Leishmaniasis Worldwide and Global Estimates of Its Incidence
Open accessAbstract
As part of a World Health Organization-led effort to update the empirical evidence base for the leishmaniases, national experts provided leishmaniasis case data for the last 5 years and information regarding treatment and control in their respective countries and a comprehensive literature review was conducted covering publications on leishmaniasis in 98 countries and three territories (see 'Leishmaniasis Country Profiles Text S1, S2, S3, S4, S5, S6, S7, S8, S9, S10, S11, S12, S13, S14, S15, S16, S17, S18, S19, S20, S21, S22, S23, S24, S25, S26, S27, S28, S29, S30, S31, S32, S33, S34, S35, S36, S37, S38, S39, S40, S41, S42, S43, S44, S45, S46, S47, S48, S49, S50, S51, S52, S53, S54, S55, S56, S57, S58, S59, S60, S61, S62, S63, S64, S65, S66, S67, S68, S69, S70, S71, S72, S73, S74, S75, S76, S77, S78, S79, S80, S81, S82, S83, S84, S85, S86, S87, S88, S89, S90, S91, S92, S93, S94, S95, S96, S97, S98, S99, S100, S101'). Additional information was collated during meetings conducted at WHO regional level between 2007 and 2011. Two questionnaires regarding epidemiology and drug access were completed by experts and national program managers. Visceral and cutaneous leishmaniasis incidence ranges were estimated by country and epidemiological region based on reported incidence, underreporting rates if available, and the judgment of national and international experts. Based on these estimates, approximately 0.2 to 0.4 cases and 0.7 to 1.2 million VL and CL cases, respectively, occur each year. More than 90% of global VL cases occur in six countries: India, Bangladesh, Sudan, South Sudan, Ethiopia and Brazil. Cutaneous leishmaniasis is more widely distributed, with about one-third of cases occurring in each of three epidemiological regions, the Americas, the Mediterranean basin, and western Asia from the Middle East to Central Asia. The ten countries with the highest estimated case counts, Afghanistan, Algeria, Colombia, Brazil, Iran, Syria, Ethiopia, North Sudan, Costa Rica and Peru, together account for 70 to 75% of global estimated CL incidence. Mortality data were extremely sparse and generally represent hospital-based deaths only. Using an overall case-fatality rate of 10%, we reach a tentative estimate of 20,000 to 40,000 leishmaniasis deaths per year. Although the information is very poor in a number of countries, this is the first in-depth exercise to better estimate the real impact of leishmaniasis. These data should help to define control strategies and reinforce leishmaniasis advocacy.
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Mucocutaneous and visceral disease can be lethal if untreated, but most deaths are attributable to visceral leishmaniasis.
“Mucocutaneous and visceral disease can be lethal if untreated, but most deaths are attributable to visceral leishmaniasis (103).”
From Macrophage Cytokines: Involvement in Immunity and Infectious Diseases (2014) · cites this paper as [103]
The Introduction says untreated visceral leishmaniasis results in death, and the Results estimate mortality on the assumption that virtually all leishmaniasis deaths are from visceral disease. The paper does not say that untreated mucocutaneous disease can be lethal; the Discussion says it made no estimate for that form. Page numbers are unavailable in our copy. (LLM, conf=0.86)
Experimental — accuracy not yet measuredDepending on the species, Leishmania can cause self-healing cutaneous lesions, disfiguring mucocutaneous disease, or severe visceral illness.
“Depending on the species, Leishmania can cause self-healing cutaneous lesions (e.g., L. tropica, L. major, L. mexicana, and L. pifanoi), disfiguring mucocutaneous disease (e.g., L. braziliensis and L. guyanensis), or severe visceral illness (e.g., L. donovani and L. Infantum chagasi).”
From Macrophage Cytokines: Involvement in Immunity and Infectious Diseases (2014) · cites this paper as [103]
The Introduction states that visceral leishmaniasis can be fatal if untreated, and the Results report both visceral and cutaneous forms. The Methods also recognize mucocutaneous leishmaniasis as a clinical form. Our copy does not describe cutaneous lesions as self-healing or mucocutaneous disease as disfiguring, nor does it link the listed species to those outcomes (searched the species names and clinical terms). (LLM, conf=0.85)
Experimental — accuracy not yet measuredThe diseases studied have important zoonotic potential, as human infections or risk of infection have been described.
“we must consider the important zoonotic potential of the diseases studied, as the presence of human infections or risk of infection has already been described (5, 24, 25, 28).”
From Current Distribution of Selected Vector-Borne Diseases in Dogs in Spain (2020) · cites this paper as [28]
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- Authors
- Alvar, J., Vélez, I. D., Bern, C., Herrero, M., Desjeux, P., Cano, J., Jannin, J., Boer, M. D., & the WHO Leishmaniasis Control Team
- Affiliations
- World Health Organization (CH)
- Universidad de Antioquia (CO)
- Centers for Disease Control and Prevention (US)
- Instituto de Salud Carlos III (ES)
- Corresponding author
- Alvar, Jorge
- Venue
- PLoS ONE
- Publisher
- Public Library of Science (PLoS)
- Published
- 2012-05-31
- Volume
- 7
- Issue
- 5
- Pages
- e35671
- ISSN
- 1932-6203 (ISSN-L)
- PMC
- PMC3365071
- OpenAlex
- W2107915297
- Cited by
- 5,141
- References
- 51
- Citations by year
- 2026: 177 · 2025: 229 · 2024: 257 · 2023: 305 · 2022: 358 · 2021: 456 · 2020: 468 · 2019: 458 · 2018: 515 · 2017: 440 · 2016: 465 · 2015: 361 · 2014: 404 · 2013: 200 · 2012: 38
- FWCI
- 310.03
- Type
- journal article
- Language
- en
- Open access
- gold
- doi.org
- Licence
- Locations
- PLoS ONE (publishedVersion, public-domain)
- Europe PMC (PubMed Central) (publishedVersion, public-domain)
- PubMed Central (publishedVersion, public-domain)
- PubMed (publishedVersion)
- LSHTM Research Online (London School of Hygiene and Tropical Medicine) (acceptedVersion)
- LA Referencia (Red Federada de Repositorios Institucionales de Publicaciones Científicas) (submittedVersion, cc-by-nc-sa)
- DOAJ (DOAJ: Directory of Open Access Journals) (submittedVersion, cc-by-sa)
- Figshare (submittedVersion, cc-by)
- Funders
- Sanofi
- Universidad de Medellín
- Pan American Health Organization
- Agencia Española de Cooperación Internacional para el Desarrollo
- Topics
- Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Research on Leishmaniasis Studies
- Health Sciences › Medicine › Infectious Diseases › Leprosy Research and Treatment
- Health Sciences › Veterinary › Small Animals › Brucella: diagnosis, epidemiology, treatment
- Keywords
- leishmaniasis, visceral leishmaniasis, cutaneous leishmaniasis, leishmaniasis incidence, country profile, leishmaniasis control, leishmaniasis treatment, access to medicines, neglected tropical diseases, case data
- MeSH terms
- Female, Geography, Humans, Leishmaniasis, Male, Time Factors, World Health Organization, Internationality
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