singh CD, Parwan UC, Sharma VK, Sharma RC. Localized cutaneous leishmaniasis due to Leishmania donovani and Leishmania tropica: preliminary findings of the study of 161 new cases from a new endemic focus in Himachal Pradesh, India. Am J Trop Med Hyg 2005; 72: 819-824.
9 Siriwardana HV, Udagedara CU, Karunaweera ND. Clinical features, risk factors and efficiency of cryotherapy in cutaneous leishmaniasis in Sri Lanka. Ceylon Med J 2003; 48: 10-12.
10 Rajapaksa US, Ihalamulla RL, Udagedera C, Karunaweera ND. Cutaneous leishmaniasis in Southern Sri Lanka. Trans R Soc Trop Med Hyg 2007; 101: 799-803.   DOI
11 Birjees MK. Epidemiology of cutaneous leishmaniasis in Larkana district of Sindh province with particular reference to phlebotomine sandflies. Public Health Division, National Institute of Health (Islamabad) 2001; 67: 1-67.
12 Ranawaka RR, Abeygunasekara PH, Weerakoon HS. Correlation of clinical, parasitological and histopathological diagnosis of cutaneous leishmaniasis in an endemic region in Sri Lanka. Ceylon Med J 2012; 57: 149-152
13 Nawaratna SS, Weilgama DJ, Rajapaksha K. Cutaneous leishmaniasis in Sri Lanka: a study of possible animal reservoirs. Int J Infect Dis 2009; 13: 513-517.   DOI
14 Abdellatif MZ, El-Mabrouk K, Ewis AA. An epidemiological study of cutaneous leishmaniasis in Al-jabal Al-gharbi, Libya. Korean J Parasitol 2013; 51: 75-84.   DOI
15 Haddad MHF, Kassiri H, Kasiri N, Panahandeh A, Lotfi M. Prevalence and epidemiologic profile of acute cutaneous leishmaniasis in an endemic focus, Southwestern Iran. J Acute Dis 2015; 4: 292-297   DOI
16 Ranawaka RR, Weerakoon HS, Opathella N Subasinha C. Leishmaniasis in the North central province, Sri Lanka-epidemiology and therapeutic response. Sri Lanka J Dermatol 2010; 14: 4-8.
17 Dantas-Torres F. The role of dogs as reservoirs of Leishmania parasites, with emphasis on Leishmania (Leishmania) infantum and Leishmania (Viannia) braziliensis. Vet Parasitol 2007; 149: 139-146.   DOI
18 Aara N, Khandelwal K, Bumb RA, Mehta RD, Ghiya BC, Jakhar R, Dodd C, Salotra P, Satoskar AR. Clinco-epidemiologic study of cutaneous leishmaniasis in Bikaner, Rajasthan, India. Am J Trop Med Hyg 2013; 89: 111-115.   DOI
19 van der Meide WF, Jensema AJ, Akrum RA, Sabajo LO, Lai A Fat RF, Lambregts L, Schallig HD, van der Paardt M, Faber WR. Epidemiology of cutaneous leishmaniasis in Suriname: a study performed in 2006. Am J Trop Med Hyg 2008; 79: 192-197.
20 Rohousova I, Talmi-Frank D, Kostalova T, Polanska N, Lestinova T, Kassahun A, Yasur-Landau D, Maia C, King R, Votypka J, Jaffe CL, Warburg A, Hailu A, Volf P, Baneth G. Exposure to Leishmania spp. and sand flies in domestic animals in north western Ethiopia. Parasit Vectors 2015; 8: 360.   DOI
21 Rosypal AC, Tripp S, Kinlaw C, Hailemariam S, Tidwell RR, Lindsay DS, Rajapakse RP, Sreekumar C, Dubey JP. Surveillance for antibodies to Leishmania spp. in dogs from Sri Lanka. J Parasitol 2010; 96: 230-231.   DOI
22 Aara N, Khandelwal K, Bumb RA, Mehta RD, Ghiya BC, Jakhar R, Dodd C, Salotra P, Satoskar AR. Clinco-epidemiologic study of cutaneous leishmaniasis in Bikaner, Rajasthan, India. Am J Trop Med Hyg 2013; 89: 111-115.   DOI
23 Zaraa I, Ishak F, Kort R, El Euch D, Mokni M, Chaker E, Ben Osman A. Childhood and adult cutaneous leishmaniasis in Tunisia. Int J Dermatol 2010; 49: 790-793.   DOI
24 Agrawal S, Khandelwal K, Bumb RA, Oghumu S, Salotra P, Satoskar AR. Pediatric cutaneous leishmaniasis in an endemic region in India. Am J Trop Med Hyg 2014; 91: 901-904.   DOI
25 Khan NH, Bari AU, Hashim R, Khan I, Muneer A, Shah A, Wahid S, Yardley V, O'Neil B, Sutherland CJ. Cutaneous leishmaniasis in Khyber Pakhtunkhwa province of Pakistan: clinical diversity and species-level diagnosis. Am J Trop Med Hyg. 2016; 95: 1106-1114.   DOI
26 Belal US, Abdel-Hafeez EH, Naoi K, Norose K. Cutaneous leishmaniasis in the Nalut District, Libyan Arab Jamahiriya: a clinico-epidemiologic study and Leishmania species identification. J Parasitol 2012; 98: 1251-1256.   DOI
27 Alam E, Abbas O, Moukarbel R, Khalifeh I. Cutaneous leishmaniasis: an overlooked etiology of midfacial destructive lesions. PLoS Negl Trop Dis 2016; 10: e0004426.   DOI
28 Guessous-Idrissi N, Chiheb S, Hamdani A, Riyad M, Bichichi M, Hamdani S, Krimech A. Cutaneous leishmaniasis: an emerging epidemic focus of Leishmania tropica in north Morocco. Trans R Soc Trop Med Hyg 1997; 91: 660-663.   DOI
29 Reithinger R, Dujardin JC, Louzir H, Pirmez C, Alexander B, Brooker S. Cutaneous leishmaniasis. Lancet Infect Dis 2007; 7: 581-596.   DOI
30 Karunaweera ND, Pratlong F, Siriwardane HV, Ihalamulla RL, Dedet JP. Sri Lankan cutaneous leishmaniasis is caused by Leishmania donovani zymodeme MON-37. Trans R Soc Trop Med Hyg 2003; 97: 308-381.   DOI
31 Goto H, Lindoso JA. Current diagnosis and treatment of cutaneous and mucocutaneous leishmaniasis. Expert Rev Anti Infect Ther 2010; 8: 419-433.   DOI
32 Ferro C, Marin D, Gongora R, Carrasquilla MC, Trujillo JE, Rueda NK, Marin J, Valderrama-Ardila C, Alexander N, Perez M, Munstermann LE, Ocampo CB. Phlebotomine vector ecology in the domestic transmission of American cutaneous leishmaniasis in Chaparral, Colombia. Am J Trop Med Hyg 2011; 85: 847-856.   DOI
33 WHO. Leishmaniasis, 2012. (available: http://www.who.int/leishmaniasis/burden/en/) [29 September 2012].
34 WHO. Control of the leishmaniases: Report of a meeting of the WHO Expert Committee on the Control of Leishmaniases, 2010. (available: http://apps.who.int/iris/bitstream/10665/44412/1/WHO_TRS_949_eng.pdf) [2 January 2011].