Cutaneous leishmaniasis: an emerging health risk in Sri Lanka.

Since the early 1990s this view changed with the recognition of autochthonous cutaneous leishmaniasis. The first documented case in 1992 was a young man from Ambalantota who initially gave a history of contact with dry zone jungle but later denied this history (1). This was followed a few years later by a number of cases from different parts of the island. The second and third case reports were from Mahiyangana (2) and Badulla (Seneviratne JKK. Personal communication). The later cases were from Pannala, Rajangana and Pottuvil (3). All were in young men presenting as cutaneous lesions in exposed body parts and with behaviour activities related to the scrub jungle. In 1996 a study done to assess disease prevalence in an area with potential risk of exposure using the leishmanin skin test and clinical examination in schoolchildren, failed to show wide prevalence. Of the 253 children examined, in the Yalwela School, close to Mahiyangana, none were leishmanin positive, nor was there clinical evidence of the disease. Two of the children tested with leishmanin, were positive. Dr. Luigi Gradoni supplied leishmanin for this study.