Leishmaniasis In Sri Lanka A Research Review 1st Edition by Yamuna Deepani Siriwardana 103225145X 9781032251455

1 History and Onset of the Epidemic

1.1 Historical Cases

1.2 Recent Epidemic in the North

1.3 Expansion of Case Reporting

1.4 Research into the Recent Epidemic

2 Attempts on Parasite Studies: The Unusual Parasite

2.1 Necessity for Parasite Identification

2.2 Commencement of Parasitological Research

2.3 L. donovani MON-2 and L. donovani MON-37

3 Clinical Aspects

3.1 Cutaneous Leishmaniasis Continue to be Reported

3.2 First Formal Study in Year 2003

3.3 Subsequent Studies on Clinical Profile

3.4 Forward Journey

4 Other Clinical Forms Emerge in Sri Lanka

4.1 Possibility of Visceral and Mucosal Infections

4.2 Recent Cases and Trends

4.3 Implications and Challenges

4.4 Asymptomatic L. donovani Infection

4.5 Challenges Posed by Asymptomatic Infections

5 Changing Trends in Cutaneous Leishmaniasis

5.1 Changing Trends in Classical Manifestations

5.2 Atypical Cutaneous Manifestations

5.3 Major Disease Foci and Regional Variations

5.4 Other Locations

5.5 Course of Skin Lesions

5.6 Expanding Case Distribution

5.7 Implications for Practice

6 The Mismatched Parasite

6.1 Strain Variation?

6.2 Why Do Not They Visceralize?

6.3 Is the Local Infection New or Old?

6.4 Why Local Infection Remained Undetected?

6.5 Concept of Co-evolution

6.6 Where is the Origin of Local Parasite?

7 Epidemiological Aspects

7.1 First Field Study in Northern Sri Lanka

7.2 First Field Study in Southern Sri Lanka

7.3 Subsequent Field Studies

7.4 Possibility of Local Animal Reservoirs

7.5 Single or Multiple Modes of Parasite Maintenance and Transmission?

7.6 Short and Long Term Implications

8 Vectors and Reservoir Hosts

8.1 Geography-Based Complexities

8.2 Sandfly Vectors in Sri Lanka

8.3 Insecticide Resistance

8.4 Information Adequacy and Gaps and Needs

9 Immunological Aspects

9.1 In Situ Lesional Response Patterns

9.2 Humoral Response Patterns

9.3 Case for Parasitological Reasons

9.4 Role of Host Genetics

9.5 Conclusions

10 Enhanced Case Detection through Clinical and Laboratory Methods

10.1 Place for Clinical Diagnosis

10.2 Patient-Centred Commencement of Interventions

10.3 Laboratory Based Methods

10.4 In Vitro Parasite Culturing

10.5 Molecular Methods

10.6 Immunological Assays

10.7 Optimal and Ideal Case Detection Rates

10.8 Gaps and Needs

10.9 Conclusions

11 Treatment Methods

11.1 Choice between Self-Cure and Intervention

11.2 Locally Available Options

11.3 Poor Response and Drug Resistance

12 Capacity Building, A Model for Handling Emerging Health Issues

12.1 Rational Thinking, Stepwise Approach, and Persistence in Development

12.2 Initial Attempts in Awareness Raising

12.3 Initial Attempts in Patient Care

12.4 Initial Attempts in Research

12.5 The Need for Enhanced Capacity

12.6 Developing Capacity in Patient Care and Research

12.7 Impact on Society and Healthcare Delivery

12.8 Capacity Building in Other Stakeholder Sectors

12.9 Professional Awareness

12.10 Planning for Scalability, Visibility, and Adoption

12.11 Team Building

13 Gaps in Knowledge, Current and Future Needs

13.1 South East Asia Region, Information Gaps and Needs

13.2 Situation in Sri Lanka

13.3 Local Research Needs

13.4 Way Forward