Department for the Control of Neglected Tropical Diseases (HTM/NTD/IDM), Leishmaniasis Control Program, World Health Organization, Geneva, Switzerland.
PLoS One. 2012;7(5):e35671. doi: 10.1371/journal.pone.0035671. Epub 2012 May 31.
As part of a World Health Organization-led effort to update the empirical evidence base for the leishmaniases, national experts provided leishmaniasis case data for the last 5 years and information regarding treatment and control in their respective countries and a comprehensive literature review was conducted covering publications on leishmaniasis in 98 countries and three territories (see 'Leishmaniasis Country Profiles Text S1, S2, S3, S4, S5, S6, S7, S8, S9, S10, S11, S12, S13, S14, S15, S16, S17, S18, S19, S20, S21, S22, S23, S24, S25, S26, S27, S28, S29, S30, S31, S32, S33, S34, S35, S36, S37, S38, S39, S40, S41, S42, S43, S44, S45, S46, S47, S48, S49, S50, S51, S52, S53, S54, S55, S56, S57, S58, S59, S60, S61, S62, S63, S64, S65, S66, S67, S68, S69, S70, S71, S72, S73, S74, S75, S76, S77, S78, S79, S80, S81, S82, S83, S84, S85, S86, S87, S88, S89, S90, S91, S92, S93, S94, S95, S96, S97, S98, S99, S100, S101'). Additional information was collated during meetings conducted at WHO regional level between 2007 and 2011. Two questionnaires regarding epidemiology and drug access were completed by experts and national program managers. Visceral and cutaneous leishmaniasis incidence ranges were estimated by country and epidemiological region based on reported incidence, underreporting rates if available, and the judgment of national and international experts. Based on these estimates, approximately 0.2 to 0.4 cases and 0.7 to 1.2 million VL and CL cases, respectively, occur each year. More than 90% of global VL cases occur in six countries: India, Bangladesh, Sudan, South Sudan, Ethiopia and Brazil. Cutaneous leishmaniasis is more widely distributed, with about one-third of cases occurring in each of three epidemiological regions, the Americas, the Mediterranean basin, and western Asia from the Middle East to Central Asia. The ten countries with the highest estimated case counts, Afghanistan, Algeria, Colombia, Brazil, Iran, Syria, Ethiopia, North Sudan, Costa Rica and Peru, together account for 70 to 75% of global estimated CL incidence. Mortality data were extremely sparse and generally represent hospital-based deaths only. Using an overall case-fatality rate of 10%, we reach a tentative estimate of 20,000 to 40,000 leishmaniasis deaths per year. Although the information is very poor in a number of countries, this is the first in-depth exercise to better estimate the real impact of leishmaniasis. These data should help to define control strategies and reinforce leishmaniasis advocacy.
作为世界卫生组织（WHO）主导的更新利什曼病实证证据基础工作的一部分，各国专家提供了过去 5 年的利什曼病病例数据，以及本国的治疗和控制信息，并进行了全面的文献综述，涵盖了 98 个国家和 3 个地区（见“利什曼病国家概况文本 S1、S2、S3、S4、S5、S6、S7、S8、S9、S10、S11、S12、S13、S14、S15、S16、S17、S18、S19、S20、S21、S22、S23、S24、S25、S26、S27、S28、S29、S30、S31、S32、S33、S34、S35、S36、S37、S38、S39、S40、S41、S42、S43、S44、S45、S46、S47、S48、S49、S50、S51、S52、S53、S54、S55、S56、S57、S58、S59、S60、S61、S62、S63、S64、S65、S66、S67、S68、S69、S70、S71、S72、S73、S74、S75、S76、S77、S78、S79、S80、S81、S82、S83、S84、S85、S86、S87、S88、S89、S90、S91、S92、S93、S94、S95、S96、S97、S98、S99、S100、S101'）的出版物。在 2007 年至 2011 年期间，还在世卫组织区域层面会议上收集了其他信息。专家和国家规划管理人员填写了两份关于流行病学和药物获取的调查问卷。根据报告的发病率、如果有漏报率以及国家和国际专家的判断，按国家和流行病学区域估计了内脏利什曼病和皮肤利什曼病的发病率范围。根据这些估计，每年分别约有 0.2 至 0.4 例和 0.7 至 1.2 百万例内脏利什曼病和皮肤利什曼病病例。全球 90%以上的内脏利什曼病病例发生在六个国家：印度、孟加拉国、苏丹、南苏丹、埃塞俄比亚和巴西。皮肤利什曼病的分布范围更广，在美洲、地中海盆地和从中东到中亚的西亚三个流行病学区域，约有三分之一的病例。估计病例数最多的 10 个国家，阿富汗、阿尔及利亚、哥伦比亚、巴西、伊朗、叙利亚、埃塞俄比亚、北苏丹、哥斯达黎加和秘鲁，占全球估计的皮肤利什曼病发病率的 70%至 75%。死亡率数据非常稀少，通常仅代表医院死亡。使用总的病死率 10%，我们得出每年约有 20,000 至 40,000 例利什曼病死亡。尽管许多国家的信息非常匮乏，但这是首次对利什曼病的实际影响进行深入评估。这些数据应该有助于确定控制策略和加强利什曼病的宣传。
