Prevalence of cutaneous leishmaniasis infection and clinico-epidemiological patterns among military personnel in Mullaitivu and Kilinochchi districts of the Northern Province, early war-torn areas in Sri Lanka
Abstract Background The 30-year-old armed conflict in Sri Lanka resulted in a general breakdown of civil administration in the Northern and Eastern provinces, leading to mobilisation of many armed forces personnel to assist with reconstruction and resettlement. This occupational group has been ident...
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| Format: | Article |
| Language: | English |
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BMC
2020-05-01
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| Series: | Parasites & Vectors |
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| Online Access: | http://link.springer.com/article/10.1186/s13071-020-04137-8 |
| _version_ | 1819298158894645248 |
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| author | Nayana Gunathilaka Saveen Semege Nishantha Pathirana Nuwani Manamperi Lahiru Udayanga Harshima Wijesinghe Prasad Premaratne Deepika Fernando |
| author_facet | Nayana Gunathilaka Saveen Semege Nishantha Pathirana Nuwani Manamperi Lahiru Udayanga Harshima Wijesinghe Prasad Premaratne Deepika Fernando |
| author_sort | Nayana Gunathilaka |
| collection | DOAJ |
| description | Abstract Background The 30-year-old armed conflict in Sri Lanka resulted in a general breakdown of civil administration in the Northern and Eastern provinces, leading to mobilisation of many armed forces personnel to assist with reconstruction and resettlement. This occupational group has been identified as a priority risk group for leishmaniasis. Methods Individuals enlisted at all military establishments in Mullaitivu and Kilinochchi districts, Northern Province of Sri Lanka were included. Five thousand individuals were screened for skin lesions between September 2018 and August 2019. Persons with lesions suspected as cutaneous leishmaniasis (CL) were further investigated. Information on sociodemographic/other potential risk factors was obtained through an interviewer-administered structured questionnaire. The diagnosis was confirmed by microscopic visualization of parasitic stages from different samples obtained (skin scraping, lesion aspirate and tissue impression smears), histopathology and polymerase chain reaction DNA amplification. Results Among 5000 individuals screened, 74 individuals were suspected of having CL. Of these, 67.6% (n = 50) patients were confirmed for CL by microscopy. Around two third of both males (67.6%; n = 48) and females (66.6%; n = 2) were positive for Leishmania. The soldiers belonging to 26–35-year age group reported the highest susceptibility (83.3%; OR: 4.83, 95% CI: 3.49–6.20%). Of the sociodemographic factors, age, wearing short-sleeved upper body clothing as the uniform and non-use of insect repellents were identified as significant risk factors. Most of the CL patients had a single lesion (86.0%; n = 43) of an ulcerative type (34.0%; n = 17), mostly on their upper limb (67.9%; n = 34). Lesions were mostly 5–10 mm diameter (59.9%; n = 30) in size with poorly defined margins (72.0%; n = 36). Amongst the diagnostic techniques, microscopic examination of slit skin smear and tissue impression smear were able to discriminate the majority of patients (92.1%; n = 46) for CL. Conclusions In order to highlight the true burden of leishmaniasis in the military personnel, cases of leishmaniasis from military institutes should be recognized as a different entity per say and be included in the national figures so as to depict the real magnitude of the disease burden amongst this high-risk group. |
| first_indexed | 2024-12-24T05:25:28Z |
| format | Article |
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| issn | 1756-3305 |
| language | English |
| last_indexed | 2024-12-24T05:25:28Z |
| publishDate | 2020-05-01 |
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| spelling | doaj.art-9e2f1854f63143228779b3ee9e63eec02022-12-21T17:13:21ZengBMCParasites & Vectors1756-33052020-05-0113111210.1186/s13071-020-04137-8Prevalence of cutaneous leishmaniasis infection and clinico-epidemiological patterns among military personnel in Mullaitivu and Kilinochchi districts of the Northern Province, early war-torn areas in Sri LankaNayana Gunathilaka0Saveen Semege1Nishantha Pathirana2Nuwani Manamperi3Lahiru Udayanga4Harshima Wijesinghe5Prasad Premaratne6Deepika Fernando7Department of Parasitology, Faculty of Medicine, University of KelaniyaDirectorate of Army Preventive Medicine & Mental Health Services, Army HeadquartersSri Lanka Army HospitalDepartment of Parasitology, Faculty of Medicine, University of KelaniyaDepartment of Biosystems Engineering, Faculty of Agriculture and Plantation Management, Wayamba University of Sri LankaDepartment of Pathology, Faculty of Medicine, University of ColomboDepartment of Parasitology, Faculty of Medicine, Kotalawela Defence UniversityDepartment of Parasitology, Faculty of Medicine, University of ColomboAbstract Background The 30-year-old armed conflict in Sri Lanka resulted in a general breakdown of civil administration in the Northern and Eastern provinces, leading to mobilisation of many armed forces personnel to assist with reconstruction and resettlement. This occupational group has been identified as a priority risk group for leishmaniasis. Methods Individuals enlisted at all military establishments in Mullaitivu and Kilinochchi districts, Northern Province of Sri Lanka were included. Five thousand individuals were screened for skin lesions between September 2018 and August 2019. Persons with lesions suspected as cutaneous leishmaniasis (CL) were further investigated. Information on sociodemographic/other potential risk factors was obtained through an interviewer-administered structured questionnaire. The diagnosis was confirmed by microscopic visualization of parasitic stages from different samples obtained (skin scraping, lesion aspirate and tissue impression smears), histopathology and polymerase chain reaction DNA amplification. Results Among 5000 individuals screened, 74 individuals were suspected of having CL. Of these, 67.6% (n = 50) patients were confirmed for CL by microscopy. Around two third of both males (67.6%; n = 48) and females (66.6%; n = 2) were positive for Leishmania. The soldiers belonging to 26–35-year age group reported the highest susceptibility (83.3%; OR: 4.83, 95% CI: 3.49–6.20%). Of the sociodemographic factors, age, wearing short-sleeved upper body clothing as the uniform and non-use of insect repellents were identified as significant risk factors. Most of the CL patients had a single lesion (86.0%; n = 43) of an ulcerative type (34.0%; n = 17), mostly on their upper limb (67.9%; n = 34). Lesions were mostly 5–10 mm diameter (59.9%; n = 30) in size with poorly defined margins (72.0%; n = 36). Amongst the diagnostic techniques, microscopic examination of slit skin smear and tissue impression smear were able to discriminate the majority of patients (92.1%; n = 46) for CL. Conclusions In order to highlight the true burden of leishmaniasis in the military personnel, cases of leishmaniasis from military institutes should be recognized as a different entity per say and be included in the national figures so as to depict the real magnitude of the disease burden amongst this high-risk group.http://link.springer.com/article/10.1186/s13071-020-04137-8Cutaneous leishmaniasisClinicalEpidemiologicalWar-torn areas |
| spellingShingle | Nayana Gunathilaka Saveen Semege Nishantha Pathirana Nuwani Manamperi Lahiru Udayanga Harshima Wijesinghe Prasad Premaratne Deepika Fernando Prevalence of cutaneous leishmaniasis infection and clinico-epidemiological patterns among military personnel in Mullaitivu and Kilinochchi districts of the Northern Province, early war-torn areas in Sri Lanka Parasites & Vectors Cutaneous leishmaniasis Clinical Epidemiological War-torn areas |
| title | Prevalence of cutaneous leishmaniasis infection and clinico-epidemiological patterns among military personnel in Mullaitivu and Kilinochchi districts of the Northern Province, early war-torn areas in Sri Lanka |
| title_full | Prevalence of cutaneous leishmaniasis infection and clinico-epidemiological patterns among military personnel in Mullaitivu and Kilinochchi districts of the Northern Province, early war-torn areas in Sri Lanka |
| title_fullStr | Prevalence of cutaneous leishmaniasis infection and clinico-epidemiological patterns among military personnel in Mullaitivu and Kilinochchi districts of the Northern Province, early war-torn areas in Sri Lanka |
| title_full_unstemmed | Prevalence of cutaneous leishmaniasis infection and clinico-epidemiological patterns among military personnel in Mullaitivu and Kilinochchi districts of the Northern Province, early war-torn areas in Sri Lanka |
| title_short | Prevalence of cutaneous leishmaniasis infection and clinico-epidemiological patterns among military personnel in Mullaitivu and Kilinochchi districts of the Northern Province, early war-torn areas in Sri Lanka |
| title_sort | prevalence of cutaneous leishmaniasis infection and clinico epidemiological patterns among military personnel in mullaitivu and kilinochchi districts of the northern province early war torn areas in sri lanka |
| topic | Cutaneous leishmaniasis Clinical Epidemiological War-torn areas |
| url | http://link.springer.com/article/10.1186/s13071-020-04137-8 |
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