Centre for Training, Research and Diagnosis of Leishmaniasis, UCFM.

Introduction                                                                                                       

Department of Parasitology has always been in the forefront for local research on parasites that are of medical importance.  Leishmaniasis is one of the main research  interests and this department has conducted pioneering work in the field of leishmaniasis in Sri Lanka and established the first diagnostic laboratory to facilitate patient care.Weekly leishmaniasis clinic was initiated in year 2001 in a small patient handling room in this department to carry out light microscopic diagnosis of leishmaniasis.  This clinic has now expanded and established with in-vitro culturing, PCR and serological assays that are offered for patients with all forms of leishmaniasis. All the services are provided free of charge to patients.

 

Activities

Publications

 

This centre  serves teaching and research purposes at present and it is coordinated by Dr. Yamuna Siriwardana. The aim of the laboratory is to investigate patients suspected of having this newly identified disease in Sri Lanka. It currently provides a free service for the whole island. Over 3000 patients referred from all over the island have been clinically evaluated and investigated so far with a view of providing a pre-treatment laboratory confirmation of leishmaniasis.

Weekly leishmaniasis clinic and the laboratory services   

Free services offered by the centre

Expert advice on case management and follow-up  

Technical advice on sample collection and transport

 

Description

Awareness programmes

Hospital visits for referrals

 Sample collection 

 Laboratory investigations

 Technical support

 Patient Follow up service

 Training of MLTs (For Ministry of Health)

  Free laboratory testing service                                                                 

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Visiting scientists to the centre

 Light microscopic examination of lesion aspirations, slit skin scrapings and touch smears

(bone marrow or any organ tissue examination)

 In-vitro cultivation 

 PCR

 Serology for visceral leishmaniasis

 

 Routine leishmaniasis clinic                                                                      
 
This is held at Department of Parasitology, Faculty of Medicine, University of Colombo on Tuesdays 8.30am-12.00 noon except public holidays and conducted by Dr Yamuna Siriwardana. Alternative dates are available by appointment.

How to send a sample?

  •  Samples accepted from  8.30 am - 12 noon

 

 

 Samples for microscopy can be sent immediately in room temperature. However, it is advised to  contact the laboratory before sending samples for other investigations. It is also advised to send  the samples without processing which will be  preferably carried out by the technical team of the  centre

  •  No formalin / No preservatives
  •  For more information please contact Ms. Udeshika/Mr.Sudath or any team member (Tel; 0112695300, ext 180)

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Leishmania parasites (X 1000)

 

Staff of the centre                                                                                        

  Leishmaniasis routine clinic and the laboratory

 Professor Nadira Karunaweera (Head of team)

 Dr Yamuna Siriwardana (laboratory in charge)

 Mr Sudath weerasinghe

 Ms Udeshika Kariyawasam,

 Ms Nirosha Pathirana

 

Laboratory diagnosis

Leishmaniasis research team

Prof. Nadira Karunaweera (Head of team)

Dr Yamuna Siriwardana  (Paraitological aspects, clinical and  epidemiological aspects)

Dr Sanath senanayake (Entomology)

Dr Nilaskhi Samaranayake (Human genetics)

Dr Panduka karunanayake (Clinical aspects of VL)

Dr Wardha Refai ( MD trainee)

Ms Udeshika Kariyawasam,(PhD trainee)

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Leishmanial ulcer on the face

 

Facts for professionals                                                                                 

What is leishmaniasis?

Leishmaniasis is a protozoan disease, caused by Leishmania species. The parasites are transmitted by female sand fly which is the known vector of leishmaniasis. This is usually an infection of vertebrate animals. Human infection is incidental. However, the burden of human leishmaniasis infection has expanded to result in a major global health issue and it is listed as one of the eight major neglected tropical parasitic diseases in the world. Leishmaniasis mainly affects tropical and subtropical countries. Number of leishmaniasis endemic sites is ever expanding with new foci and new epidemics in endemic sites being continuously reported at a global scale. Different clinical forms are associated with higher levels of morbidity and mortality also. Sri Lanka is a new focus of human leishmaniasis.  

When should you suspect leishmaniasis, what should be done? 

If there is a slow progressing, un-disturbing skin lesion or  fever without a known other reason in patient residing or working in a leishmaniasis prevalent area in Sri Lanka or in a person who had travelled abroad, it is justifiable to exclude leishmaniasis. Early clinical suspicion is important to avoid complications of long lasting illness.

 Thorough clinical evaluation and specific investigations are necessary to confirm/exclude.

 If leishmaniasis is confirmed, completion of the treatment regimen with investigation back up is very important.

 Thereafter a long term follow up of the patient for possible complications should be carried out.

 What are the methods of diagnosis?                                                        

 Parasitological /Microscopic detection

  • Slit skin smear (SSS)
  •  Lesion aspirate(LA)
  •  Impression smears
  •  Swabs from lesions
  • Punch biopsies

These samples can be obtained in patients with CL skin lesions.

Bone marrow, liver and splenic aspirations can be used in VL.

Serological diagnosis

  •   rK39
  •   Serum proteins (albumin and globulins )

Serological assays are performed mainly in VL.

Not very useful in CL, since an increase of antibody levels is not usually associated with CL.

 Genetic based diagnosis

  • Polymerase Chain Reaction(PCR) on lesion material / Bone marrow

PCR is an expensive investigation. Not available freely in health care settings. However, PCR can be used to diagnose CL, MCL and VL.