LEISHMANIASIS COUNTRY PROFILE – PRIORITY COUNTRIES
As part of a WHO-led effort to monitor the progress in the control or elimination of the leishmaniases, national control programmes in
countries where the burden of the disease is high for that particular WHO Region, are providing monthly or annual data on yearly basis.
Previous and latest /media/upload/arxius/country_profiles are therefore posted in this web page for comparative purposes.
The latest version summarizes information collected for 18 and 12 indicators, for visceral and cutaneous leishmaniasis respectively, on
epidemiology, control and surveillance, diagnosis and treatment outcome.
The latest version of the national guidelines is also posted if available.
In addition to the 43 new profiles based on routine surveillance data, a further 101 profiles for all endemic countries worldwide are included
containing information based on a literature review and expert opinion for data as of 2008 (maps) and 2010 (number of cases).
Country profiles have been provided by the WHO- Department of Control of Neglected Tropical Diseases (NTD).
Saudi Arabia
Saudi Arabia is endemic for ACL, CL, VL and ZCL.
CL caused by L. major has been known in several areas of the country, but was considered only a minor problem until 1975. Several factors have amplified transmission: rapid urbanization, migration, intensive agriculture, poor living conditions on farms and massive immigration. CL caused by L. tropica is endemic in the south-western part of the country. Cases of leishmaniasis recidivans are not uncommon in the area.
VL is sporadic and mostly seen in Jazan region.
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Somalia
VL is endemic along the Wabe Shebelle and Juba river basins of southern Somalia. The first cases date back to 1930–1940 in the Jowhar area of Middle Shabelle region. In this region, positive skin test results were found in 26% of people in 1995, with a low prevalence of cases. Cases have been described throughout Somalia but currently occur most frequently in the Bakool and Bay regions bordering Ethiopia and in the Gedo region bordering Kenya. Termite hills and red acacia trees are breeding sites for the vector. Children under 5 years old are mostly affected. PKDL seems rare.
Sporadic imported cases of CL have been reported from the south and a few cases of MCL and CL have been reported from northern Somalia.
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South Sudan
One of the distinctive characteristics of VL in South Sudan is that outbreaks occur regularly and unexpectedly in areas that were previously assumed to be unaffected. The main risk factor for their occurrence is the introduction of the disease in non-immune populations through migrations from endemic to non-endemic areas.
Ethnicity was identified as a risk factor for disease in several Sudanese epidemic sites. Sudanese tribal people appear to be exceptionally susceptible to developing full-blown VL. A genetic factor has been considered. An estimated 10% of VL cases in South Sudan are coinfected with HIV.
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Spain
Leishmaniasis is hypoendemic in Spain (0.41 cases every 100 000 inhabitants) and is caused by L. infantum. The dog is the main reservoir host. Canine VL is endemic and its prevalence varies in the different regions of Spain. Studies in different areas have detected prevalence varying from 4% to 35% seropositive dogs, with 7.8% seropositive dogs in the Madrid region and a high proportion of them not showing any clinical signs of leishmaniasis. In 2010–2011 an outbreak of both CL and VL due to L. infantum affected three municipalities in the province of Madrid.
CL is less frequent, but there is no accurate information.
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Sudan
Sudan is endemic for CL, MCL and VL.
It is the original focus of VL. DNA of L. donovani was found in bone marrow samples taken from ancient Egyptian and Nubian mummies originating from around 4000 BC, and it has been proposed that the Leishmania parasite has evolved before or at the same time as homosapiens in East Africa. The reported occurrence of VL in Sudan is wide and variable.
Gedaref State, in northern Sudan, is a known hyperendemic area. Kordofan State, Western Upper Nile, White Nile State and central Sudan are also well-known endemic areas. Transmission during oubreaks is predominantly anthroponotic. PKDL occurs in about 55% of Sudanese patients. VL occurrence in game wardens in uninhabited Dinder National Park indicates zoonotic transmission also.
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Suriname
Suriname is endemic for cutaneous leishmaniasis of zoonotic nature caused by L. guyanensis, L. amazonensis, L. lainsoni and L. naiffi. Transmission is associated with forest activities, thus peridomestic transmission occurs in dwellings close to the forest.
Between 2012 and 2016, a total of 1,862 cases have been reported to PAHO/WHO in the SisLeish.
Proven vectors are Lu. umbratilis, Lu. anduzei and Lu. flaviscutellata.
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Syrian Arab Republic
The Syrian Arab Republic is endemic for ACL, CL, VL and ZCL.
CL is an ancient endemic disease in Syria. CL caused by L. tropica is still endemic in its traditional home of Aleppo but occurs also in Hama, Idlib, Latakia and Tartus, and in the city of Damascus. L. tropica causes the majority of all CL cases and is responsible for one of the most important public health problems in the country, especially in Aleppo. CL caused by L. major is less common and occurs in rural areas close to Al-Hasakah, Damascus and Deir ez-Zour. Only a few cases of VL are recorded annually, mainly from Idlib province.
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