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Spatiotemporal distribution of cutaneous leishmaniasis in Sri Lanka and future case burden estimates

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dc.contributor.author Karunaweera, N.D.
dc.contributor.author Senanayake, S.
dc.contributor.author Ginige, S.
dc.contributor.author Silva, H.
dc.contributor.author Manamperi, N.
dc.contributor.author Samaranayake, N.
dc.contributor.author Dewasurendra, R.
dc.contributor.author Karunanayake, P.
dc.contributor.author Gamage, D.
dc.contributor.author de Silva, N.
dc.contributor.author Senarath, U.
dc.contributor.author Zhou, G.
dc.date.accessioned 2021-04-27T09:18:54Z
dc.date.available 2021-04-27T09:18:54Z
dc.date.issued 2021
dc.identifier.citation PLoS Neglected Tropical Diseases. 2021; 15(4):e0009346. en_US
dc.identifier.issn 1935-2735 (Electronic)
dc.identifier.issn 1935-2727 (Print)
dc.identifier.issn 1935-2727 (Linking)
dc.identifier.uri http://repository.kln.ac.lk/handle/123456789/22175
dc.description Indexed in MEDLINE en_US
dc.description.abstract BACKGROUND: Leishmaniasis is a neglected tropical vector-borne disease, which is on the rise in Sri Lanka. Spatiotemporal and risk factor analyses are useful for understanding transmission dynamics, spatial clustering and predicting future disease distribution and trends to facilitate effective infection control. METHODS: The nationwide clinically confirmed cutaneous leishmaniasis and climatic data were collected from 2001 to 2019. Hierarchical clustering and spatiotemporal cross-correlation analysis were used to measure the region-wide and local (between neighboring districts) synchrony of transmission. A mixed spatiotemporal regression-autoregression model was built to study the effects of climatic, neighboring-district dispersal, and infection carryover variables on leishmaniasis dynamics and spatial distribution. Same model without climatic variables was used to predict the future distribution and trends of leishmaniasis cases in Sri Lanka. RESULTS: A total of 19,361 clinically confirmed leishmaniasis cases have been reported in Sri Lanka from 2001-2019. There were three phases identified: low-transmission phase (2001-2010), parasite population buildup phase (2011-2017), and outbreak phase (2018-2019). Spatially, the districts were divided into three groups based on similarity in temporal dynamics. The global mean correlation among district incidence dynamics was 0.30 (95% CI 0.25-0.35), and the localized mean correlation between neighboring districts was 0.58 (95% CI 0.42-0.73). Risk analysis for the seven districts with the highest incidence rates indicated that precipitation, neighboring-district effect, and infection carryover effect exhibited significant correlation with district-level incidence dynamics. Model-predicted incidence dynamics and case distribution matched well with observed results, except for the outbreak in 2018. The model-predicted 2020 case number is about 5,400 cases, with intensified transmission and expansion of high-transmission area. The predicted case number will be 9115 in 2022 and 19212 in 2025. CONCLUSIONS: The drastic upsurge in leishmaniasis cases in Sri Lanka in the last few year was unprecedented and it was strongly linked to precipitation, high burden of localized infections and inter-district dispersal. Targeted interventions are urgently needed to arrest an uncontrollable disease spread. en_US
dc.language.iso en_US en_US
dc.publisher Public Library of Science en_US
dc.subject Spatiotemporal distribution en_US
dc.title Spatiotemporal distribution of cutaneous leishmaniasis in Sri Lanka and future case burden estimates en_US
dc.type Article en_US


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