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Alqahtani SS, Menachery SJ, Ravi R, Hakami T, Almalki M. The use and perceived value of electronic health information resources by health care professionals in the field of medicine, pharmacy, and nursing in Jazan province, Saudi Arabia. Saudi Pharm J 2024; 32:102056. [PMID: 38577489 PMCID: PMC10992691 DOI: 10.1016/j.jsps.2024.102056] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/08/2024] [Accepted: 03/27/2024] [Indexed: 04/06/2024] Open
Abstract
Background Healthcare workers increasingly use Electronic Health Information Resources (EHIRs) to make evidence-based decisions. Our study was intended to assess the perception, attitude, and practice of healthcare professionals in medicine, pharmacy, and nursing regarding their perceived value and use of EHIRs. Methods We conducted an observational cross-sectional study using a pre-validated questionnaire among healthcare professionals in Jazan province from September 2022 to February 2023. We included healthcare professionals and interns with medical, pharmacy, or nursing degrees and excluded those who refused informed consent. Results We included fully completed data from 294 participants, with an actual response rate of just 80.1 %. Almost 87.41 % utilized the health information resources at their workplace, with UpToDate [39.45 %] and Medscape [67.01 %] being the most frequently used medical databases. The health facilities' access to electronic health resources significantly impacted healthcare professionals' [p = 0.04] and medical interns' [p = 0.02] roles. Faculty members felt the need to access electronic health information at their workplace [p = 0.00]. Lack of time to access electronic health information due to a busy schedule was a significant reason that impacted the attitude of medical professionals [p = 0.008] and nursing staff [p = 0.025]. An excessive amount of clinically unrelated data was the primary obstacle (181/294, p < 0.0001) in using electronic health information resources. Conclusion Our study showed the pattern of healthcare professionals using EHIRs in the Jazan province, Saudi Arabia. We believe the study's outcome can help increase the calibre of electronic health information services available to healthcare professionals and raise awareness of different EHIRs in improving clinical care.
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Affiliation(s)
- Saad S. Alqahtani
- Department of Clinical Pharmacy, College of Pharmacy, King Khalid University, Abha, Saudi Arabia
| | - Santhosh Joseph Menachery
- Pharmacy Practice Research Unit, Clinical Pharmacy Department, College of Pharmacy, Jazan University, Jazan, Saudi Arabia
| | - Renju Ravi
- Department of Clinical Pharmacology, Faculty of Medicine, Jazan University, Jazan, Saudi Arabia
| | - Tahir Hakami
- Department of Clinical Pharmacology, Faculty of Medicine, Jazan University, Jazan, Saudi Arabia
| | - Manal Almalki
- Department of Health Informatics, Faculty of Public Health and Tropical Medicine, Jazan University, Box 82726, Jazan, Saudi Arabia
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Kukkaro P, Vedithi SC, Blok DJ, van Brakel WH, Geluk A, Srikantam A, Scollard D, Adams LB, Duck M, Anand S, Tucker A, Cruz I, Pemmaraju VRR, Dagne DA, Asiedu K, Hanna C. Target product profiles: leprosy diagnostics. Bull World Health Organ 2024; 102:288-295. [PMID: 38562197 PMCID: PMC10976862 DOI: 10.2471/blt.23.290881] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/18/2023] [Revised: 11/22/2023] [Accepted: 12/06/2023] [Indexed: 04/04/2024] Open
Abstract
The World Health Organization (WHO) aims to reduce new leprosy cases by 70% by 2030, necessitating advancements in leprosy diagnostics. Here we discuss the development of two WHO's target product profiles for such diagnostics. These profiles define criteria for product use, design, performance, configuration and distribution, with a focus on accessibility and affordability. The first target product profile outlines requirements for tests to confirm diagnosis of leprosy in individuals with clinical signs and symptoms, to guide multidrug treatment initiation. The second target product profile outlines requirements for tests to detect Mycobacterium leprae or M. lepromatosis infection among asymptomatic contacts of leprosy patients, aiding prophylactic interventions and prevention. Statistical modelling was used to assess sensitivity and specificity requirements for these diagnostic tests. The paper highlights challenges in achieving high specificity, given the varying endemicity of M. leprae, and identifying target analytes with robust performance across leprosy phenotypes. We conclude that diagnostics with appropriate product design and performance characteristics are crucial for early detection and preventive intervention, advocating for the transition from leprosy management to prevention.
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Affiliation(s)
| | | | - David J Blok
- Department of Public Health, Erasmus University Medical Center, Rotterdam, Kingdom of the Netherlands
| | | | - Annemieke Geluk
- Department of Infectious Diseases, Leiden University Medical Center, Leiden, Kingdom of the Netherlands
| | - Aparna Srikantam
- Clinical and Laboratory Research Division, Blue Peter Public Health and Research Centre-LEPRA Society, Hyderabad, India
| | - David Scollard
- National Hansen’s Disease Program, Baton Rouge, United States of America (USA)
| | - Linda B Adams
- National Hansen’s Disease Program, Baton Rouge, United States of America (USA)
| | - Mathias Duck
- The Leprosy Mission International, Brentford, England
| | | | - Andie Tucker
- The Task Force for Global Health, Inc, Decatur, USA
| | - Israel Cruz
- National School of Public Health, Instituto de Salud Carlos III, Madrid, Spain
| | - VRR Pemmaraju
- Global Leprosy Programme, WHO Regional Office for South-East Asia, New Delhi, India
| | - Daniel Argaw Dagne
- Department of Control of Neglected Tropical Diseases, World Health Organization, Geneva, Switzerland
| | - Kingsley Asiedu
- Department of Control of Neglected Tropical Diseases, World Health Organization, Geneva, Switzerland
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Utap MS, Ng CJ, Lee YK, Kiyu A. Prevalence Trend and Clinical Profile of Leprosy Among the Indigenous Penan Community in Rural Baram, Sarawak, Malaysia: A Retrospective Study. Asia Pac J Public Health 2024; 36:219-224. [PMID: 38258742 DOI: 10.1177/10105395241227507] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/24/2024]
Abstract
In Malaysia, despite achieving leprosy-elimination status in 1994, leprosy remains a public health issue among the indigenous Penan community in Sarawak. This study aimed to determine the prevalence trend and clinical profile of leprosy among the Penans in rural Baram, Sarawak, Malaysia. A retrospective records review was conducted on 10-year (2008-2018) time trend of annual prevalence rate and 5-year (2013-2018) Penan leprosy patient clinical profile. Out of the 257 new cases of leprosy reported in Sarawak, 42.8% were Penans, and 72.7% were from Baram. The annual Penan ethnic-specific prevalence rate ranged from 2.08 to 35.5/10 000. Forty-six cases were analyzed for clinical profile: There were more males, active case detection, and multibacillary leprosy. The prevalence trend of leprosy among the Penans in rural Baram exceeded recommended elimination targets. Majority of the cases were detected through active case detection, but cases were detected late. Interventions are needed to improve early diagnosis and detection to achieve elimination of leprosy.
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Affiliation(s)
| | - Chirk Jenn Ng
- SingHealth Polyclinics, Singapore
- Duke-National University of Singapore Medical School, Singapore
| | - Yew Kong Lee
- Department of Primary Care Medicine, Faculty of Medicine, Universiti Malaya, Kuala Lumpur, Malaysia
| | - Andrew Kiyu
- Faculty of Medicine and Health Science, University Malaysia Sarawak, Kota Samarahan, Malaysia
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Batista G, Dioussé P, Diagne PM, Cissé M, Tamba IT, Diop F, Diop F, Fall L, Sakho D, Bammo M, Guèye N, Kasang C, Ortuño-Gutiérrez N, Zoubi LH, Diop MM. Feasibility of post-exposure-prophylaxis with single-dose rifampicin and identification of high prevalent clusters in villages' hyperendemic for leprosy in Senegal. PLoS Negl Trop Dis 2024; 18:e0011755. [PMID: 38300955 PMCID: PMC10863860 DOI: 10.1371/journal.pntd.0011755] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/03/2023] [Revised: 02/13/2024] [Accepted: 01/14/2024] [Indexed: 02/03/2024] Open
Abstract
INTRODUCTION Senegal is a leprosy low-endemic country with nine villages known to be hyperendemic with a leprosy incidence rate above 1,000 per million inhabitants. We aim to implement a door-to-door screening strategy associated with the administration of a single-dose-rifampicin (SDR) as post-exposure prophylaxis (PEP) to household and social contacts in these villages and to identify spatial clustering and assess the risk of leprosy in population according to the physical distance to the nearest index-case. METHODS From October/2020 to February/2022 active door-to-door screening for leprosy was conducted in nine villages. Using an open-source application, we recorded screening results, demographic and geographic coordinate's data. Using Poisson model we analysed clustering and estimated risk of contracting leprosy in contacts according to the distance to the nearest new leprosy patient. RESULTS In nine villages, among 9086 contacts listed, we examined 7115. Among 6554 eligible contacts, 97.8% took SDR. We found 39(0.64%) new leprosy cases among 6,124 examined in six villages. Among new cases, 21(53.8%) were children, 10(25.6%) were multibacillary and 05(12.8%) had grade 2 disability. The prevalent risk ratio and 95% confidence intervale(95%CI) adjusted by village were 4.2(95%CI 1.7-10.1), 0.97(95%CI 0.2-4.4), 0.87(95%CI 0.2-25), 0.89(95%CI 0.3-2.6) and 0.70(95%CI 0.2-2.5) for the contacts living in the same household of an index case, 1-25m, 26-50m, 51-75m and 76-100m compared to those living at more than 100m respectively. We identified nine high prevalent clusters including 27/39(69%) of new cases in 490/7,850(6%) inhabitants, with relative risks of 46.6(p-value = 0.01), and 7.3, 42.8, 8.2, 12.5, 11.4, 23.5, 22.3, and 14.6 (non-significant p-values). CONCLUSIONS Our strategy has proved the feasibility of active screening for leprosy in contacts and the introduction of PEP for leprosy under programmatic conditions. Only individuals living in the same household as the leprosy patient had a significant risk of contracting leprosy. We documented nine clusters of leprosy that could benefit from tailored control activities while optimizing resources.
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Affiliation(s)
| | - Pauline Dioussé
- Unité de Formation et Recherche en Santé, Université de Thiès, Sénégal
| | - Papa Mamadou Diagne
- Association Sénégalaise de lutte contre la lèpre et les MTN (ASCL/MTN), Dakar, Sénégal
| | - Mahamat Cissé
- Association allemande de lutte contre la lèpre et la tuberculose–DAHW Sénégal
| | | | - Fatou Diop
- Centre hospitalier régional de Kaolack, Sénégal
| | - Fanta Diop
- Centre hospitalier régional de Louga, Sénégal
| | - Lahla Fall
- Centre hospitalier de l’ordre de Malte–CHOM Dakar, Sénégal
| | - Diama Sakho
- Centre hospitalier régional de Ziguinchor, Sénégal
| | | | | | - Christa Kasang
- DAHW German Leprosy and Tuberculosis Relief Association, Germany
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Santos GMCD, Byrne RL, Cubas-Atienzar AI, Santos VS. Factors associated with delayed diagnosis of leprosy in an endemic area in Northeastern Brazil: a cross-sectional study. CAD SAUDE PUBLICA 2024; 40:e00113123. [PMID: 38198383 PMCID: PMC10775965 DOI: 10.1590/0102-311xen113123] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/20/2023] [Revised: 08/19/2023] [Accepted: 10/05/2023] [Indexed: 01/12/2024] Open
Abstract
This study aimed to investigate the factors related to the individual and the health system that contribute to delayed diagnosis of leprosy in an endemic area in the Northeastern Brazil. This is a cross-sectional study of 120 individuals with leprosy. Demographic and clinical data and information on the factors related to the individual and the health system that contribute to delayed diagnosis of leprosy were obtained. Delayed diagnosis in months was estimated for each participant by interviews. A multivariate Poisson's regression analysis was performed between the outcome and the independent variables. The median delay in the diagnosis of leprosy was 10.5 (4.0-24.0) months. Approximately 12.6% of participants had grade 2 disability (G2D) at the time of diagnosis. In the multivariate Poisson regression analysis, males, older age, low schooling level, residing in urban areas, multibacellar or tuberculoid leprosy, not seeking healthcare immediately after symptom onset, suspected leprosy, excessive referrals, and the need for three or more consultations to confirm the diagnosis were associated with longer diagnostic delay. This study found a significant delay in the diagnosis of leprosy in Arapiraca, Northeastern Brazil, which may explain the continuously high rate of G2D among new cases. Factors related to the individual and the health system were associated with longer diagnostic delay. Interventions to raise awareness of the disease among the general population and strengthen primary health care are urgently needed.
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Duighuisen HNW, Fastenau A, Eslava Albarracin DG, Ortuño-Gutiérrez N, Penna S, Kamenshchikova A. Scrutinising delay in leprosy diagnosis in Colombia: perceptions and experiences by leprosy health professionals. Glob Public Health 2024; 19:2354777. [PMID: 38794800 DOI: 10.1080/17441692.2024.2354777] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/23/2023] [Accepted: 05/08/2024] [Indexed: 05/26/2024]
Abstract
Leprosy is an infectious neglected tropical disease, which can cause irreversible disabilities if not diagnosed in time. Colombia continues to show high rates of leprosy-related disability, mainly due to a delay in diagnosis. Limited knowledge is available that explains this delay, therefore our study aimed to explore the perceptions and experiences of leprosy health professionals with the delay in leprosy diagnosis in the Cesar and Valle del Cauca departments, Colombia. Nine semi-structured expert interviews with leprosy health professionals were conducted in May-June 2023 in Colombia. Thematic analysis was performed to analyse the interview results. Our analysis highlighted that the main reasons for delay at the health system-level included accessibility issues to obtain a diagnosis, lack of expertise by health staff, and barriers related to the organisation of the care pathway. Individual - and community-level factors included a lack of leprosy awareness among the general population and leprosy-related stigma. Diagnostic delay consists of a fluid interplay of various factors. Structural changes within the health system, such as organising integral leprosy care centres and highlighting leprosy in the medical curriculum, as well as awareness-related interventions among the general population, might help reducing diagnostic delays.
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Affiliation(s)
- Heleen Neeltje Willemijn Duighuisen
- Department of Health, Ethics and Society, Faculty of Health, Medicine and Life Sciences, Maastricht University, Maastricht, the Netherlands
- German Leprosy and Tuberculosis Relief Association (GLRA/DAHW), Bogotá, Colombia
| | - Anil Fastenau
- Department of Health, Ethics and Society, Faculty of Health, Medicine and Life Sciences, Maastricht University, Maastricht, the Netherlands
- Department of Global Health, Institute of Public Health and Nursing Research, University of Bremen, Germany
- German Leprosy and Tuberculosis Relief Association (GLRA/DAHW), HQ, Wuerzburg, Germany
- Heidelberg Institute of Global Health, University of Heidelberg, Heidelberg, Germany
- Marie Adelaide Leprosy Center, Karachi, Pakistang Escuela de Enfermería, Fundación Universitaria Cafam, UNICAFAM, Bogotá, Colombia
| | - Daniel Gonzalo Eslava Albarracin
- German Leprosy and Tuberculosis Relief Association (GLRA/DAHW), Bogotá, Colombia
- Escuela de Enfermería, Fundación Universitaria Cafam, UNICAFAM, Bogotá, Colombia
| | | | - Srilekha Penna
- German Leprosy and Tuberculosis Relief Association (GLRA/DAHW), New Delhi, India
| | - Alena Kamenshchikova
- Department of Health, Ethics and Society, Department of Social Medicine, Department of Medical Microbiology, Infectious Diseases and Infection Prevention, Maastricht University, Maastricht, the Netherlands
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Dharmawan Y, Korfage IJ, Abqari U, Widjanarko B, Richardus JH. Measuring leprosy case detection delay and associated factors in Indonesia: a community-based study. BMC Infect Dis 2023; 23:555. [PMID: 37626291 PMCID: PMC10464084 DOI: 10.1186/s12879-023-08552-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/20/2023] [Accepted: 08/21/2023] [Indexed: 08/27/2023] Open
Abstract
BACKGROUND Leprosy is a public health burden in Indonesia with a high number of new cases every year and a high proportion of disability among new cases. Case detection delay (CDD) can contribute to ongoing transmission and increased disability chances among leprosy patients. This study aimed to establish the CDD of leprosy and the factors associated with detection delay in Indonesia. METHOD Community-based study with a cross-sectional design. Data were collected through interviews about sociodemographic and behavioral factors, anticipated stigma, and duration of CDD. Leprosy classification and case detection methods were obtained from health service records. A random sample was taken of 126 leprosy patients registered between 1st October 2020 and 31st March 2022 in the Tegal regency in the Central Java Province. Data were analysed by descriptive and analytical statistics using multiple linear regression. RESULTS The mean CDD, patient delay, and health system delay were 13.0 months, 9.7 months, and 3.2 months, respectively. Factors associated with longer CDD are younger age (below 35 years), male, found through passive case detection, and not having a family member with leprosy. Factors associated with longer patient delay were being younger (below 35 years), being male, not having a family member with leprosy, and anticipated stigma of leprosy. It was not possible to reliably identify factors associated with health system delay. CONCLUSION CDD in leprosy should be reduced in Indonesia. The Indonesian National Leprosy Control Program (NLCP) is advised to adopt an integrated intervention programme combining active case detection with targeted health education to reduce CDD and thereby preventing disabilities in people affected by leprosy.
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Affiliation(s)
- Yudhy Dharmawan
- Department of Public Health, Erasmus MC, University Medical Center Rotterdam, Rotterdam, the Netherlands.
- Faculty of Public Health, Universitas Diponegoro, Semarang, Indonesia.
| | - Ida J Korfage
- Department of Public Health, Erasmus MC, University Medical Center Rotterdam, Rotterdam, the Netherlands
| | - Ulfah Abqari
- Department of Public Health, Erasmus MC, University Medical Center Rotterdam, Rotterdam, the Netherlands
- NLR Indonesia, Jakarta, Indonesia
| | - Bagoes Widjanarko
- Faculty of Public Health, Universitas Diponegoro, Semarang, Indonesia
| | - Jan Hendrik Richardus
- Department of Public Health, Erasmus MC, University Medical Center Rotterdam, Rotterdam, the Netherlands
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Gunasekara SD, Wickramasinghe ND, Agampodi SB, Fernando MS, Weerakoon KG, Liyanage C, Dikomitis L, Agampodi TC. 'We do not rush to the hospital for ordinary wounds (suḷu tuvāla)': A qualitative study on the early clinical manifestations of cutaneous leishmaniasis and associated health behaviours in rural Sri Lanka. PLoS Negl Trop Dis 2023; 17:e0010939. [PMID: 37172051 DOI: 10.1371/journal.pntd.0010939] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/09/2022] [Revised: 05/24/2023] [Accepted: 04/29/2023] [Indexed: 05/14/2023] Open
Abstract
BACKGROUND Knowledge of early clinical manifestations, people's perceptions and behaviours is crucial in preventing and controlling neglected tropical diseases (NTDs). Cutaneous leishmaniasis is an NTD that causes skin lesions and affects millions worldwide. Delayed healthcare-seeking behaviour leading to prolonged treatment periods and complications is rife among people with cutaneous leishmaniasis. This study examined the patient-reported early clinical manifestations of cutaneous leishmaniasis, local interpretations and associated health behaviours within the socio-cultural context of rural Sri Lanka. METHODOLOGY/PRINCIPAL FINDINGS We conducted a qualitative study among people with cutaneous leishmaniasis in three rural communities in the Anuradhapura district, Sri Lanka. Participants' experiences were explored through a study-bespoke participant experience reflection journal and in-depth interviews. We analysed the data using a narrative-thematic approach. The study included 30 people with cutaneous leishmaniasis (12 females and 18 males) aged between 18 and 75 years. We identified four major themes during the analysis: 1) patient-reported early clinical manifestations of cutaneous leishmaniasis, 2) local interpretations of the early skin lesion(s), 3) associated actions and behaviours, and 4) the time gap between the initial notice of symptoms and seeking healthcare for cutaneous leishmaniasis. Early clinical manifestations differed among the participants, while the majority misinterpreted them as a mosquito/ant bite, pimple, wart, eczema, macule, or worm infestation. Participants undertook different context-specific self-management actions to cure cutaneous leishmaniasis. We identified an average time gap between the notice of symptoms and the first visit to the healthcare facility ranging from three to twelve months. CONCLUSIONS/SIGNIFICANCE Diverse early clinical manifestations, local interpretations, and associated behaviours of people with cutaneous leishmaniasis have led to a substantial delay in healthcare-seeking. The study sheds light on the importance of understanding the manifestations of NTDs within the social context. Our findings will inform designing context-specific health interventions to improve awareness and healthcare-seeking in cutaneous leishmaniasis in rural settings.
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Affiliation(s)
- Sonali Dinushika Gunasekara
- Department of Community Medicine, Faculty of Medicine and Allied Sciences, Rajarata University of Sri Lanka, Saliyapura, Anuradhapura, Sri Lanka
| | - Nuwan Darshana Wickramasinghe
- Department of Community Medicine, Faculty of Medicine and Allied Sciences, Rajarata University of Sri Lanka, Saliyapura, Anuradhapura, Sri Lanka
| | - Suneth Buddhika Agampodi
- Section of Infectious Diseases, Department of Internal Medicine, School of Medicine, Yale University, New Haven, Connecticut, United States of America
- International Vaccine Institute, Seoul, Republic of Korea
| | - Manoj Sanjeewa Fernando
- Department of Health Promotion, Faculty of Applied Sciences, Rajarata University of Sri Lanka, Mihintale, Anuradhapura, Sri Lanka
| | - Kosala Gayan Weerakoon
- Department of Parasitology, Faculty of Medicine and Allied Sciences, Rajarata University of Sri Lanka, Saliyapura, Anuradhapura, Sri Lanka
| | - Chandani Liyanage
- Department of Sociology, Faculty of Arts, University of Colombo, Colombo, Sri Lanka
| | - Lisa Dikomitis
- Kent and Medway Medical School, University of Kent and Canterbury Christ Church University, Canterbury, United Kingdom
| | - Thilini Chanchala Agampodi
- Department of Community Medicine, Faculty of Medicine and Allied Sciences, Rajarata University of Sri Lanka, Saliyapura, Anuradhapura, Sri Lanka
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