The North Central Province is one of the nine provinces of Sri Lanka. With a population of 1.3 million, it is the second least populated province in the country. Local languages spoken are Sinhalese and Tamil. Almost 90% of the population is Buddhist. The provincial capital, Anuradhapura, is considered to be one of the most sacred cities in Sri Lanka, with many places of Buddhist worship being located in this area. The beginnings of the ancient city dates all the way back to prehistoric times, making it one of the oldest continuously inhabited cities in the world.
When we began the ECLIPSE project, it was believed that CL was an emerging public health issue in Sri Lanka. The first locally acquired case reported in the scientific literature was in 1992 (Athukorale et al 1992). However, research by the ECLIPSE Sri Lanka team has shown that CL is not emerging but actually re-emerging in the country. Searches of the Sri Lankan medical archives revealed that over 33,000 cases of the disease were reported in the country between 1904 and the 1960s. You can read more about this in our publication (Nuwangi et al 2022).
Since the 1990s, there has been a major increase in new cases, particularly in the north of the island. Our research has shown there is little awareness of the condition in these endemic regions, which are mainly rural and agricultural. The three ECLIPSE hubs are located in rural villages where paddy farming is the main economic activity.
Athukorale DN, Seneviratne JKK, Ihalamulla RL, Premaratne UN (1992). Locally Acquired Cutaneous Leishmaniasis in Sri Lanka. J Trop Med Hyg. 95:432–33. pmid:1460704
Nuwangi H, Weerakoon KG, Agampodi TC, Price HP, Dikomitis L, Agampodi SB (2022) Rewriting the history of leishmaniasis in Sri Lanka: An untold story since 1904. PLoS Negl Trop Dis 16(12): e0010918.