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Afghanistan
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Afghanistan is endemic for ACL, CL, VL and ZCL. ACL is widespread across 254 districts in 20 provinces with 10.3 million population at risk in endemic areas. Poor housing conditions and displacement of people are key factors in maintaining the endemicity. CL is a well-known condition in endemic areas and is also called “saldana” (one-year sore) in the local language. Afghanistan has the largest foci of CL in the world. VL endemicity is not fully understood and is considered to be poorly reported due to limited surveillance and availability of diagnostic services. ZCL is reported to be endemic in all 16 districts of Balkh province. |
| Available /media/upload/arxius/country_profiles |
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| 2015 |
| 2014 |
| 2010 |
| Distribution of new cases per disease form (maps) |
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| 2015-ACL |
| 2015-ZCL |
| 2015-VL |
| National guidelines |
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Albania
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Albania is endemic for zoonotic visceral leishmaniasis and cutaneous leishmaniasis caused by L. infantum. Between 1998 and 2016, about 1631 VL cases have been reported. The disease is zoonotic and domestic dogs and wild canines serve as reservoir hosts, bringing the infection close to humans. About 124 CL cases were reported during the same period. Cutaneous lesions usually present as small nodules or ulcerations. Sandfly species prevalent are P. neglectus, P. perfiliewi and P.tobbi. |
| Available /media/upload/arxius/country_profiles |
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| 2016 |
| Distribution of new cases per disease form (maps) |
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| 2016-CL |
| 2016-VL |
| National guidelines |
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Algeria
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Algeria is endemic for CL and VL. CL is a serious public health problem; Algeria has the second largest focus in the world after Afghanistan. CL is also called “Biskra boil” in the local language. It is reported to be endemic in 328 third sub-national administrative levels with 10 million population at risk. Between 2004 and 2006, three major outbreaks of CL were reported with a total of 60 994 cases. In 2014, 5423 CL cases were reported with an incidence rate of 5.42 per 10 000 population. VL cases have been detected mainly from the central and eastern parts of the Tell region. New foci have appeared and the number of cases has resurged. |
| Available /media/upload/arxius/country_profiles |
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| 2014 |
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| Distribution of new cases per disease form (maps) |
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| National guidelines |
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Argentina
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Argentina is endemic for visceral and cutaneous leishmaniasis caused by zoonotic Leishmania species. Between 1998 and 2016, a total of 5,880 cases of CL have been reported with an annual average of 309 cases. There are foci of visceral leishmaniasis caused by L.infantum with dog is main reservoir hosts. Cutaneous leishmaniasis is caused by L. guyanensis, L. braziliensis and L amazonensis. Vector species prevalent are Lu. whitmani, Lu. neivai, Lu. migonei and Lu. longipalpis |
| Available /media/upload/arxius/country_profiles |
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| PAHO-2018-PT |
| PAHO-2018-EN |
| PAHO-2018-SP |
| PAHO-2017-SP |
| PAHO-2017-PT |
| PAHO-2017-EN |
| PAHO-2016-EN |
| PAHO-2016-SP |
| PAHO-2016-PT |
| PAHO-2015-EN |
| PAHO-2015-SP |
| PAHO-2015-PT |
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Bangladesh
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Bangladesh is endemic for VL in the Indian sub-continent. It is one of the five endemic countries in WHO’s South-East Asia Region implementing a kala-azar elimination programme. Currently, 100 upazilas (third sub-national administrative divisions) are endemic with 30 million population at risk. Between 1998 and 2014, about 78 530 VL cases were reported, peaking at 9379 in 2006. Since then, the number of cases has continuously declined, with only 650 cases reported in 2014. PKDL cases are also detected and there is an increasing trend of reporting. Humans seem to be the only reservoir of infected patients, and PKDL cases constitute the source of infection. |
| Available /media/upload/arxius/country_profiles |
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| 2015 |
| 2014 |
| 2010 |
| Distribution of new cases per disease form (maps) |
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| 2015-VL |
| National guidelines |
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| National guideline for kala-azar case management |
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Bolivia
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Bolivia is endemic for cutaneous (CL), mucocutaneous (MCL) and visceral leishmaniasis (VL). The transmission cycle of leishmaniasis is zoonotic, requiring the presence of an animal reservoir for the maintenance of the parasite in nature. Bolivia is one of the three countries in the region of Americas reporting more cases of mucocutaneous leishmaniasis due to L. braziliensis. Other species present are L. amazonensis, L. guyanensis, L. lainsoni and L. infantum. Vector species prevalent are Lu. neneztovari anglesi, Lu. flaviscutellata, Lu. nuneztovari, Lu. carrerai carrerai , Lu. ayrozai, L. yucumensis, Lu. llanosmartinsi, Lu. shawi, Lu. longipalpis, and recently it was identified Lu. cruzi in the endemic area border with Brazil. |
| Available /media/upload/arxius/country_profiles |
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| PAHO-2018-PT |
| PAHO-2018-EN |
| PAHO-2018-SP |
| PAHO-2017-SP |
| PAHO-2017-PT |
| PAHO-2017-EN |
| PAHO-2016-EN |
| PAHO-2016-SP |
| PAHO-2016-PT |
| PAHO-2015-EN |
| PAHO-2015-SP |
| PAHO-2015-PT |
| Distribution of new cases per disease form (maps) |
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Brazil
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Brazil is endemic for CL, MCL and VL. It reports the highest number of CL cases in South America. CL and MCL are endemic in large geographical areas of 1488 municipalities (second sub-national administrative level) with 97 million population at risk in 2016. VL is a health problem due to geographical expansion and represents 96% of VL cases in the Americas. Canine VL is also widespread, with up to 20% of dogs infected in the highly endemic localities. The fatality rate related to VL and cases of VL–HIV coinfection have increased over the years. |
| Available /media/upload/arxius/country_profiles |
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| 2015 |
| 2014 |
| 2010 |
| PAHO-2018-PT |
| PAHO-2018-EN |
| PAHO-2018-SP |
| PAHO-2017-SP |
| PAHO-2017-PT |
| PAHO-2017-EN |
| PAHO-2016-EN |
| PAHO-2016-SP |
| PAHO-2016-PT |
| PAHO-2015-EN |
| PAHO-2015-SP |
| PAHO-2015-PT |
| Distribution of new cases per disease form (maps) |
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| 2015-CL |
| 2015-VL |
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China
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China is endemic for CL and VL. CL caused by L. infantum occurs in Karamay, Xinjiang. CL caused by L. major is suspected to be present also in Xingjian, with an endemic area extending into Mongolia. VL is endemic in six provinces with 229 million population at risk. VL caused by L. donovani has been reported from the eastern plains and desert regions of eastern China in the past. VL caused by L. infantum seems to be present in two subtypes, one of which has been reported in the western high altitude regions of the provinces of Gansu, Shaanxi, Shanxi and Sichuan. Dogs are the principal source of infection. The other subtype is reported in the deserts of the north-western regions of China, including Xinjiang, western Inner Mongolia and northern Gansu. Transmission is probably sylvatic. |
| Available /media/upload/arxius/country_profiles |
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| 2015 |
| 2014 |
| 2010 |
| Distribution of new cases per disease form (maps) |
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| 2015-VL |
| National guidelines |
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| Diagnostic criteria of leishmaniasis-WS 258-2006 |
| Diagnostic criteria and principles of management of leishmaniasis-GB15986-1995 |
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Colombia
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Colombia is one of the three countries with the highest number of Leishmania species affecting humans in the world (nine species in total). Most cases are CL; a small proportion are MCL and VL. Currently, 449 second sub-national administrative levels are endemic for CL with 20 million population at risk. Between 2000 and 2016, about 177,468CL cases were reported, peaking at 18 043 in 2005. Since then, at least 10,000 cases have been reported annually. |
| Available /media/upload/arxius/country_profiles |
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| 2015 |
| 2014 |
| 2010 |
| PAHO-2018-PT |
| PAHO-2018-EN |
| PAHO-2018-SP |
| PAHO-2017-SP |
| PAHO-2017-PT |
| PAHO-2017-EN |
| PAHO-2016-EN |
| PAHO-2016-SP |
| PAHO-2016-PT |
| PAHO-2015-EN |
| PAHO-2015-SP |
| PAHO-2015-PT |
| Distribution of new cases per disease form (maps) |
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| 2015-CL |
| 2015-VL |
| National guidelines |
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| Protocolo de vigilancia en salud pública |
| Guia de atención clínica integral del paciente con leishmaniasis |
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Costa Rica
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Costa Rica is endemic for cutaneous leishmaniasis and sporadic cases of mucocutaneous and visceral forms are reported. Between 2001 and 2016, a total of 21,711 CL cases have been reported with an annual average of at least 1514 cases. The leishmaniasis is zoonotic disease and the important parasite species are L. panamensis, L. mexicana, L. braziliensis, L. garnhami, and L.infantum. For CL caused by L. panamensis, the three- toed sloth, Bradypus griseus, is said to be the principal reservoir host in Costa Rica. Vector species prevalent are Lu. ylephiletor, Lu. trapidoi, Lu. olmeca olmeca, Lu. olmeca bicolor and others. |
| Available /media/upload/arxius/country_profiles |
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| PAHO-2018-PT |
| PAHO-2018-EN |
| PAHO-2018-SP |
| PAHO-2017-SP |
| PAHO-2017-PT |
| PAHO-2017-EN |
| PAHO-2016-EN |
| PAHO-2016-SP |
| PAHO-2016-PT |
| PAHO-2015-EN |
| PAHO-2015-SP |
| PAHO-2015-PT |
| Distribution of new cases per disease form (maps) |
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| National guidelines |
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Ecuador
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Ecuador is endemic for cutaneous and mucocutaneous leishmaniasis of zoonotic nature. Between 2001 and 2016 a total of 23,947 CL cases have been reported with an annual average of at least 1,500 cases. Parasite species endemic are L. braziliensis, L. panamensis, L. guyanensis, L. amazonensis, and L. mexicana. Vector species prevalent are Lu. trapidoi, Lu. hartmanni, Lu. gomezi and others. |
| Available /media/upload/arxius/country_profiles |
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| PAHO-2018-PT |
| PAHO-2018-EN |
| PAHO-2018-SP |
| PAHO-2017-SP |
| PAHO-2017-PT |
| PAHO-2017-EN |
| PAHO-2016-EN |
| PAHO-2016-SP |
| PAHO-2016-PT |
| PAHO-2015-EN |
| PAHO-2015-SP |
| PAHO-2015-PT |
| Distribution of new cases per disease form (maps) |
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| National guidelines |
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El Salvador
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El Salvador is endemic for cutaneous and visceral leishmaniasis. There are foci of visceral leishmaniasis caused by L. infantum with known or assumed canine reservoir hosts. Cutaneous lesions caused by L. infantum usually present as small nodules without ulcerations. In this cycle the proven vector is Lu. longipalpis, and the domestic dog is the reservoir host. Between 2001 and 2016 a total of 421 CL cases have been reported and one case of VL was notified in the last six years. |
| Available /media/upload/arxius/country_profiles |
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| PAHO-2018-PT |
| PAHO-2018-EN |
| PAHO-2018-SP |
| PAHO-2017-SP |
| PAHO-2017-PT |
| PAHO-2017-EN |
| PAHO-2016-EN |
| PAHO-2016-SP |
| PAHO-2016-PT |
| PAHO-2015-EN |
| PAHO-2015-SP |
| PAHO-2015-PT |
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Ethiopia
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CL and VL are growing public health problems in Ethiopia. CL has been a well-known condition since 1913 and is endemic in most regions. It is a highly neglected disease. The first case of VL in Ethiopia was documented in 1942 in the southern parts of the country. Endemic areas have progressed in the lowlands of the north-west, central, south and south-western areas. Currently, five regions (first sub-national administrative levels) are endemic with 3.2 million population at risk. PKDL seems to occur in varying rates within different regions and patient populations. |
| Available /media/upload/arxius/country_profiles |
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| 2015 |
| 2014 |
| 2010 |
| Distribution of new cases per disease form (maps) |
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| 2015-CL |
| 2015-VL |
| National guidelines |
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| Guideline for diagnosis, treatment and prevention of leishmaniasis in Ethiopia |
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Georgia
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Georgia is endemic for CL and VL. CL is relatively less frequent than VL. Mandatory registration of CL started in 2001. Both CL and VL are underreported due to their relatively recent re-emergence and a consequent lack of awareness as well as the lack of a training programme for medical doctors. VL is endemic in 20 municipalities (third sub-national administrative level) with 1.4 million population at risk. The main endemic area is between the capital (Tbilisi) and the Armenian border; many cases occur in Tbilisi which is an active focus with a high prevalence of human and canine cases. Most cases are recorded in children. |
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| 2016 |
| 2015 |
| 2014 |
| 2008 |
| Distribution of new cases per disease form (maps) |
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| National guidelines |
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Guatemala
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Guatemala is endemic for foci of visceral leishmaniasis caused by L. infantum with known or assumed canine reservoir hosts. The disease is zoonotic involving domestic dogs and wild canines (foxes, jackals, wolves) that serve as reservoir hosts and bring infection close to humans. Cutaneous and mucocutaneous leishmaniasis caused by L. panamensis, L mexicana, and L. braziliensis is also endemic... Between 2001 and 2016 a total of 10,309 CL cases have been reported. Lu. longipalpis, Lu. ylephiletor, Lu. panamensis, Lu. trapidoi, Lu. ovallesi and other vector species are prevalent. |
| Available /media/upload/arxius/country_profiles |
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| PAHO-2018-PT |
| PAHO-2018-EN |
| PAHO-2018-SP |
| PAHO-2017-SP |
| PAHO-2017-PT |
| PAHO-2017-EN |
| PAHO-2016-EN |
| PAHO-2016-SP |
| PAHO-2016-PT |
| PAHO-2015-EN |
| PAHO-2015-SP |
| PAHO-2015-PT |
| Distribution of new cases per disease form (maps) |
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| National guidelines |
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Guyana
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Guyana is endemic for cutaneous leishmaniasis caused by L. guyanensis and L. braziliensis of zoonotic nature. Between 2003 and 2016 a total of 724 CL cases have been reported, witch in the last three years occurred the increase cases after capacity building of the professionals in microscopic diagnosis and treatment of leishmaniasis. Transmission is associated with activities in forests thus peridomestic transmission occurs when dwellings are close to the forest. Transmission occurs throughout the year. Sloths (Choloepus didactylus) and anteaters (Tamandua tetradactyla) are the primary reservoir hosts. Marsupials, which are the secondary reservoir hosts, can be of major importance in areas where the ecology has been altered. Proven vector is Lu. umbratilis, which rests on the trunk of large trees. Others are Lu. anduzei and Lu. panamensis. |
| Available /media/upload/arxius/country_profiles |
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| PAHO-2018-PT |
| PAHO-2018-EN |
| PAHO-2018-SP |
| PAHO-2017-SP |
| PAHO-2017-PT |
| PAHO-2017-EN |
| PAHO-2016-EN |
| PAHO-2016-SP |
| PAHO-2016-PT |
| PAHO-2015-EN |
| PAHO-2015-SP |
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Honduras
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Cutaneous and mucocutaneous leishmaniasis is caused by L. panamensis and L. braziliensis. Transmission occurs throughout the year but with seasonal fluctuations. The risk for infection is not uniform and may be high in population groups that penetrate the forest. Between 2002 and 2016, a total of 25,492 cases have been reported. Visceral and cutaneous nodular lesions without ulceration are also caused by L. infantum with domestic dog as the reservoir host. |
| Available /media/upload/arxius/country_profiles |
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| PAHO-2018-PT |
| PAHO-2018-EN |
| PAHO-2018-SP |
| PAHO-2017-SP |
| PAHO-2017-PT |
| PAHO-2017-EN |
| PAHO-2016-EN |
| PAHO-2016-SP |
| PAHO-2016-PT |
| PAHO-2015-EN |
| PAHO-2015-SP |
| PAHO-2015-PT |
| Distribution of new cases per disease form (maps) |
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| National guidelines |
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India
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India is endemic for CL and VL in the Indian sub-continent. PKDL cases are also reported with an increasing trend. CL caused by L. tropica and L. major occurs in the north-western states of India (foci in Rajasthan and Punjab). The most affected area in Rajasthan is Bikaner district. Historically, VL caused by L. donovani was widely prevalent in India and it was almost eliminated as a result of extensive DDT spraying under the national malaria eradication programme in the 1960s. A total 130 million population is at risk in 611 blocks (third sub-national administrative level). The number of cases is in constant decline due to implementation of the kala-azar elimination programme. |
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| 2014 |
| 2010 |
| Distribution of new cases per disease form (maps) |
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Iran (Islamic republic of)
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The Islamic Republic of Iran is endemic for CL and VL. About 70% of CL is caused by L. major and it is endemic in many rural areas. ACL caused by L. tropica is found in Tehran as well as in other areas. Outbreaks are related to population increase, unplanned urbanization and the abundant sandfly population. ACL is endemic in 160 districts (third sub-national administrative level) with 9.6 million population at risk. ZCL is endemic in 842 districts with 2.4 million population at risk. VL is reported to be endemic in 30 districts with 2 million population at risk. It is caused by L. infantum and is less common. The main endemic areas are the province of Fars, in the south, and the districts of Meshkinshahr in the north-west. |
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| Distribution of new cases per disease form (maps) |
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Israel
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Leishmaniasis is a notifiable disease in Israel since 1949. The Israeli Ministry of Health conducts routine passive national surveillance of leishmaniasis. Reports are centralized at the Ministry of Health from each of the 15 regional health districts. The main burden of leishmaniasis in Israel is due to zoonotic cutaneous leishmaniasis (~ 99%). L. major and L. tropica are the main causative agents of CL in Israel, but CL caused by L. infantum also exists in very small numbers. Only sporadic cases of human VL occur. During 2005-2016, the majority of patients each year are reported from the southern district (the Negev area), which is an endemic region for leishmania due to L.major. |
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| 2016 |
| Distribution of new cases per disease form (maps) |
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Italy
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Italy is endemic for visceral leishmaniasis and cutaneous leishmaniasis. Transmission occurs by L. infantum. VL focus is zoonotic in nature and domestic dogs and wild canines serve as reservoir hosts, bringing the infection close to humans. Between 1998 and 2016, about 2030 VL cases have been reported. About 807 CL cases were reported during the same period. Cases have seen a sharp increase in 2016. Sandfly species prevalent are P. perniciosus, P. perfiliewi, P. neglectus and P. ariasi. |
| Available /media/upload/arxius/country_profiles |
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| 2016 |
| Distribution of new cases per disease form (maps) |
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| National guidelines |
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Kenya
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Kenya is endemic for CL, MCL and VL, and has cases of PKDL. The Baringo and Pokot areas are highly endemic, which affects the very poor tribal nomadic population. CL caused by L. aethiopica is well known in the mountainous regions, such as Mount EIgon, and in the Rift valley escarpments. The extension of farming and grazing in the region has increased the risk of cases occurring because farmers and shepherds tend to sleep in caves where the vector is present. CL caused by L. major is seen in the lowlands of Baringo district. Both CL and VL mainly affect children and young adults. VL transmission is believed to be mainly anthroponotic. |
| Available /media/upload/arxius/country_profiles |
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| 2017 NEW RELEASE |
| 2016 NEW RELEASE |
| 2015 |
| 2014 |
| 2009 |
| Distribution of new cases per disease form (maps) |
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| National guidelines |
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Mexico
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Mexico is endemic for visceral, cutaneous and mucocutaneous leishmaniasis. Foci of visceral leishmaniasis is caused by L. infantum with known or assumed canine reservoir hosts. Domestic dogs and wild canines serve as reservoir hosts. Cutaneous and mucocutaneous leishmaniasis is caused by L. braziliensis and L. mexicana and the vector are Lu.ovallesi, Lu. olmeca olmeca, Lu. panamensis, Lu. ylephiletor, Lu. diabolica, Lu. deleoni, Lu. cruciate and Lu. shannoni. Between 2001 and 2016, a total of 8,206 cases have been reported. |
| Available /media/upload/arxius/country_profiles |
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| PAHO-2018-PT |
| PAHO-2018-EN |
| PAHO-2018-SP |
| PAHO-2017-SP |
| PAHO-2017-PT |
| PAHO-2017-EN |
| PAHO-2016-EN |
| PAHO-2016-SP |
| PAHO-2016-PT |
| PAHO-2015-EN |
| PAHO-2015-SP |
| PAHO-2015-PT |
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| National guidelines |
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Morocco
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Morocco is endemic for ACL, CL, VL and ZCL. CL due to L. tropica is considered a major public health threat. It is distributed throughout Morocco in a band stretching from the Atlantic Ocean along the length of the Atlas Mountains almost to the Mediterranean Sea, where it is considered epidemic in suburban areas. Occasional cases of CL caused by L. infantum occur in the north of the country. CL caused by L. major has been reported since 1914 and has become epidemic since 1976. It occurs in the south and south-east of the Atlas mountains, and seems to have moved in waves from west to east over several years. VL is endemic in the Rift and pre-Rift mountains. |
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| 2015 |
| 2014 |
| 2010 |
| Distribution of new cases per disease form (maps) |
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Nepal
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Nepal is endemic for VL in the Indian subcontinent. Historically, VL was highly prevalent but the number of cases was reduced significantly due to extensive use of DDT in the 1960s. VL was officially reported again in 1980, when incidence was observed to steadily increase and cases and deaths were reported from 16 affected districts in regions bordering the endemic districts of Bihar in India. Nepal is one of the five endemic countries in WHO’s South-East Asia Region implementing a kala-azar elimination programme. Since 2003, the number of cases has continuously declined, with only 150 cases reported in 2016. PKDL cases are also detected. Humans seem to be the only reservoir, with infected patients and PKDL cases constituting the source of infection. |
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| 2015 |
| 2014 |
| 2010 |
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Nicaragua
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Nicaragua is endemic for visceral, cutaneous and mucocutaneous leishmaniasis. Cutaneous and mucocutaneous leishmaniasis is caused by L. braziliensis and L. panamensis and the proven vectors are Lu. panamensis, Lu. trapidoi, Lu. ylephiletor and L. cruciate. It is one of the 10 high endemic countries sharing up to 90% of CL in the world. Between 2001 and 2016, a total of 50,829 cases have been reported. Cutaneous nodular lesions and visceral leishmaniasis are caused by L. infantum with domestic dog as the reservoir host and the vectors know are Lu. longipalpis and Lu. evansi. |
| Available /media/upload/arxius/country_profiles |
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| PAHO-2018-PT |
| PAHO-2018-EN |
| PAHO-2018-SP |
| PAHO-2017-SP |
| PAHO-2017-PT |
| PAHO-2017-EN |
| PAHO-2016-EN |
| PAHO-2016-SP |
| PAHO-2016-PT |
| PAHO-2015-EN |
| PAHO-2015-SP |
| PAHO-2015-PT |
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Pakistan
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Pakistan is endemic for ACL, CL, VL and ZCL. CL is a major and rapidly increasing public health problem. Its extensive spread is associated with mass migration from endemic to non-endemic areas and vice versa. Outbreaks are frequent. Two causative parasites of CL are present: L. major, which mainly occurs in Balochistan and neighbouring Punjab and Sindh provinces, and L. tropica, which has the widest distribution and is prevalent in urban areas of southern Punjab (Multan) and Balochistan (Quetta) but also focally in the northern areas. |
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| 2015 |
| 2014 |
| 2010 |
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Panama
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Panama is endemic for cutaneous and mucocutaneous leishmaniasis and between 2001 and 2016, a total of 34,231 cases have been reported. These leishmaniasis forms is caused by L. panamensis, L. braziliensis and L. colombiensis. Sloth species (Choloepus hoffmani and Bradypus griseus) are the primary reservoir host of L. panamensis. In areas of Panama, 19.3% of C. hoffmani were found to be infected. The parasite was present in skin, blood, bone marrow, liver and spleen. The proven vectors are Lu. panamensis, Lu. gomezi, Lu. Trapidoi, Lu. Ylephiletor, Lu. cruciata and Lu. sanguinaria. |
| Available /media/upload/arxius/country_profiles |
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| PAHO-2018-PT |
| PAHO-2018-EN |
| PAHO-2018-SP |
| PAHO-2017-SP |
| PAHO-2017-PT |
| PAHO-2017-EN |
| PAHO-2016-EN |
| PAHO-2016-SP |
| PAHO-2016-PT |
| PAHO-2015-EN |
| PAHO-2015-SP |
| PAHO-2015-PT |
| Distribution of new cases per disease form (maps) |
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| National guidelines |
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Paraguay
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Paraguay is endemic for cutaneous, mucosal and visceral leishmaniasis. CL is reportedly endemic in 59 districts (second sub-national administrative level) with 1.9 million population at risk. Between 2001 and 2016 a total of 6,979 cases have been reported. The first VL case in South America was described in Paraguay in 1913, but it was possibly imported. A confirmed autochthonous case was first reported in 1945. In 2016 around 70% of VL cases originate in central departments and in the capital (Asunción), where urban transmission is a major concern. The high proportion of dogs in Asunción with canine VL combined with a high vector density, uncontrolled urbanization and population growth are associated with the rise in case numbers. Paraguay is the second country with more reported cases in this region. In the period from 2013 to 2016 a total of 381 cases were notified to PAHO/WHO. Adjacent areas in Argentina and Brazil share the epidemic progression of zoonotic VL. |
| Available /media/upload/arxius/country_profiles |
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| 2015 |
| 2014 |
| 2010 |
| PAHO-2018-PT |
| PAHO-2018-EN |
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| PAHO-2017-SP |
| PAHO-2017-PT |
| PAHO-2017-EN |
| PAHO-2016-EN |
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Peru
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Leishmaniasis remains an important public health problem in Peru, and it is transmitted in around 74% of the country’s surface. The two forms of CL are mainly defined by their geographical and clinical characteristics, namely: Andean leishmaniasis (“uta”) and sylvatic leishmaniasis (“espundia”). Uta occurs on the western slopes of the Andean and inter-Andean valleys at altitudes of 900–3000 m, where it is caused by L. peruviana. Agricultural workers are at high risk of infection. Most uta cases are in children and more than 80% of the adult population exhibit scars. Espundia is caused mostly by L. braziliensis in the primary tropical forest, where close contact between humans and the sylvatic vector occurs. Between 2001 and 2016 a total of 66,391 cases have been reported to PAHO/WHO and in 2016 the mucocutaneous form represented 7,5% of total cases notified in the country. |
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| PAHO-2018-PT |
| PAHO-2018-EN |
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| PAHO-2017-SP |
| PAHO-2017-PT |
| PAHO-2017-EN |
| PAHO-2016-EN |
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| PAHO-2016-PT |
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Saudi Arabia
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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
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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
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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
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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
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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
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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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| PAHO-2018-PT |
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Syrian Arab Republic
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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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Tajikistan
| Tajikistan is endemic for visceral leishmaniasis and cutaneous leishmaniasis. However leishmanial and vector species are unknown. Between 2007 and 2016, about 481 VL cases were reported. About 472 CL cases were reported during the same period. |
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Tunisia
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Tunisia is endemic for CL and VL. CL caused by L. major is a major public health problem. It occurs mainly in central and south-western Tunisia (semi-arid and arid areas) and causes thousands of cases. In some villages, up to 60% of the population are infected. Less frequent, CL caused by L. tropica occurs mostly in south-eastern Tunisia. Sporadic CL due to L. infantum occurs in towns and villages in the north of the country. Sporadic CL due to L. killicki occurs further south, sometimes in small outbreaks. VL is endemic in the north of the country in areas linked to irrigation development and to agriculture that favours the multiplication of vector sandflies and dogs, the reservoirs of L. infantum. |
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Turkey
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Turkey is endemic for CL and VL. CL is caused by L. tropica and is more prevalent in south-eastern Anatolia, where 96% of cases are located in central Anatolia, the western regions and, less frequently, in the Aegean and Mediterranean regions. Sanliurfa and south-eastern Anatolia also report cases. Some CL cases are attributed to L. infantum in WHO’s Eastern Mediterranean Region. VL is endemic in Turkey, with sporadic cases reported mostly from the Armenian border, in the Aegean, Central Anatolia and Mediterranean regions. Dogs seem to be the main animal reservoir, with a high seroprevalence exceeding 20% in some of the endemic regions. |
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Uganda
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Uganda is endemic for VL. VL is considered to be endemic in the Karamoja subregion of Amudat district, an area of semi-arid steppe (north-eastern Uganda). The real burden of the disease and its geographical spread remain unknown. Identified risk factors for contracting VL include sitting on termite mounds, treating livestock with insecticides and having a low socioeconomic status. Owning a mosquito bednet is associated with a reduced risk of contracting the disease. CL has been reported for several years. Today, it probably occurs in the foothills of Mount Elgon, but this needs confirmation. The disease is caused by L. aethiopica (Mulago hospital report; Uganda Ministry of Health). A case of CL due to L. donovani, in an HIV coinfected patient living in the Ssese Islands in Lake Victoria, has also been reported. |
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| 2018 NEW RELEASE |
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Uzbekistan
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Uzbekistan is endemic for visceral leishmaniasis and cutaneous leishmaniasis. VL is caused by L. infantum. The disease is zoonotic and domestic dogs and wild canines serve as reservoir hosts, bringing the infection close to humans. Between 1998 and 2016, about 305 VL cases have been reported. CL and ACL is transmitted by L. major and L. tropica, respectively. About 5812CL cases were reported during the same period. Cases have seen a sharp increase in 2016. Sandfly species prevalent are P. longiductus, P. papatasi and P. sergenti. |
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Venezuela
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Leishmaniasis remains an important public health problem in Venezuela. It is endemic for zoonotic visceral leishmaniasis, cutaneous and mucocutaneous leishmaniasis. Infection is associated with jungle activities and particularly the clearing of land. Transmission occurs throughout the year with seasonal fluctuations. Between 2011 and 2016, a total of 11,024 cutaneous and mucosal leishmaniasis cases have been reported and we observe the annual increase of visceral leishmaniasis in the last four years The Leishmania identified are L. amazonensis, L. pifanoi, L. venezuelensis, L. braziliensis, L. colombiensis, L. guyanensis and L. infantum. Proven vectors are Lu. ovallesi, Lu. trinidanensis, Lu. flaviscutellata, Lu. spinicrassa, Lu. panamensis, Lu. olmeca bicolor, Lu. longipalpis, Lu. evansi and others. |
| Available /media/upload/arxius/country_profiles |
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| PAHO-2018-PT |
| PAHO-2018-EN |
| PAHO-2018-SP |
| PAHO-2017-SP |
| PAHO-2017-PT |
| PAHO-2017-EN |
| PAHO-2016-EN |
| PAHO-2016-SP |
| PAHO-2016-PT |
| PAHO-2015-EN |
| PAHO-2015-SP |
| PAHO-2015-PT |
| Distribution of new cases per disease form (maps) |
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