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Leishmaniasis Worldwide and Global Estimates of Its Incidence

Open access
Alvar, Jorge, Vélez, Iván D., Bern, Caryn, Herrero, Mercé, Desjeux, Philippe, Cano, Jorge, Jannin, Jean, Boer, Margriet den, the WHO Leishmaniasis Control Team·2012·PLoS ONE

Abstract

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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  1. AN Maia-Elkhoury, 2007, [Analysis of visceral leishmaniasis reports by the capture-recapture method]., Rev Saude Publica, 41, 931

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Metadata

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
Published
2012-05-31
Volume
7
Issue
5
Pages
e35671
ISSN
1932-6203 (ISSN-L)
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
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 › Medicine › Infectious Diseases › 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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