OVERLOOKED LEPTOSPIROSIS: A RAPIDLY EMERGING CHALLENGE FOR RURAL AGRICULTURAL COMMUNITIES IN SRI LANKA

Abstract

Leptospirosis is an infectious disease that the Leptospira bacterium causes and spreads, typically through contact with contaminated soil or water. Farmers who are often open to soil and water in Sri Lanka are susceptible to a wide variety of lep- tospirosis-related clinical conditions. In 2022, there was a modest increase in lepto- spirosis-related fatalities, which totalled 123 deaths, and the case fatality rate (CFR) was 1.7%. Despite numerous interventions, leptospirosis is on the rise, according to national statistics. The present qualitative study was conducted to gain insight into the social factors that exacerbate the prevalence of leptospirosis in agricultural commu- nities. In Matara district, employing a qualitative research strategy, 50 in-depth inter- views were conducted over 12 months in 2022 and 2023 with physicians (5), physical health instructors (10), midwives (5), and cultivators (30) from five divisional secre- tariats, who reported a high number of leptospirosis cases. Five major themes emerged from the thematic analysis. Leptospirosis is associated exclusively with paddy culti- vation, and its severity is often overlooked when people engage in other activities involving the environment. The disease was known by various other names represent- ing non-real causes (including mada una, wel una, and pathal una), which concealed its true cause. Though other mammals could also transmit the disease, people still believed that rats were the only ones who could spread it. People from low-income groups relied on agriculture and were not adequately integrated into treatment referral systems. There is a close relationship between poverty and disease. Finally, this led to negative implications, such as delays in patients seeking medical attention, physi- cians making diagnoses, and investigations being conducted. These delays could have devastating effects on the livelihoods of agricultural households. This study concludes that leptospirosis is frequently overlooked in agricultural communities; consequently, there is a need for grassroots information-driven initiatives to prevent the spread of the disease and improve the success rate of existing policy interventions.