Knowledge, attitudes, and awareness of leishmaniasis in selected MOH areas in Sri Lanka: Perspectives from the public and healthcare officials

Leishmaniasis, predominantly in its cutaneous form, has been present in Sri Lanka for over two decades; however, public awareness of the disease, its vectors, and control measures remains low. A cross-sectional survey was conducted from February 2023 to October 2024 in ten Medical Officer of Health (MOH) areas across five districts, representing high-, moderate-, and low-risk zones. Two structured, interviewer-administered questionnaires were developed: one for the general public (aged 13–65 years) and another for healthcare personnel (Nurses, Public Health Inspectors, Public Health Midwives, Healthcare Assistants, and Pharmacists), to assess Knowledge, Attitudes, Perceptions, and Practices related to leishmaniasis. A total of 1,000 community participants were recruited through household visits, and 100 healthcare personnel were enrolled from local health institutions using purposive sampling. Data were analyzed using descriptive statistics, chi-square tests, ANOVA, and logistic regression to assess associations and predictors of awareness. Among participants, females accounted for 56%, and the majority were aged 35–55 years (48%). Awareness of leishmaniasis was low, with only 46% of previously diagnosed patients having prior knowledge of the disease. Significant differences in awareness were observed by education level (p = 0.001), gender (p = 0.019), and MOH area (p = 0.001). Although 72% of participants had heard of sandflies, only 30% correctly identified them as vectors. Preventive practices such as the use of insect repellents (34%) and insecticide-treated nets (8%) were limited. Among healthcare personnel, 84% were aware of leishmaniasis; however, only 40% could identify patients based on symptoms, and just 12% had received formal training. More than 90% expressed the need for further training. Identified risk factors included engagement in outdoor activities (87%) and frequent visits to forested (55%) and agricultural areas (14%), which increase exposure to sandflies. These findings reveal key gaps in awareness and prevention, underscoring the need for targeted awareness and improved vector control in Sri Lanka.