Leishmaniasis in Sri Lanka: A Research Review

Cover
Half Title
Title Page
Copyright Page
Dedication
Table of Contents
Foreword
Preface
Acknowledgements
Author
Abbreviations
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
Bibliography
Index