Spatial Epidemiologic Trends and Hotspots of Leishmaniasis, Sri Lanka, 2001-2018

Emerg Infect Dis. 2020 Jan;26(1):1-10. doi: 10.3201/eid2601.190971.

Abstract

Leishmaniasis, a neglected tropical disease, is on the decline in South Asia. However, cases of cutaneous leishmaniasis have risen in Sri Lanka since 2001, and the lack of in-depth research on its epidemiologic characteristics hampers control efforts. We analyzed data collected from patients with cutaneous leishmaniasis in Sri Lanka during 2001-2018 to study temporal and geographic trends and identify and monitor disease hotspots. We noted a progression in case rates, including a sharp rise in 2018, showing temporal expansion of disease-prevalent areas and 2 persistent hotspots. The northern hotspot shifted and shrank over time, but the southern hotspot progressively expanded and remained spatially static. In addition, we noted regional incidence differences for age and sex. We provide evidence of temporally progressive and spatially expanding incidence of leishmaniasis in Sri Lanka with distinct geographic patterns and disease hotspots, signaling an urgent need for effective disease control interventions.

Keywords: Asia; Indian subcontinent; Leishmania donovani; Sri Lanka; cutaneous leishmaniasis; dermatological pathologies; epidemiology; infectious diseases; leishmaniasis; parasites; protozoa; skin lesions; vector-borne infections.

Publication types

  • Research Support, N.I.H., Extramural

MeSH terms

  • Adolescent
  • Adult
  • Age Factors
  • Child
  • Child, Preschool
  • Disease Outbreaks / statistics & numerical data*
  • Female
  • Humans
  • Incidence
  • Infant
  • Infant, Newborn
  • Leishmania donovani
  • Leishmaniasis, Cutaneous / epidemiology*
  • Male
  • Middle Aged
  • Prevalence
  • Retrospective Studies
  • Sex Factors
  • Spatio-Temporal Analysis
  • Sri Lanka / epidemiology
  • Young Adult