The Quest for Understanding Cutaneous Leishmaniasis in Northern Province, Sri Lanka: An Analysis of Clinical Data from the District General Hospital, Vavuniya

Abstract The study aimed to examine the clinical and epidemiological patterns of cutaneous leishmaniasis (CL) in patients attending the Dermatology Unit, District General Hospital in Vavuniya, Sri Lanka. A total of 77 patients clinically suspected for CL were interviewed through a structured questionnaire and skin-lesion samples were obtained between January 2016 and January 2017. The definitive diagnosis of CL was made through microscopic identification of smears, histopathological examination of biopsies and kDNA PCR. Treatment modalities were chosen based on the location of the lesions on the body and complexity of the lesions. Of 77 suspected patients, 68 were confirmed for CL, with a mean age of 34.6 (±12.7) years, and included 54 males (79.4%) and 14 females (20.6%). Being a male was a significant risk factor ( P = 0.032, OR = 4.82) associated with CL. Lesions were observed mainly on the exposed areas of the body, of which the forearm (22.1%) was the most commonly affected site. Single lesions (75.0%) and ulcerated nodules with central crust (39.7%) were the prominent features among the infected group. The age-group of 21-40 years was significantly associated with healing lesions ( P = 0.028, ME = 0.55). However, a significant negative relationship was detected between ulcerated nodular lesions and lesion healing ( P = 0.0436, ME = -0.375). Males are at higher risk of CL. Early diagnosis and specific treatment, along with preventive measures such as protective clothing and sand fly repellents can limit the spread of the disease. There is a need for a comprehensive approach to prevent and control the transmission of CL.