Some sociological aspects of cutaneous leishmaniasis in patients attending a tertiary referral centre in Colombo, Sri Lanka.

Over 1800 clinically suspected cases of cutaneous leishmaniasis have been referred to the Department of Parasitology, Faculty of Medicine, Colombo, Sri Lanka for investigation since 2001. This study analyses some sociological aspects of 120 patients with laboratory confirmed cutaneous leishmaniasis. This information is important to design and implement control programmes. The disease was predominant among males. In females lesions occurred mainly on the face, while in men they were seen mainly on the limbs. Immediate medical advice was sought by 13% of the population; the others sought treatment when the skin lesion grew or failed to heal. Females delayed seeking treatment as they probably misinterpreted the lesion as a pimple. Only 39% were referred to a Consultant Dermatologist by a medical officer during the first visit. The mean duration of time from the detection of the lesion to referral was approximately eight months. Psychologically, the presence of the lesion affected less than 20% of individuals. Costs related to treatment were relatively low in Sri Lanka. Late presentation and diagnostic delay was related to lack of awareness. Educational programmes should be carried out, aimed both at health care workers and the community to ensure early diagnosis and treatment for cutaneous leishmaniasis.