Leishmaniasis in Sri Lanka: A Research Review

Description

Leishmaniasis in Sri Lanka: A Research Review has presented a unique and interesting scientific problem; Leishmania donovani-induced cutaneous leishmaniasis (CL). This new clinical entity is increasingly reported in many countries at present. This book presents the story of leishmaniasis in Sri Lanka through the author’s 20-year experience. Through its comprehensive 13 chapters, book sheds crucial light on the past, present, and future of leishmaniasis on the island while covering historical aspects, progression in research on parasite, vector, host, immunology, clinical, diagnostic, treatment, patient care, and their corresponding trends The content builds gradually to a final discussion of the gaps in knowledge, research needs, capacity building and a model to manage an emerging health issue in a country. This concise yet comprehensive book is an ideal thought-provoking reference guide to professionals with a keen interest in the field of leishmaniasis. Key Features • Provides a comprehensive and complete resource on leishmaniasis, including various aspects of the disease, distilling credible information from available literature coupled with historical references. • Follows a model approach for handling emerging infectious diseases for the benefit of clinicians and front-line workers. • Discusses the unique problem of skin localizing visceralizing parasites of Leishmania and provides basic principles of management for other infectious diseases and vector-borne infections. 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