Zhang Shun-Xian, Yang Guo-Bing, Sun Jian-Yong, Li Yong-Jun, Yang Jian, Wang Ji-Chun, Deng Yao
Longhua Hospital, Shanghai University of Traditional Chinese Medicine, Shanghai, 200032, China.
Gansu Provincial Center for Disease Control and Prevention, Lanzhou, 730000, Gansu, China.
Parasit Vectors. 2025 Apr 26;18(1):157. doi: 10.1186/s13071-025-06796-x.
Leishmaniasis is a vector-borne parasitic disease caused by protozoa of the Leishmania genus; it is transmitted through the bites of infected phlebotomine sandflies. Clinically, it manifests in three primary forms: cutaneous, mucocutaneous, and visceral leishmaniasis (VL). Among these, VL represents the most severe form, characterized by high morbidity and mortality, and poses a considerable public health burden, particularly in endemic regions. This study utilizes data from the Global Burden of Disease (GBD) study 2021 to conduct a comprehensive analysis of the global epidemiological trends and burden of VL from 1990 to 2021, aiming to generate evidence-based insights to inform prevention and control strategies.
Using GBD 2021 data, this study examined trends in the incidence, prevalence, mortality, and disability-adjusted life years (DALYs) of VL across 204 countries and territories, stratified by age, sex, and sociodemographic index (SDI) levels. Average annual percent change (AAPC) was calculated to describe trends in age-standardized rates and indicator counts from 1990 to 2021.
From 1990 to 2021, the global age-standardized incidence rate (ASIR; AAPC = -0.25, 95% confidence interval (CI) -0.25, -0.24), age-standardized prevalence rate (ASPR; AAPC = -0.06, 95% CI -0.06, -0.05), age-standardized mortality rate (ASMR; AAPC = -0.03, 95% CI -0.04, -0.02), and DALY rate (AAPC = -2.38, 95% CI -2.44, -2.33) for VL all showed a declining trend. The ASMR was highest among children under 5 years old and decreased progressively with age. VL remains a critical and under-recognized tropical disease in Latin America, the Middle East, Africa, and South Asia.
VL disproportionately affects males and presents the highest risk in children under 5 years. Enhanced global collaboration in infectious disease control, with a focus on regions such as Latin America, Africa, the Middle East, and South Asia, is essential to further reduce the burden of VL.
利什曼病是一种由利什曼原虫属原生动物引起的媒介传播寄生虫病；它通过受感染的白蛉叮咬传播。临床上，它表现为三种主要形式：皮肤利什曼病、黏膜皮肤利什曼病和内脏利什曼病（VL）。其中，VL是最严重的形式，发病率和死亡率高，给公共卫生带来相当大的负担，特别是在流行地区。本研究利用2021年全球疾病负担（GBD）研究的数据，对1990年至2021年全球VL的流行病学趋势和负担进行全面分析，旨在产生基于证据的见解，为预防和控制策略提供依据。
利用GBD 2021数据，本研究调查了204个国家和地区按年龄、性别和社会人口指数（SDI）水平分层的VL发病率、患病率、死亡率和伤残调整生命年（DALY）趋势。计算年均变化百分比（AAPC）以描述1990年至2021年年龄标准化率和指标计数的趋势。
1990年至2021年，全球VL年龄标准化发病率（ASIR；AAPC = -0.25，9５%置信区间（CI）-0.25，-0.24）、年龄标准化患病率（ASPR；AAPC = -0.06，95% CI -0.06，-0.05）、年龄标准化死亡率（ASMR；AAPC = -0.03，95% CI -0.04，-0.02）和DALY率（AAPC = -2.38，95% CI -2.44，-2.33）均呈下降趋势。5岁以下儿童的ASMR最高，并随年龄增长逐渐下降。VL在拉丁美洲、中东、非洲和南亚仍然是一种严重但未得到充分认识的热带疾病。
VL对男性的影响尤为严重，5岁以下儿童风险最高。加强全球传染病控制合作，重点关注拉丁美洲、非洲、中东和南亚等地区，对于进一步减轻VL负担至关重要。
