Economic impact and risk factors affecting transmission of cutaneous leishmaniasis in the district of Matara, Sri Lanka

Abstract

Cutaneous leishmaniasis (CL) has shown a rising trend in Sri Lanka since 2008 and the disease is associated with low socio-economic status. The current study aimed to determine the economic burden of CL on households and the risk factors affecting transmission of CL in the district of Matara, Sri Lanka. Information on household, demographic, socio-economic characteristics and direct/indirect cost incurred for CL were obtained from patients reported in 2018 and 2019 in three selected medical officers of health areas in the district of Matara using an interviewer-administered questionnaire in 2019 and 2020. Monthly climatic factors, rainfall, temperature and humidity data were obtained from the meteorology department. A total of 101 patients from 100 households were interviewed, of which 53.5% (54/101) were males and the majority of them 67% (36/54) were heads of the household. The median age of patients was 40 years (IQR= 54-19) and household size was five persons (IQR=5-4). A majority of patients, 56.4% (57/101) were economically active at the time of their illness. Of them, 68.4% (39/57) of the individuals were the only persons contributing to the household income. The main source of income of the majority of patients, 29.8% (17/101) was agricultural practices. The median monthly income of a patient was 108.1 USD (SRL Rs. 20,000) (IQR = 135-70.3USD) in 2020. Because of the free health services, there was no significant economic impact of cutaneous leishmaniasis on households. The number of CL cases was positively correlated with temperature (r=0.314) and negatively correlated with precipitation (r= -0.275) and humidity (r=-0.281). The presence of domestic animal reservoirs (96%=96/100), gender (males 53.5%=245/101), age (40 years, IQR=54-19), mean percentage of vegetation cover (47%=47/100), occupation (agricultural- 29.8%), and the average time of outdoor activities (5-6 hours per day), are the other risk factors associated with transmission of CL in the District of Matara.