Health-seeking behaviour for leptospirosis in the Monaragala District of Sri Lanka

Introduction: Health-seeking behaviour (HSB) plays a crucial role in determining outcomes for infectious diseases such as leptospirosis, a bacterial zoonosis prevalent in tropical regions, including Sri Lanka. Understanding the factors influencing HSB is essential for improving early diagnosis and treatment, thereby reducing morbidity and mortality associated with the disease.  
Objectives: To evaluate the health-seeking practices of individuals in the Monaragala District, an endemic area for leptospirosis 
Methods: A hospital-based cross-sectional study was conducted from 2018 to 2019 in all major hospitals in the Monaragala District. Patients aged 15 years and older who were diagnosed with suspected leptospirosis were included. Data on socio-demographic characteristics, clinical presentations and laboratory results were collected through a pre-tested, interviewer-administered questionnaire. The timeliness of presentation, reasons for delays and their consequences were assessed. 
Results: Out of 450 participants, 77.6% presented late for medical care and the primary reasons for delays included misattributing symptoms to occupational hazards (23.8%) and lack of awareness of leptospirosis as a significant health threat (16.4%). Most participants first contacted general practitioners (53.3%) or government hospitals (43.1%). Laboratory confirmation rates showed a significant difference in timely versus delayed presentations. 
Conclusions & Recommendations: The findings highlight the urgent need for targeted health education campaigns in the Monaragala District to raise awareness of leptospirosis symptoms and encourage timely healthcare seeking. Enhancing community knowledge and engagement can improve early detection and treatment, ultimately reducing the disease burden in endemic areas.