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Background/objectives: Sri Lanka has been targeted zero rabies by the end of 2025. Towards the elimination, the country needs more effective, evidence-based strategies and efforts to achieve its ultimate goal. Therefore, we conducted a systematic review of scientific literatures and data to assess current human and animal rabies control and prevention strategies in Sri Lanka., Methods: We compiled documents regarding current and previous rabies control and prevention activities implemented in the entire country of Sri Lanka. The documents included published literatures issued between 1946 and 2020 from both online databases and university library in Sri Lanka. All the collected documents were screened based on the PRISMA statement and categorized into several types of rabies control and prevention strategies. Official reports including epidemiological data in Sri Lanka were also filed in order to analyze the current trend of rabies control and prevention in the nation., Results: As of end December 2020, we found 119 scientific literatures regarding rabies control and prevention in Sri Lanka. Human rabies deaths in Sri Lanka have been reduced for the last half century by successful implementation of mass dog vaccination, animal birth control and awareness raising activities. However, the country is still facing on sporadic rabies cases, limited dog vaccination coverage and insufficient dog population management in the district level. Despite the nationwide standard of dog to human ratio of 1:8, there are huge disparities or unknown of dog ecology in regions. Awareness raising including has been enhancing for both general public and school children. Surveillance system is poorly operated so that simultaneous data analysis for decision-making is impractical., Conclusions: In order to achieve nationwide rabies elimination, it is highly recommended to implement more effective rabies control and prevention activities and build adequate scientific evidences., (Copyright © 2021. Published by Elsevier B.V.)

Currently, interventions for HIV/AIDS control in Sri Lanka are only carried out among the most-at-risk populations. This study was conducted to identify the level of awareness and stigma-related attitudes among the general population of Sri Lanka. A cross-sectional study was carried out among 869 residents of 18-64 years of age in Kandy, Sri Lanka. A self-administered questionnaire was utilised to obtain information about stigma, discrimination and HIV/AIDS-related knowledge. Chi-square test and multivariate analysis were applied to find possible associations between HIV-related variables and socio-demographic indicators. Response rate was 82.0%. Overall, 93.5% of the participants have heard of HIV/AIDS but the knowledge on HIV/AIDS was low with an average score of 51.7%, no statistically significant difference between genders (p = 0.352). Only 58.1% were aware that a condom was an effective tool for its prevention. There were many misconceptions related to epidemiology of HIV/AIDS. The participants showed more positive attitudes towards HIV/AIDS and people living with HIV/AIDS (PLHIV) for all questionnaire items except for those listed under shame and blame. Positive attitudes towards PLHIV were observed to be greater among those with a better HIV/AIDS-related knowledge score. There was no significant association between the attitudes towards PLHIV and socio-demographic characteristics such as ethnicity and religion. There is a greater need of making attempts towards educating the public regarding HIV/AIDS to eliminate misconceptions prevalent in the society. Stigma-related attitudes are mainly due to shame and blame associated with the disease. As the attitudes towards PLHIV were more positive among those with a better HIV/AIDS-related knowledge score, targeted HIV/AIDS-related health education interventions maybe recommended in this regard.

Religious leaders in Sri Lanka may have a high potential of contributing to HIV/AIDS prevention among the general public because of their social status. In order to assess their current HIV/AIDS-related knowledge and attitude and the possibility of becoming community advocates of HIV/AIDS prevention, we conducted a questionnaire survey among Buddhist, Hindu, Muslim and Christian leaders in Sri Lanka in 2009. There were limited correct responses about HIV/AIDS-related knowledge and attitudes toward people living with HIV/AIDS (PLHIV), and information regarding condoms, HIV testing and counselling were poorly understood. Although a condom was less acceptable as a part of HIV/AIDS prevention, they were willing to learn more about HIV/AIDS and expressed support for both PLHIV and HIV prevention activities. Their experiences, preparedness and willingness of HIV prevention activities were associated with age, knowledge and/or religious background. In conclusion, intensive and systematic learning opportunities should be provided to equip the religious leaders with overall HIV/AIDS knowledge to become key players for HIV/AIDS prevention in their communities.

To help formulate a local intervention for leptospirosis in Sri Lanka, we determined the serogroups of leptospiral species among 97 patients diagnosed with leptospirosis at the University of Peradeniya Teaching Hospital, Sri Lanka. Ninety-two point eight percent of the patients were men; nearly two-thirds were > or = 35 years old; the majority had secondary or higher education level, half were farmers or laborers; and 57.7% presented in the acute-phase of the illness. Twenty-five patients (25.8%) were confirmed to have leptospirosis by a positive laboratory method; 17 and 8 cases were confirmed with a positive test by quantitative MAT and nested PCR, respectively. Of the 17 MAT positive cases, infection occurred in a variety of serogroups, but the predominant groups were Sejroe and Tarassovi. Of the 8 nested PCR positive cases, 7 were seen among those with a MAT titer <200 and 1 occurred in a patient with a MAT titer > or = 200 but <400. Of the 8 PCR positive cases, 7 were infected with the leptospiral species L. interrogans. Approximately 26% of the clinically diagnosed patients were confirmed by the two laboratory methods. Laboratory positivity was based on the time of blood collection after the onset of fever. Further studies are warranted to refine the clinical diagnostic criteria and to develop more efficient and accurate diagnostic tests for leptospirosis in resource limited settings.

Leptospirosis is an important bacterial zoonotic disease globally and one of the notifiable diseases in Sri Lanka. Other than human leptospirosis, little information is available on leptospirosis in domestic and feral animals in Sri Lanka. Thus, this study attempted to determine the prevalence and carrier status of leptospirosis in smallholder dairy cattle and peridomestic rodents to understand the impact of the disease on public health in Kandy, Sri Lanka. Cattle and rodent samples were collected from the Yatinuwara and Udunuwara divisional secretaries in Kandy. Serum samples were analyzed for the presence of antileptospiral antibodies using microscopic agglutination test. DNA was extracted from cattle urine and rodent kidney tissue samples, in which polymerase chain reaction was carried out to detect the Leptospira flaB gene. The cattle in 19 (38.8%) of the 49 farms harbored antileptospiral antibodies. Out of 113 cattle serum samples, 23 (20.3%) were positive; 17 (73.9%) and 6 (26.1%) reacted with serogroups Sejroe and Hebdomadis, respectively. Out of the 74 rodent samples, 13 (17.5%) were positive; 8 (61.5%) and 4 (30.8%) had reactions to serogroups Javanica and Icterohaemorrhagiae, respectively. Leptospiral DNA was detected in one cattle urine sample and identified as Leptospira interrogans. This study revealed a high prevalence of leptospirosis in cattle and rodents in Kandy. These animals were infected with a wide array of leptospiral serogroups, which are consistent with the research findings observed in humans in Kandy. Overall, serological data indicate that relative to rodents, cattle may be a more significant reservoir for human transmission and a greater source of potential risk to local agricultural communities.

Background: Human immunodeficiency virus (HIV) prevalence is relatively lower in Sri Lanka than in other Asian countries; however, the number of HIV-infected persons has rapidly increased in recent years., Methodology: A baseline study on HIV, acquired immunodeficiency virus (AIDS), and sexually transmitted infections (STI) knowledge, attitude, and practice was conducted at two construction sites in Sri Lanka from January to February 2007 to design an effective intervention strategy for the construction workers., Results: Among 611 respondents (mostly males, mean age 32.8 years), nearly two-thirds lived away from home. Knowledge was fairly good on AIDS prevention but poorer on STI than on HIV. Some misconceptions were also observed. A high percentage did not consider HIV/AIDS as their own personal issue, and over 50% respondents expressed discriminatory attitudes towards HIV positives. Condom access was limited due to social and cultural norms. Mobility was not significantly associated with practice of prevention of HIV and STI., Conclusion: This study showed that the construction workers were not specially at higher risk of HIV at that time. In order to minimize the potential risk of infection, however, it would be effective to reduce stigma and discrimination among them through the prevention program, working together with community or religious leaders in the areas. More comprehensive assessment among other population groups would also be beneficial to identify their risk of infection.

Background: Rabies remains endemic in Sri Lanka despite a strong government patronized anti-rabies campaign. Personal, cultural or religious beliefs have been thought to influence health practices that could render rabies prevalent in the country., Methodology: The knowledge, attitudes, and beliefs of 580 household heads/members from Nuwara Eliya District, Sri Lanka, regarding rabies were explored through a structured questionnaire. An improvement/deterioration in their knowledge and practices after the use of information and education campaign (IEC) materials was assessed through a repeat exploration at an interval of four weeks., Results: Respondents showed inclination toward animal birth control (60%) rather than elimination methods (24%). There was disparity between pet owners enthusiasm to take pets for rabies inoculation (57%) and their ability to show dog vaccination cards (40%). Almost twice more pet owners than non-pet owners believed that it is their responsibility to control the population of roaming pet dogs (aOR=1.78; 95% CI: 1.14 to 2.76). The rabies leaflets were very effective in informing the people on how to deal with rabid animals, the earliest schedule for anti-rabies vaccine (ARV), and repeat vaccination., Conclusions: Awareness and proper attitude toward rabies management and canine population control are adequate among the rural Sinhalese and Buddhist populations of Sri Lanka; however, their current health practices should be improved. The rabies KAP could be further enhanced through the use of IEC materials.