This collaborative study, is ongoing under the Principal Investigator, Dr. Samitha Fernando (Graduate MPH student, Johns Hopkins University) with supervision from Prof. Champica Bodinayake (Faculty of Medicine, University of Ruhuna) and Prof. Gayani Tillekeratne (Duke University School of Medicine), and seeks to characterize the epidemiology, microbiological causes,resistance patterns, and risk factors associated with infective endocarditis in Southern Sri Lanka. Ethical approval was granted on 31 July 2025, and data collection is currently underway. The research team includes Prof. Chris Woods (Duke Global Health Institute), Dr. Ruvini Kurukulasooriya (Duke Ruhuna Collaborative Research Center), Dr. Warsha de Zoysa (Department of Medicine, University of Ruhuna), Dr. Lakmal Fonseka (Department of Medicine, University of Ruhuna), Dr. Subodha Wickramasinghe (Department of Microbiology, University of Ruhuna), Dr. Dhammika Palangasinghe (Department of Medicine, University of Ruhuna), and Dr. Harshani Thabrew (Department of Microbiology, University of Ruhuna). Given the limited regional data, this study will generate critical insights to improve patient outcomes in collaboration with local microbiology and cardiology teams.