Departamento de Ecologia, Instituto de Biociências, Universidade de São Paulo, 321 Rua do Matão, Travessa 14, Cidade Universitaria, São Paulo, SP, 05508-090, Brazil.
Department of Ecology, Columbia University, 1200 Amsterdam Ave., New York, NY, 10027, USA.
Parasitol Res. 2020 Feb;119(2):365-384. doi: 10.1007/s00436-019-06575-5. Epub 2020 Jan 2.
We performed a systematic review of the literature published since 1900 about leishmaniasis a neglected vector-borne disease, focused on environmental and social risk factors for visceral (VL) and cutaneous leishmaniasis (CL) to better understand their impact on the incidence of disease. The search terms were "leishmaniasis" AND "risk factors" using Google Scholar, PudMed, and Scielo. We reviewed 177 articles, 95 studies for VL, 75 for CL, and 7 on both forms. We identified 14 categories of risk factors which were divided into three groups: socioeconomic (7), environmental (5), and climate (2) variables. Socioeconomic factors were also associated with disease incidence in vulnerable human populations of arid and tropical developing regions. Environmental and climate factors showed significant associations with the incidence of VL and CL in all the studies that considered them. Proximity to natural vegetation remnants increased disease risk in both the New and Old World while the climate conditions favorable for disease transmission differed among regions. We propose a common conceptual framework for both clinical forms that highlights networks of interaction among risk factors. In both clinical forms, the interplay of these factors played a major role in disease incidence. Although there are similarities in environmental and socioeconomic conditions that mediate the transmission cycle of tropical, arid, and Mediterranean regions, the behavior of vector and reservoirs in each region is different. Special attention should be given to the possibility of vector adaptation to urban environments in developing countries where populations with low socioeconomic status are particularly vulnerable to the disease.
我们对 1900 年以来发表的关于利什曼病(一种被忽视的媒介传播疾病)的文献进行了系统综述,重点关注内脏利什曼病(VL)和皮肤利什曼病(CL)的环境和社会风险因素,以更好地了解它们对疾病发病率的影响。我们使用 Google Scholar、PudMed 和 Scielo 搜索了“利什曼病”和“风险因素”这两个术语。我们共查阅了 177 篇文章,其中 95 篇是关于 VL 的,75 篇是关于 CL 的,还有 7 篇是关于两种疾病的。我们确定了 14 类风险因素,分为三组:社会经济因素(7 类)、环境因素(5 类)和气候因素(2 类)。社会经济因素也与干旱和热带发展中地区脆弱人群的疾病发病率有关。环境和气候因素在考虑到这些因素的所有研究中均与 VL 和 CL 的发病率有显著关联。在新旧大陆,靠近自然植被残余物都会增加疾病风险,而有利于疾病传播的气候条件在不同地区也有所不同。我们提出了一种适用于两种临床形式的通用概念框架,突出了风险因素之间的相互作用网络。在这两种临床形式中,这些因素的相互作用在疾病发病率中起着重要作用。尽管在介导热带、干旱和地中海地区传播周期的环境和社会经济条件方面存在相似之处,但每个地区的媒介和宿主的行为却有所不同。应特别注意在发展中国家,由于人口的社会经济地位较低,媒介可能会适应城市环境,从而导致疾病的发生。
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