A Simple Intervention to Prevent Cutaneous Larva Migrans among Devotees of the Nallur Temple in Jaffna,Sri Lanka

Background

A cross sectional study conducted during the annual festival at Nallur temple in Jaffna, Sri Lanka, in 2010, showed that the prevalence of cutaneous larva migrants (CLM) among the devotees who performed the side roll ritual was 58.2% (95%CI: 51.2%–65.0%).

Objective

To test the hypothesis that the deworming stray dogs around the temple premises effectively reduces the prevalence of CLM among devotees.

Methodology/Principal Findings

All stray dogs (8) in the vicinity of the temple were treated, with mebendazole (100 mg) crushed and filled into sausages, 10 days before the commencement of festival in 2011. The same procedure was repeated a week later to ensure complete coverage. A cross-sectional study was conducted among 200 systematically selected devotees in August 2011 using an interviewer-administered questionnaire and the clinical examination of the skin. Baermann''s technique was used for the recovery of nematode larvae from 40 soil samples collected from the temple premises. Ten samples of dog faeces collected from the same premises were also examined for nematode eggs. Prevalence of CLM among devotees in 2010 (Pre intervention) and 2011(Post intervention) were compared to test the hypothesis. Prevalence of CLM declined from 58% to 8% (Chi-square = 112.90, p<0.001) following the intervention. None of the subjects practiced new precautionary measures compared to the previous year. Soil and fecal samples were negative for parasites.

Conclusions/Significance

Regular dog deworming is an important and effective method for the prevention of CLM among the devotees doing side roll ritual and represents a pragmatic intervention that municipal authorities could perform on annual basis.     

Resource partitioning among the fishes of rainforest streams in Sri Lanka

The fish assemblage typical of small rainforest streams of Sri Lanka was investigated to see if the fishes were characterized by a high degree of specialization, expected of equilibrium communities, or if they were relatively unspecialized, expected of more stochastic (non-equilibrium) communities. Morphological features, habitats, microhabitats and diets of the 20 most abundant fish species were measured. The fishes included 11 Cyprinidae (including seven Barbus spp. and two Rasbara spp.), two Gobiidae, two Channidae, and one species each in the Cobitidae, Cyprinodontidae, Belontidae, Belonidae, and Mastacembelidae. Microhabitats were determined by measuring (for 6760 fish) water column depth, distance of fish from bottom, mean water column velocity, water velocity at fish, and substrate. Morphologically, the species showed a high degree of specialization, especially in structures related to feeding. Although several species were habitat generalists, most species occurred in distinct habitats. Within habitats, microhabitat overlap among co-occuring species was low, particularly in relation to position in the water column. Principal component analysis of the microhabitat measurements produced three new variables. Most species not clearly segregated by the overlap analysis showed segregation on the new variables. Fishes not segregated by habitat or microhabitat tended to show low dietary overlaps. Specialization in feeding habits was more pronounced among the Sri Lankan fishes than noted for fishes in small rainforest streams elsewhere, in part because of the greater reliance of the Sri Lanka fishes on autochthonous foods. Overall, the fish assemblage had the characteristics expected of an equilibrium (deterministic) assemblage.     

Enterotoxigenic staphylococci in Sri Lanka

Two hundred and ninety-three strains of Staphylococcus aureus isolated from clinical specimens were tested for enterotoxigenicity by the Optimum Sensitivity Plate (OSP) method. Thirty-nine per cent produced enterotoxins A, B, C, D or E. Enterotoxin B was detected more often than the others. The OSP technique was found to be satisfactory for the detection of enterotoxigenic staphylococci.     

Infant mortality in Sri Lanka

Infant mortality in Sri Lanka declined substantially between 1961 and 1980, the reduction being higher during the post-natal period. 3 distinct phases were identified: 1) a declining trend in the face of several fluctuations; 2) a sharp reversal of the trend and then an increase; and 3) a more consistent decline. Between the periods 1961-65 and 1976-80, deaths from exogenous and endogenous causes were reduced considerably and nearly equally. The probabilities of survival increased in every age group, proportionally more in the 1st week of life. There was no evidence that changes in national income or total food supply were factors, but protein calorie availability appeared to affect the rate. Distribution of free supplementary food, increase in public health personnel, more immunization, and a rise in the number of institutional births appeared to have initiated and sustained the more recent decline in infant mortality. Increasing levels of female education also augmented these developments. Further efforts to improve living conditions, access to safe water and flush or water-seal toilets, and motivating women to deliver in institutions and extend their postnatal stay, would probably result in a further decline, as well as general strategies such as integrating public health and medical services and improving health education programs.     

Two imported cases of cutaneous larva migrans

Cutaneous larva migrans (CLM) is a rare serpiginous cutaneous eruption caused by accidental penetration and migration in the skin with infective larvae of nematode that normally do not have the human as their host. Although CLM has a worldwide distribution, the infection is most frequent in warmer climates. More recently, they have been increasingly imported from the tropics or subtropics by travelers. We experienced two patients who had pruritic serpiginous linear eruption in their skin for a few weeks after traveling to the endemic areas (Brazil and Thailand, respectively). After the treatment with albendazole, the skin lesions resolved with post-inflammatory hyperpigmentation. We report herein two cases of cutaneous larva migrans successfully treated with albendazole.     

Three clinical cases of cutaneous larva migrans

Three cases of cutaneous larva migrans (CLM) were diagnosed in a returnee from a trip to Thailand and in 2 domestic farmers during July and September, 2003. The linear and serpiginous skin lesions on the lower extremities were presented in all 3 cases. Routine laboratory findings were normal. In the imported case, a 650 x 30 micrometer sized filariform nematode larva, presumably a species of hookworm, was detected in the lesion. All cases were treated with 400 mg albendazole once daily for 3-5 days, and their skin lesions gradually improved. In the present study, a causative agent of CLM was isolated for the first time in the Republic of Korea. Moreover, we speculate that CLM is prevalent in farmers who are in frequent contact with soil in the Republic of Korea.     

Cutaneous Manifestations of Spotted Fever Rickettsial Infections in the Central Province of Sri Lanka: A Descriptive Study

Background

Characteristic skin lesions play a key role in clinical diagnosis of spotted fever group rickettsioses and this study describes these cutaneous manifestations along with basic histological features.

Methods and Findings

Study was conducted at Medical Unit, Teaching Hospital, Peradeniya, from November 2009 to October 2011, where a prospective data base of all rickettsial infections is maintained. Confirmation of diagnosis was made when IgM and IgG immunofluorescent antibody titre of 1/32 and >1/256 respectively. Of the 210 clinical cases, 134 had cutoff antibody titers for Rickettsia conorii antigen for confirmation. All these 134 patients had fever and skin rash, and of them 132(98%) had discrete maculopapular rash while eight (6%) had fern leaf type skin necrosis. Eight patients (6%) had healed tick bite marks. Average size of a skin lesion was 5 mm and rash involved 52% of body surface, distributed mainly in limbs and back of the chest. Generally the facial and leg skin was slightly oedematous particularly in old aged patients. Sixteen patients (12%) had pain and swelling of ankle joints where swelling extended to feet and leg. Biopsies from skin rash of six patients showed evidence of cutaneous vasculitis and of them, 247 bp region of the 17-kDa spotted fever group specific protein antigen was amplified using PCR.

Conclusions

A discrete maculopapular rash and occasional variations such as fern leaf shape necrosis and arthritis are found in spotted fever group. Histology found vasculitis as the pathology of these lesions.     

Ephemeroptera of Sri Lanka: Ephemeridae

Abstract Two new species of Ephemera are described, Ephemera supposita Eaton is redescribed, and Rhoenanthus posticus Banks is transferred to Ephemera and redescribed. A key to the imagos of Ephemera from Sri Lanka is included.     

Movement among healers in Sri Lanka: A case study of a sinhalese patient

Sinhalese patients in Sri Lanka have a variety of practitioners to choose from in seeking treatment for illness. These include: Ayurvedic physicians, Western physicians, and ritual practitioners. This paper traces the movement of a single patient seeking treatment for pissu (madness) from a number of healers. It is suggested that this movement of the patient among a variety of treatment systems allows a fluidity of diagnosis which prevents any one explanatory system from dominating her perception of her illness. It is also argued that treatments are linked by an underlying continuity of process, in which the personal antecedents of the illness are reinterpreted in terms of public representations of affliction and in which all treatments phrase illness most basically in terms of excess and imbalance.This paper was originally represented to an Anthropology Department colloquium at the University of Massachusetts, Boston, in the fall of 1977. I would like to thank the following people for reading and commenting on an earlier version of the paper: H. L. Seneviratne, Brenda Beck, David Landy, Nancy Waxler, Arthur Kleinman, Charles Ducey, Daniel Brown, John McCreery, and Allan Meyers.     

The Musca domestica complex in Sri Lanka

An account is given of samples of houseflies taken from various natural populations in Sri Lanka (Ceylon) to investigate the number of evolutionary forms of housefly that may occur on the island. The results are related to the formal taxonomy of the genus Musca.     

Visceral larva migrans (toxocariasis) in Toronto.

A 7-year-old child was admitted to Toronto''s Hospital for Sick Children in 1976 with symptoms and laboratory findings compatible with visceral larva migrans, a disease usually caused by Toxocara canis. This prompted a search for other cases seen at the hospital during the period 1952 through 1978. Only 18 cases were discovered that met at least three of six criteria and thus were considered possible or probably cases of the disease. Three possible cases of ocular toxocariasis during the same period were also uncovered. Fever was the commonest presenting symptom. Eosinophilia, leukocytosis and hyperglobulinemia were the most frequent laboratory findings. In view of the small number of cases found in 27 years at this large pediatric hospital with a broad referral base, it is concluded that visceral larva migrans poses little risk to the health of children in the Toronto area.     

Seroprevalence of Toxoplasma gondii in cats from Colombo, Sri Lanka

Cats are essential in the life cycle of Toxoplasma gondii because they are the only hosts that can excrete the environmentally resistant oocysts in nature. Nothing is known of the prevalence of Toxoplasma gondii in cats from Sri Lanka. Serum samples from 86 cats from Colombo, Sri Lanka, were tested for antibodies to T. gondii using the modified agglutination test; antibodies were found in 26 (30.2%) cats with titers of 1:25 in 4, 1:50 in 4, 1:100 in 3, 1:400 in 2, 1:800 in 3, 1:1,600 in 4, and 1:3,200 or higher in 6 cats. Seropositivity increased with age and was higher in stray cats versus pet cats. This is the first report of seroprevalence of T. gondii in cats from Sri Lanka.     

Constraints to the implementation of biological control in Sri Lanka

Sri Lanka is a tropical island with a rich diversity of arthropods, with many species of indigenous natural enemies of economic pests. However, no extensive island wide surveys have been carried out for natural enemies of major crop ecosystems and only a few of the indigenous natural enemies are reported useful for augmentation biological pest control by massive field releases of laboratory-produced insects. Most successful biological control programs on the island are importation (i.e. classical) biological control programs, where established exotic natural enemies control certain pest populations in valuable crops. There is growing interest in the use of native natural enemies in pest management, thus creating a need for intensive research on the ecology of indigenous natural enemies and development of infrastructure and technology to produce natural enemies for augmentation. This paper examines constraints and opportunities for implementation of biological control in Sri Lanka.     

Fungi associated with dried fish in Sri Lanka

The mycoflora of dried-salted fish from markets in Kandy, Sri Lanka was studied with emphasis on visibly spoiled dried fish. A total of 61 fungal isolates from 25 dried-fish were isolated and identified. The most prevalent fungus wasAspergillus niger. Species ofAspergillus flavus, A. fumigatus, A. glaucus, A. restrictus, Aureobasidium spp.Basipetospora halophila (a genuinely halophilic fungus)Cladosporium herbarum, Gliomastix, spp.,Penicillium chalybeum andPenicillium expansum were present. The isolated fungi did not grow in synthetic media containing more than 30% sodium chloride.Aureobasidium spp. andGliomastix spp. did not grow on dried-fish under laboratory conditions. The protective exoskeleton appeared to prevent fungal growth on dried shrimp. TheA. flavus strains isolated were not aflatoxigenic.