First Evidence for Two Independent and Different Leishmaniasis Transmission Foci in Sri Lanka: Recent Introduction or Long-Term Existence?
Cutaneous leishmaniasis caused by a genetic variant of L. donovani is being reported from Sri Lanka since year 2001. Patients presented from different geographical locations (600 patients from North or South and a minority of cases from other foci, 2001-2013) were studied. Analysis revealed two diff...
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| Format: | Article |
| Language: | English |
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Wiley
2019-01-01
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| Series: | Journal of Tropical Medicine |
| Online Access: | http://dx.doi.org/10.1155/2019/6475939 |
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| author | Yamuna Siriwardana Bhagya Deepachandi Shreenika de S. Weliange Chandanie Udagedara Chandanie Wickremarathne Wipula Warnasuriya Ranthilaka R. Ranawaka Indira Kahawita P. H. Chandrawansa Nadira D. Karunaweera |
| author_facet | Yamuna Siriwardana Bhagya Deepachandi Shreenika de S. Weliange Chandanie Udagedara Chandanie Wickremarathne Wipula Warnasuriya Ranthilaka R. Ranawaka Indira Kahawita P. H. Chandrawansa Nadira D. Karunaweera |
| author_sort | Yamuna Siriwardana |
| collection | DOAJ |
| description | Cutaneous leishmaniasis caused by a genetic variant of L. donovani is being reported from Sri Lanka since year 2001. Patients presented from different geographical locations (600 patients from North or South and a minority of cases from other foci, 2001-2013) were studied. Analysis revealed two different sociodemographic and clinical profiles of leishmaniasis in Northern and Southern Sri Lanka. Also, the same different profiles were present in these foci since the onset of the recent outbreak and had independently propagated within each focus over the time. A profile of 14 parameters identified in the Northern focus was further examined with regard to other locations. Northwestern (10/14) and Central parts (9/14) of the island were more similar to Northern focus (14/14). Infection would have originated in one focus and spread to other 2 in Northern Sri Lanka. Southern focus was different from and appeared older than all others (2/14). Western focus that accommodates a large transient population had a mixed picture of North and South features (4/14). Lesions in North showed a slow progression and a nonulcerative nature (128/185, 69.2%), while those in South showed a rapid progression and less nonulcerative lesions (193/415, 46.5%). Clinical analysis favoured a parasite aetiology (considerable strain differences) rather than a host aetiology (age, gender, or genetics). Both foci demonstrated a biannual seasonal variation since the onset of the epidemic. Two peaks were observed during the early and latter parts of the year. Furthermore, long-term existence and recent spatiotemporal expansion and detection of leishmaniasis in this country rather than a recent introduction and establishment were indicated by these findings. Vigorous antimalarial activities that existed in Sri Lanka until few decades ago, lack of professional awareness, and more recent military activities that brought human population in close contact with a sylvatic cycle would have played a role in silent propagation of Leishmania parasites and subsequent increment in human cases, respectively, in this country. |
| format | Article |
| id | doaj-art-bcd2b51ac2264ecbb1c1c12d5590dece |
| institution | DOAJ |
| issn | 1687-9686 1687-9694 |
| language | English |
| publishDate | 2019-01-01 |
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| series | Journal of Tropical Medicine |
| spelling | doaj-art-bcd2b51ac2264ecbb1c1c12d5590dece2025-08-20T03:23:18ZengWileyJournal of Tropical Medicine1687-96861687-96942019-01-01201910.1155/2019/64759396475939First Evidence for Two Independent and Different Leishmaniasis Transmission Foci in Sri Lanka: Recent Introduction or Long-Term Existence?Yamuna Siriwardana0Bhagya Deepachandi1Shreenika de S. Weliange2Chandanie Udagedara3Chandanie Wickremarathne4Wipula Warnasuriya5Ranthilaka R. Ranawaka6Indira Kahawita7P. H. Chandrawansa8Nadira D. Karunaweera9Department of Parasitology, Faculty of Medicine, University of Colombo, Colombo 00800, Sri LankaDepartment of Parasitology, Faculty of Medicine, University of Colombo, Colombo 00800, Sri LankaDepartment of Community Medicine, Faculty of Medicine, University of Colombo, Colombo 00800, Sri LankaTeaching Hospital, Kandy 20000, Sri LankaNational Hospital, Colombo 00800, Sri LankaTeaching Hospital, Kurunegala 60000, Sri LankaTeaching Hospital, Kalutara 12000, Sri LankaBase Hospital, Homagama 10200, Sri Lanka332/4, Anagarika Dharmapala Mawatha, Nupe, Matara 81000, Sri LankaDepartment of Parasitology, Faculty of Medicine, University of Colombo, Colombo 00800, Sri LankaCutaneous leishmaniasis caused by a genetic variant of L. donovani is being reported from Sri Lanka since year 2001. Patients presented from different geographical locations (600 patients from North or South and a minority of cases from other foci, 2001-2013) were studied. Analysis revealed two different sociodemographic and clinical profiles of leishmaniasis in Northern and Southern Sri Lanka. Also, the same different profiles were present in these foci since the onset of the recent outbreak and had independently propagated within each focus over the time. A profile of 14 parameters identified in the Northern focus was further examined with regard to other locations. Northwestern (10/14) and Central parts (9/14) of the island were more similar to Northern focus (14/14). Infection would have originated in one focus and spread to other 2 in Northern Sri Lanka. Southern focus was different from and appeared older than all others (2/14). Western focus that accommodates a large transient population had a mixed picture of North and South features (4/14). Lesions in North showed a slow progression and a nonulcerative nature (128/185, 69.2%), while those in South showed a rapid progression and less nonulcerative lesions (193/415, 46.5%). Clinical analysis favoured a parasite aetiology (considerable strain differences) rather than a host aetiology (age, gender, or genetics). Both foci demonstrated a biannual seasonal variation since the onset of the epidemic. Two peaks were observed during the early and latter parts of the year. Furthermore, long-term existence and recent spatiotemporal expansion and detection of leishmaniasis in this country rather than a recent introduction and establishment were indicated by these findings. Vigorous antimalarial activities that existed in Sri Lanka until few decades ago, lack of professional awareness, and more recent military activities that brought human population in close contact with a sylvatic cycle would have played a role in silent propagation of Leishmania parasites and subsequent increment in human cases, respectively, in this country.http://dx.doi.org/10.1155/2019/6475939 |
| spellingShingle | Yamuna Siriwardana Bhagya Deepachandi Shreenika de S. Weliange Chandanie Udagedara Chandanie Wickremarathne Wipula Warnasuriya Ranthilaka R. Ranawaka Indira Kahawita P. H. Chandrawansa Nadira D. Karunaweera First Evidence for Two Independent and Different Leishmaniasis Transmission Foci in Sri Lanka: Recent Introduction or Long-Term Existence? Journal of Tropical Medicine |
| title | First Evidence for Two Independent and Different Leishmaniasis Transmission Foci in Sri Lanka: Recent Introduction or Long-Term Existence? |
| title_full | First Evidence for Two Independent and Different Leishmaniasis Transmission Foci in Sri Lanka: Recent Introduction or Long-Term Existence? |
| title_fullStr | First Evidence for Two Independent and Different Leishmaniasis Transmission Foci in Sri Lanka: Recent Introduction or Long-Term Existence? |
| title_full_unstemmed | First Evidence for Two Independent and Different Leishmaniasis Transmission Foci in Sri Lanka: Recent Introduction or Long-Term Existence? |
| title_short | First Evidence for Two Independent and Different Leishmaniasis Transmission Foci in Sri Lanka: Recent Introduction or Long-Term Existence? |
| title_sort | first evidence for two independent and different leishmaniasis transmission foci in sri lanka recent introduction or long term existence |
| url | http://dx.doi.org/10.1155/2019/6475939 |
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