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Burden of disease
Economic and social impact/Risk factors
The leishmaniases are related to enviromental changes such as deforestation, building of dams, new irrigation schemes, urbanization and migration of non-immune people to endemic areas. They seriously hamper socioeconomic progress.
Epidemics have significantly delayed the implementation of numerous development programmes. This is particularly true in the Amazon basin, the tropical regions of the Andean countries, Morocco and Saudi Arabia.
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The increase in risk factors for leishmaniasis worldwide [pdf 2.64Mb]
Transactions of the Royal Society of Tropical Medicine and Hygiene.
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Urbanization: an increasing risk factor for leishmaniasis [pdf 193kb]
Weekly Epidemiological Record, N° 77, 44, 1 November 2002
Magnitude of the problem
For many years, the public health impact of the leishmaniases has been grossly underestimated, mainly due to lack of awareness of its serious impact on health.
Over the last 10 years, endemic regions have been spreading further and there has been a sharp increase in the number of recorded cases of the disease. As declaration is compulsory in only 32 of the 88 countries affected by leishmaniasis, a substantial number of cases are never recorded. In fact, 2 million new cases (1.5 million for CL and 500 000 for VL) are considered to occur annually, with an estimated 12 million people presently infected worldwide....
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Leishmania/HIV co-infection
In Europe, intravenous drug users have been identified as the main population at risk. In response to this situation, WHO and UNAIDS have set up a surveillance system through a network of 28 institutions worldwide. All members of the network use the same guidelines for diagnosis and a computerized case report form, both endorsed by WHO.
In a particularly ominous trend, the spread of HIV infection is bringing the severe visceral form to new geographical areas and changing the epidemiology of this disease in dangerous ways. The two infections coexist in a deadly synergy. Where leishmaniasis occurs in urban areas, conditions often favour explosive epidemics - thus transforming leishmaniasis from a sporadic to an epidemic threat....
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Geographical distribution
Currently the leishmaniases, prevalent in four continents, are considered to be endemic in 88 countries, 72 of which are developing countries:
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Maps on geographical distribution of leishmaniasis
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