Global Alert and Response (GAR)

WHO Report on Global Surveillance of Epidemic-prone Infectious Diseases - Leishmaniasis

Description of the global surveillance system and data

In 1994 a surveillance network with 13 institutions was set up to monitor Leishmania/HIV co-infection. The main objective is to improve case management (detection and treatment) and to coordinate preventive measures. Today the surveillance network includes 28 institutions in 13 countries. Most institutions are situated in Europe.

The institutions follow standard guidelines and use standard case report forms in order to ensure a common approach. The individual case reports provide detailed information on age, sex, geographical location, travel to endemic countries and details on the HIV and leishmaniasis infection. The institutions report annually to WHO.

Strengths and weaknesses of the data

Surveillance is limited to the Leishmania/HIV co-infection; no regular global surveillance exists on leishmaniasis itself, even though leishmaniasis is notifiable in 33 out of the 88 countries where it occurs.

The surveillance system of Leishmania/HIV co-infection is just beginning and coverage of areas that are at risk is still incomplete. At present, most of the surveillance is carried out in Europe, although the problem of co-infection is widespread. Out of the 28 surveillance institutions, 17 are located in south-western Europe. In addition, the fact that visceral leishmaniasis is not recognized as an official opportunistic infection means that it is often not reported in HIV/AIDS notification systems. Furthermore, because the immune system of HIV patients is impaired and due to the presence of other opportunistic diseases, leishmaniasis is difficult to diagnose in HIV patients.