ABSTRACT
It is possible that large numbers of cases of leishmaniasis would have been occurring in Sri Lanka until the detection of them recently as a result of activated passive case detection (APCD) in clinical settings that followed our awareness campaigns. Collection of accurate epidemiological information and timely implementation of control activities are important for successful disease control. During early stages, the majority of patients were reported from Northern Sri Lanka, and risk factor studies in this area indicated an outdoor transmission. Subsequent studies conducted in Southern and Northern Sri Lanka have indicated both outdoor and peri-domestic transmission. With increased case reporting, leishmaniasis was declared a notifiable disease in Sri Lanka by the Ministry of Health, in 2008. Meanwhile, preliminary evidence for possible animal reservoir hosts has also been highlighted in Sri Lanka. The possibility of regional variation in the mode of transmission of the parasites causing cutaneous leishmaniasis within Sri Lanka is supported by previous observations on the varying behaviour of Phlebotomus argentipes, the local vector. This can probably complicate preventive activities. Once the full characteristics are known, an evidence-based, integrated control programme should be urgently implemented. Meanwhile, focus should also be on adopting general preventive measures, strengthening case management, and further research in all relevant areas.
