Improving leptospirosis treatment through increased suspicion-"Leptospirosis calendar for general practitioners in Sri Lanka".

Introduction: Sri Lanka has one of the highest incidences of leptospirosis worldwide. Continuous awareness of leptospirosis as a differential diagnosis will improve the diagnosis of leptospirosis among General Practitioners (GPs). The objective of this study is to describe the development of a leptospirosis calendar for GPs in Sri Lanka.

Methods: The Leptospirosis calendar was meticulously crafted by synthesizing information obtained from a combination of Key Informant Interviews (KII), an extensive literature review, and the valuable insights of experts in the field. It underwent a refinement process during a one-day workshop, which was attended by a team of experts, including consultants from the Epidemiology unit, the Health Promotion Bureau, a Consultant Community Physician, two GPs, and two Medical Officers of Health (MOHs). The calendar was designed to be a practical and user-friendly tool, ensuring its comprehensiveness, relevance, applicability, and suitability within the context of healthcare in Sri Lanka. The main theme of the calendar was related to paddy cultivation, as it is the main risk exposure in Monaragala. To achieve a wide reach and ensure that it effectively caught the attention of treating physicians, it was agreed upon to present the calendar in a desk format. Before finalizing the calendar, it underwent a pretesting phase involving ten experienced GPs located in the Monaragala and Colombo districts. This pretesting aimed to assess its effectiveness as a tool in aiding healthcare professionals to consider leptospirosis as a potential differential diagnosis when treating patients.

Results: The Leptospirosis calendar was designed to coincide with different seasonal activities of paddy cultivation related to leptospirosis depicted by month, and regarding the people who are involved in those activities so that the GP can include leptospirosis as a differential diagnosis, refer for the treatment and to educate the clients. It also prompts the GP to encourage prophylaxis in the farming community when they visit for other ailments.

Conclusions: The desk calendar aligns paddy farming activities with leptospirosis risk periods in Sri Lanka, aiding timely diagnosis, prevention, and outbreak response.