Department of Cellular and Molecular Biology, College of Science, Northeastern University, Boston, Massachusetts, United States of America.
African Centre for Community Investment in Health, Nginyang, Baringo County, Kenya.
PLoS Negl Trop Dis. 2023 Jun 1;17(6):e0011358. doi: 10.1371/journal.pntd.0011358. eCollection 2023 Jun.
The leishmaniases are a group of four vector-borne neglected tropical diseases caused by 20 species of protozoan parasites of the genus Leishmania and transmitted through a bite of infected female phlebotomine sandflies. Endemic in over 100 countries, the four types of leishmaniasis-visceral leishmaniasis (VL) (known as kala-azar), cutaneous leishmaniasis (CL), mucocutaneous leishmaniasis (MCL), and post-kala-azar dermal leishmaniasis (PKDL)-put 1.6 billion people at risk. In Kenya, the extent of leishmaniasis research has not yet been systematically described. This knowledge is instrumental in identifying existing research gaps and designing appropriate interventions for diagnosis, treatment, and elimination.
METHODOLOGY/PRINCIPAL FINDINGS: This study used the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) methodology to determine the state of leishmaniases research in Kenya and identify research gaps. We searched seven online databases to identify articles published until January 2022 covering VL, CL, MCL, and/or PKDL in Kenya. A total of 7,486 articles were found, of which 479 underwent full-text screening, and 269 met our eligibility criteria. Most articles covered VL only (n = 141, 52%), were published between 1980 and 1994 (n = 108, 39%), and focused on the theme of "vectors" (n = 92, 34%). The most prevalent study types were "epidemiological research" (n = 88, 33%) tied with "clinical research" (n = 88, 33%), then "basic science research" (n = 49, 18%) and "secondary research" (n = 44, 16%).
CONCLUSION/SIGNIFICANCE: While some studies still provide useful guidance today, most leishmaniasis research in Kenya needs to be updated and focused on prevention, co-infections, health systems/policy, and general topics, as these themes combined comprised less than 4% of published articles. Our findings also indicate minimal research on MCL (n = 1, <1%) and PKDL (n = 2, 1%). We urge researchers to renew and expand their focus on these neglected diseases in Kenya.
利什曼病是一组由 20 种原生动物寄生虫引起的 4 种经媒介传播的被忽视的热带病，通过受感染的雌性白蛉沙蝇叮咬传播。这种病在 100 多个国家流行，四种利什曼病——内脏利什曼病（VL）（又称黑热病）、皮肤利什曼病（CL）、黏膜皮肤利什曼病（MCL）和黑热病后皮肤利什曼病（PKDL）——使 16 亿人面临风险。在肯尼亚，利什曼病研究的范围尚未得到系统描述。这种知识对于确定现有研究差距以及为诊断、治疗和消除疾病设计适当的干预措施至关重要。
方法/主要发现：本研究使用系统评价和荟萃分析的首选报告项目（PRISMA）方法，以确定肯尼亚利什曼病研究的现状并确定研究差距。我们在七个在线数据库中搜索了截至 2022 年 1 月发表的涵盖肯尼亚 VL、CL、MCL 和/或 PKDL 的文章。共发现 7486 篇文章，其中 479 篇进行了全文筛选，269 篇符合我们的入选标准。大多数文章仅涵盖 VL（n = 141，52%），发表于 1980 年至 1994 年之间（n = 108，39%），并侧重于“媒介”主题（n = 92，34%）。最常见的研究类型是“流行病学研究”（n = 88，33%）与“临床研究”（n = 88，33%）相结合，其次是“基础科学研究”（n = 49，18%）和“二次研究”（n = 44，16%）。
结论/意义：虽然一些研究今天仍然提供了有用的指导，但肯尼亚的大多数利什曼病研究需要更新，并侧重于预防、合并感染、卫生系统/政策和一般主题，因为这些主题加起来只占已发表文章的不到 4%。我们的研究结果还表明，MCL（n = 1，<1%）和 PKDL（n = 2，1%）的研究很少。我们敦促研究人员在肯尼亚重新关注并扩大对这些被忽视疾病的研究。
