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Leishmaniasis Worldwide and Global Estimates of Its Incidence

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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

DOI 10.1371/journal.pone.0035671PMC PMC3365071

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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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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
ORCID: Alvar, Jorge
Vélez, Iván D.
Bern, Caryn
Cano, Jorge
Boer, Margriet den
Venue: PLoS ONE
Publisher: Public Library of Science (PLoS)
Published: 2012-05-31
Volume: 7
Issue: 5
Pages: e35671
ISSN: 1932-6203 (ISSN-L)
DOI: 10.1371/journal.pone.0035671
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: public-domain
creativecommons.org/publicdomain/zero/1.0/ (unspecified)
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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