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Cutaneous leishmaniasis occurs most commonly in Africa, Middle East
Global and national data comparisons found the highest prevalence of cutaneous leishmaniasis occurred in Africa and the Middle East, according to a recently published study.
The researchers, including Chante Karimkhani, MD, of Case Western Reserve University, used estimated data from the Global Burden of Disease Study 2013 to produce the “first global effort to measure the burden of cutaneous leishmaniasis.”
Karimkhani and colleagues performed a cross-sectional analysis of the country-level burden of cutaneous leishmaniasis from 1990 to 2013 for nine countries with significantly greater incidence of cutaneous leishmaniasis, and compared these with the overall global burden.
The researchers also extracted data from scientific literature, hospital sources, country reports, and WHO sources on the prevalence of both acute and chronic cutaneous leishmaniasis. Prevalence was combined with disability weight to yield years lived with disability. Disability-adjusted life-years (DALYs), a sum of years lived with disability and years of life lost, was used to compare cutaneous leishmaniasis across 152 countries.
The global mean DALY for cutaneous leishmaniasis was 0.58 per 100,000 people in 2013. Nine countries had significantly greater DALYs than the global mean, including Afghanistan (87.0), Sudan (20.2), Syria (9.2). Yemen (6.2), Iraq (6.0), Burkina Faso (4.8) and Bolivia (4.6). The highest DALYs from cutaneous leishmaniasis were in Andean Latin America, North Africa and the Middle East, western sub-Saharan Africa, and south Asia.
Among males, Palestine has the highest incidence rates (616.2 cases per 100,000 people), followed by Afghanistan (566.4), Syria (357.1) and Nicaragua (354.8). The greatest incidence among females occurred in Afghanistan (623.9), Syria (406.3), Palestine (222.1) and Nicaragua (180.8).
The investigators wrote that urbanization, combined with poverty, malnutrition, poor sanitary conditions, and inadequate housing are major contributors to the high incidence of cutaneous leishmaniasis in these countries.
“To improve surveillance and epidemiological assessment, partnerships between countries and world organizations are crucial,” the researchers wrote. “Data from [the Global Burden of Disease Study] have the potential to inform public health policy and the setting of priorities to eradicate a preventable and debilitating disease.”
In an accompanying editorial, Najoua Haouas, college of applied medical sciences, University of Hail, Saudi Arabia, also cited the need for more worldwide data to reduce disease incidence.
“The lack of reliable data for many regions creates an urgent need for collaboration to improve surveillance, detection, and control of leishmaniasis,” Haouas wrote. “Leishmaniasis is a major challenge to public health since the increases in deforestation, urbanization, population movement and climate change in many regions of the world. In the absence of vaccine against Leishmania, prevention remains the cornerstone to reduce disease burden.” – by Taylor Groff
Disclosures: The researchers and Haouas report no relevant financial disclosures.