Analysis of gaps in the correct diagnosis of leishmaniasis at primary care level; socio-demographic and environmental risk factors of leishmaniasis transmission in Anuradhapura

H. Weerakoon, R. Ranawaka, J. Warnasekara, P. Bandara
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引用次数: 2

Abstract

Background The leishmaniasis is an emerging health problem in dry zone of Sri Lanka. The multiplicity of factors involved in the transmission of leishmaniasis constitutes a challenge to its control. Knowledge of such factors may contribute to identify the control strategies. Although Medical officers have been given training on leishmaniasis, still patients with leishmaniasis had been diagnosed incorrectly. Aim of the study was to analysis of the diagnosis pattern of leishmaniasis patients by the primary care medical officers and to identify potential socio demographic and environmental risk factors of leishmaniasis transmission. Methods A descriptive cross sectional study conducted among the leishmaniasis patients attending to the Dermatology clinic, Teaching Hospital Anuradhapura during November 2015 to November 2016 using interviewer administered questionnaire.  Results  The study sample was 300 leishmaniasis patients .Male to female ratio was 2:1.The commonest affected age group was 20 to 40 years .Lesser number (33%) had heard about leishmaniasis. Nearly one forth (23%) of patients had been diagnosed incorrectly at the primary health care level. Nearly 50%of patients got leishmaniasis due to occupation related activities. Most (75%) of patients had paddy fields, large number of Banana bushes, Manna bushes and large wild area near their residence. Nearly 50% of patients had water channel near their residence. All most all (96%) patients use bed nets. Conclusion Nearly one forth of patients missed diagnosis at the primary health care level. Paddy fields, Banana bushes, Manna bushes, large wild area and water channels close to residence may play role in leishmaniasis transmission.
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分析初级保健水平对利什曼病正确诊断的差距;阿努拉德普拉利什曼病传播的社会人口和环境危险因素
背景:利什曼病是斯里兰卡干旱地区新出现的卫生问题。利什曼病传播涉及多种因素,对控制该病构成挑战。了解这些因素可能有助于确定控制策略。尽管对医务人员进行了关于利什曼病的培训,但利什曼病患者仍被错误诊断。本研究的目的是分析初级保健医务人员对利什曼病患者的诊断模式,并确定潜在的利什曼病传播的社会人口和环境危险因素。方法对2015年11月至2016年11月在阿努拉德拉普勒教学医院皮肤科门诊就诊的利什曼病患者进行描述性横断面研究。结果研究对象为300例利什曼病患者,男女比例为2:1。最常见的发病年龄组为20 ~ 40岁。较少的人(33%)听说过利什曼病。近四分之一(23%)的患者在初级卫生保健一级被错误诊断。近50%的患者因职业相关活动而患利什曼病。大多数(75%)患者住所附近有水田、大量香蕉灌木、甘露灌木和大片野生区域。近50%的患者住所附近有水道。几乎所有(96%)患者都使用蚊帐。结论近四分之一的患者在初级卫生保健阶段漏诊。稻田、香蕉灌木、甘露灌木、大面积野生区域和靠近居民区的水道可能是利什曼病传播的重要渠道。
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