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全球旅行、移民、难民群体及人道主义危机背景下的皮肤利什曼病

Cutaneous Leishmaniasis in the Context of Global Travel, Migration, Refugee Populations, and Humanitarian Crises.

作者信息

Kim Janice, Zieneldien Tarek, Ma Sophia, Cohen Bernard A

机构信息

College of Osteopathic Medicine, Michigan State University, East Lansing, MI 48824, USA.

School of Medicine, Johns Hopkins University, Baltimore, MD 21205, USA.

出版信息

Clin Pract. 2025 Apr 8;15(4):77. doi: 10.3390/clinpract15040077.

Abstract

Cutaneous leishmaniasis (CL) is a vector-borne infection caused by protozoan parasites belonging to the genus . CL is an emerging global health concern due to increasing migration, travel, and climate change. Traditionally, it was confined to endemic regions such as the Americas, the Middle East, and Central Asia; however, it is now spreading to non-endemic areas. Climate change has further contributed to the expansion of sandfly habitats, increasing CL transmission risk in previously unaffected areas. Healthcare providers in non-endemic regions often misdiagnose CL, delaying treatment and morbidity. Diagnosis remains challenging due to the need for species-specific identification, while treatment is limited by cost, availability, and personnel expertise. This review explores the epidemiology, clinical presentation, diagnostic challenges, and management of CL in the context of global mobility. It highlights rising CL cases in refugee settlements, particularly in Lebanon and Jordan, due to poor living conditions, inadequate vector control, and healthcare barriers. While there have been advances in systemic and topical therapies, access in refugee and resource-poor settings remains a barrier. Addressing the global burden of CL requires improved surveillance, healthcare provider training, and increased awareness. By enhancing global collaboration and policy changes, public health efforts can mitigate the expanding impact of CL.

摘要

皮肤利什曼病(CL)是一种由利什曼原虫属原生动物寄生虫引起的媒介传播感染。由于移民增加、旅行和气候变化,CL已成为一个新出现的全球卫生问题。传统上,它局限于美洲、中东和中亚等流行地区;然而,现在它正在蔓延到非流行地区。气候变化进一步促使白蛉栖息地扩大,增加了以前未受影响地区CL的传播风险。非流行地区的医疗服务提供者常常误诊CL,延误治疗和发病。由于需要进行物种特异性鉴定,诊断仍然具有挑战性,而治疗则受到成本、可及性和人员专业知识的限制。本综述探讨了在全球人口流动背景下CL的流行病学、临床表现、诊断挑战和管理。它强调了由于生活条件差、媒介控制不足和医疗障碍,难民定居点(特别是在黎巴嫩和约旦)的CL病例不断增加。虽然全身和局部治疗方面已有进展,但在难民和资源匮乏地区获得治疗仍然是一个障碍。应对CL的全球负担需要加强监测、培训医疗服务提供者并提高认识。通过加强全球合作和政策变革,公共卫生努力可以减轻CL不断扩大的影响。

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