Peri-domestic factors associated with transmission of cutaneous leishmaniasis in selected areas in Hambantota district, Sri Lanka

Abstract

Cutaneous leishmaniasis (CL) is a notifiable disease in Hambantota district and aim of this study was to identify the peri-domestic environmental factors, which attributed potentially to increase CL cases in Hambantota. CL suspected patients who attended to the Tangalle Hospital from June 2016 to January 2017 were interviewed using a questionnaire. Information on the presence of other CL patients in neighbourhood, owned land area, presence of trees, unutilized lands, forests, paddy fields and other agricultural lands, water bodies and distance from patient’s house to them were recorded from each patient. Positivity of CL was detected by the presence of Leishmania amastigotes in slit-skin smears from skin lesions of each patient. Out of 314, 183 (58.92%) patients were CL positive. Out of 182 positive patients, 49.4% (N=90) had family members or neighbours or co-workers that infected with CL during last five years period. The size of the land of 54.2% (N=64) CL patients were >1000 m2 (P<0.0001). Most of these lands were covered with tall trees and small plants. Majority of patients (N=116, 99.1%) dumped their garbage (N=56, 42.4%) and wastewater (N= 79, 58.1%) to the open land < 100 m from their houses. Present findings revealed that distance of houses of noticeable number of CL patients were <100 m to unutilized lands (N=104, 68.9%), shrub jungles (N= 92, 60.9%), agricultural lands (N= 48, 31.4%), forests (N= 26, 17.1%) and water bodies (N=24, 15.8%). Therefore, it can be concluded that CL positive patients in this study profile are living close to (less than 100m) previously infected CL patients and habitats preferred by the CL vector for their resting, feeding and breeding.