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Investigating disease awareness of cutaneous leishmaniasis in rural Sri Lanka to inform public health services: a cross-sectional study.

Gunasekara, Sonali Dinushika; Agampodi, Thilini Chanchala; Weerasinghe, Manjula; Fernando, Manoj Sanjeewa; Price, Helen Philippa; Wickramasinghe, Nuwan Darshana; Agampodi, Suneth Buddhika

Investigating disease awareness of cutaneous leishmaniasis in rural Sri Lanka to inform public health services: a cross-sectional study. Thumbnail


Authors

Sonali Dinushika Gunasekara

Thilini Chanchala Agampodi

Manjula Weerasinghe

Manoj Sanjeewa Fernando

Nuwan Darshana Wickramasinghe

Suneth Buddhika Agampodi



Abstract

ObjectiveTo assess community awareness of cutaneous leishmaniasis (CL) in a disease-endemic district in Sri Lanka.DesignPopulation-based cross-sectional study.SettingThis study was conducted in selected 158 Grama Niladhari divisions covering all the 22 Divisional Secretariat areas of the Anuradhapura district, Sri Lanka.Sampling technique and participantsA probability sample of households was selected using multistage cluster sampling. Adults (≥18 years) who resided permanently in the Anuradhapura district during the data collection period were eligible, and individuals who could not comprehend or respond to the questions were excluded. The primary or secondary healthcare-related decision-maker of 1555 households participated in the study, in which 1479 (95.1%) were Sinhalese in ethnicity, including 1157 (74.4%) females.Primary and secondary outcome measuresThe primary outcome measure was 'CL awareness,' operationalised by awareness of the disease name, transmission mode and the primary disease characteristic based on a systematic expert consensus approach. Secondary outcome measures included awareness and perceptions of CL curability, treatment centres and perceived susceptibility.ResultsOnly 3.6% (n=56) demonstrated CL awareness based on the definition. We observed low disease awareness even among people who claimed having CL or previously had the disease (n=6, 27.3%). While 1065 (68.5%) had heard the correct name ('leishmaniasis') or the local name ('wæli mæssāgē leḍē') for the disease, only 224 (21.0%) out of that knew the mode of transmission and 128 (12.0%) the chronic nature of CL skin lesions, respectively. Among the respondents with CL awareness (n=56), 42 (75.0%), 54 (96.4%) and 44 (88.0%) perceived CL as curable, were aware of treatment centres and expressed self-perceived susceptibility, respectively. Despite 423 (46.4%) who claimed to know more beyond the disease name, only 35 (8.3%) demonstrated actual CL awareness.ConclusionFindings highlight significantly low CL awareness in the disease-endemic Anuradhapura district, and we recommend developing evidence-based, context-specific public health interventions targeting CL awareness gaps.

Citation

Gunasekara, S. D., Agampodi, T. C., Weerasinghe, M., Fernando, M. S., Price, H. P., Wickramasinghe, N. D., & Agampodi, S. B. (2024). Investigating disease awareness of cutaneous leishmaniasis in rural Sri Lanka to inform public health services: a cross-sectional study. BMJ Open, 14(11), 1-10. https://doi.org/10.1136/bmjopen-2024-088714

Journal Article Type Article
Acceptance Date Oct 23, 2024
Online Publication Date Nov 24, 2024
Publication Date Nov 24, 2024
Deposit Date Dec 13, 2024
Publicly Available Date Dec 13, 2024
Journal BMJ open
Electronic ISSN 2044-6055
Publisher BMJ Publishing Group
Peer Reviewed Peer Reviewed
Volume 14
Issue 11
Article Number e088714
Pages 1-10
DOI https://doi.org/10.1136/bmjopen-2024-088714
Keywords Infectious diseases, Cross-sectional studies, Awareness, Neglected Diseases, Surveys And Questionnaires, Humans, Leishmaniasis, Cutaneous, Cross-Sectional Studies, Health Knowledge, Attitudes, Practice, Public Health, Adolescent, Adult, Aged, Middle Aged, Rural Population, Sri Lanka, Female, Male, Young Adult, Surveys and Questionnaires
Public URL https://keele-repository.worktribe.com/output/1013085
PMID 39581720

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This is an open access article distributed in accordance with the Creative Commons Attribution 4.0 Unported (CC BY 4.0) license, which permits others to copy, redistribute, remix, transform and build upon this work for any purpose, provided the original work is properly cited, a link to the licence is given, and indication of whether changes were made. See: https://creativecommons.org/licenses/by/4.0/.






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