Kim Janice, Zieneldien Tarek, Ma Sophia, Cohen Bernard A
College of Osteopathic Medicine, Michigan State University, East Lansing, MI 48824, USA.
School of Medicine, Johns Hopkins University, Baltimore, MD 21205, USA.
Trop Med Infect Dis. 2025 Aug 28;10(9):245. doi: 10.3390/tropicalmed10090245.
Cutaneous leishmaniasis (CL) is a vector-borne parasitic disease caused by protozoa of the genus. Once confined to endemic regions such as the Middle East, Americas, North Africa, and Central Asia, CL is increasingly emerging in non-endemic areas due to a multitude of drivers, including population displacement, environmental disruption, and political instability. These overlapping drivers contribute to expanding sand fly habitats, degrading living conditions, and weakening health systems, increasing transmission. Rising global temperatures further facilitate vector expansion into new regions, where clinical unfamiliarity often leads to misdiagnosis, delayed treatment, increased morbidity, and greater financial burden. Despite its rising incidence and global spread, CL remains a neglected tropical disease since it is seldom fatal, with scant interest by public health authorities and financial donors, limiting activities that further research and prevent spread of the disease. This review synthesizes current evidence on how geopolitical instability, forced migration, and climate-driven ecological changes collectively reshape CL epidemiology and complicate diagnosis, treatment, and surveillance. As CL extends beyond traditional geographic boundaries, it requires integrated strategies that address its multifaceted drivers through strengthened cross-border surveillance, provider education, and international coordination-focusing on prevention, diagnosis, and equitable access to diagnostics and therapeutics, especially among displaced and underserved populations.
皮肤利什曼病（CL）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。CL曾经局限于中东、美洲、北非和中亚等流行地区，但由于人口流离失所、环境破坏和政治不稳定等多种因素，它在非流行地区日益出现。这些相互重叠的因素导致白蛉栖息地扩大、生活条件恶化和卫生系统薄弱，从而增加了传播。全球气温上升进一步促使媒介向新地区扩张，在这些地区，临床经验不足往往导致误诊、治疗延误、发病率增加和经济负担加重。尽管CL的发病率不断上升且在全球蔓延，但它仍然是一种被忽视的热带病，因为它很少致命，公共卫生当局和金融捐助者对此兴趣寥寥，限制了进一步研究和预防该病传播的活动。本综述综合了当前关于地缘政治不稳定、被迫迁移和气候驱动的生态变化如何共同重塑CL流行病学并使诊断、治疗和监测复杂化的证据。随着CL超越传统地理边界，需要采取综合策略，通过加强跨境监测、医疗服务提供者教育和国际协调来应对其多方面驱动因素，重点是预防、诊断以及公平获得诊断和治疗手段，特别是在流离失所和服务不足的人群中。
