Epidemiology
| Visceral leishmaniasis is currently considered an emerging and reemerging disease in both rural and urban areas. According to the World Health Organization (WHO), in 1990 there were 12 million cases with 400 thousand new cases every year. In Brazil, the estimate is approximately 3000 cases per year. | |
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The WHO has currently pointed out the increase in the number of cases of co-infection HIV/visceral leishmaniasis, especially in southern Europe. This is due to primarily tosharing of needles and syringes. This route of infection has been extending to the Nordic countries. |
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Leishmania is largely distributed in tropical and subtropical areas, extending from Central America to the Mediterranean countries, Africa, Central Asia, India, and China. Leishmaniasis is considered the second most important protozoal disease in the world, with its incidence being lower than malaria only. |
| In humans, visceral leishmaniasis affects mainly children and immunosuppressed individuals, and it is characterized by long periods of irregular fever, weakness, weight loss, pancytopenia, hepato- and splenomegaly, hypergammaglobulinemia, and hypoalbuminemiawhich progresses to chronicity or death in the absence of adequate treatment. | |
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Several species of canids (dogs, foxes, and coyotes), marsupials, and rodents have been incriminated as reservoirs in endemic areas. Dogs play an essential role for maintenance of the disease in endemic areas where they act as domestic reservoir and source of infection for the Phlebotomus and consequently human infections. |
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