Is Leishmaniasis adequately notified in Sri Lanka? A survey among doctors from high endemic district of Sri Lanka.
Abstract Background : Leishmaniasis is a notifiable disease in Sri Lanka since 2008. Previous studies show a gap in the notification. Purpose of the present study was to determine the Knowledge, attitudes and practice of medical officers regarding leishmaniasis. Methods : A cross-sectional study was conducted in Anuradhapura district which reported the highest prevalence of leishmaniasis. Participants from public and private health care institutes in the area filled a self-administered questionnaire in the presence of the investigators. Results : One hundred and eighty-eight (188) medical officers (involved in treating 75,326 population) completed the questionnaire. Of them, 95.7% (n=177) were aware of leishmaniasis as a parasitic infection and 84.7% (n=155) correctly identified Leishmania donovani as the causative organism in Sri Lanka. From the respondents, 96.8% (n=181) knew that the vector of leishmaniasis is sandfly. Cutaneous leishmaniasis was reported as the most prevalent form of leishmaniasis in the country by 94.1% (n=176). Nearly half of the population (54.1%, n=98) was aware of the fact that Anuradhapura district has the highest prevalence of the disease. Many of them had the idea that leishmaniasis is an emerging disease (84.3%, n=155) and early diagnosis is important in controlling the disease (89.1%, n=163). Although about three fourth (73.7 %, n=123) of the population mentioned that leishmaniasis should be notified at first clinical suspicion, only 42.5% (n=74) were aware that it is a legal requirement. Some medical officers (22%, n=39) believed the current notification system in the country is not effective. Unavailability of notification forms (36.8%, n=60), heavy workload (50.3%, n=85) and inadequate supportive staff (35.1%, n=55) were reported as barriers for timely notification. Even though 58.0% (n=105) of medical officers had suspected leishmaniasis during last eight years period only 19.4% (n=35) had notified. Conclusions : Even though more than 90% of the participants had good theoretical knowledge about leishmaniasis; notification of leishmaniasis is considerably inadequate. This study emphasizes the need for greater efforts to improve the notification of leishmaniasis in Sri Lanka. Keywords : Leishmaniasis, Notification, Physicians, Knowledge, attitude, practice, Sri Lanka