I found a study which ran from 2/2003-3/2003 conducted by International Health Central American Institute by, Jean Lee, Harvard Medical school. The study was conducted in the northern half of the country, Los Chiles, San Rafael and Puerto Viejo. The study was conducted to determine the incidence of Leishmans in this area of Costa Rica, to understand the various manners of disease presentation, diagnosis, and responses to treatment, and to understand patients' knowledge about the disease, their treatment preferences, and their sources of leishmans education. It looks like a reasonably done study. There is a section about patients knowledge of their disease. This part of the study revealed that 3 out of 6 had suspicions that their symptoms were consistant with "papalomoyo", the colloquial term for Leishmaniasis. Most of the patients interviewed believed that the disease came from a mosquito. None were familiar with the sand fly. For those of you who are interested in this presentation the link is:
www.ihcai.org.