Burden and Trends of Leishmaniasis over the last one Decade Across the Globe: Trend Analysis of WHO Regions

Abstract

Introduction: In terms of the global burden of diseases, leishmaniasis is the third most serious and often fatally untreated tropical disease. The number of people suffering from leishmaniasis is estimated to be 12–15 million. Because of the comparatively underestimated reported number of cases, leishmaniasis is not seen as an immediate health issue in various regions by local and international health policymakers. Therefore, strong evidence is required for policymakers to make decisions. Therefore, we aimed to conduct secondary data analysis to assess the trends of Leishmaniasis over the last decade and understand the endemicity of different regions for Leishmaniasis across the world. Methods:  We undertook a retrospective study with secondary data analysis of the WHO data from 2008 to 2018, publicly available, for cutaneous and visceral Leishmaniasis. The data for around 194 countries were included in the analysis and these countries were merged into different regions based on the WHO classification. We categorized all 94 countries into regions such as America, Europe, Africa, South-East Asia, the Eastern Mediterranean, and Western Pacific. Since the data were limited to the frequency of cases and there were no other variables, therefore, we were able to do the descriptive analysis. Results: Generally, the number of cutaneous Leishmaniasis cases has declined for all regions except for the Eastern Mediterranean region. A declining trend of imported cases of cutaneous Leishmaniasis was found for all regions mainly from 2015 to 2018. The cases of visceral leishmaniasis in the Eastern Mediterranean region, Africa, America, and Europe have remained stable. However, after remaining stagnant for about four years, the number of visceral leishmaniasis in South Asia showed a steep decline. Of the 194 countries, 76.39% are considered as endemic for cutaneous Leishmaniasis and 44.3% are considered as endemic for visceral Leishmaniasis. Conclusion: Though cases of Leishmaniasis have decreased over the past decade, regions need to make efforts to capture the true number of cases with an effective surveillance system. There appears to be a stable trend in most countries, although it is unclear whether that trend is due to regulation steps taken by various governments or to cases being underreported. Governments in various regions therefore need to make efforts to identify true cases and to take effective control steps.