Leishmaniasis Beyond East Africa

Abstract

Climate change is having a substantial impact on our environment and ecosystems and has altered the way humans live, access, and utilize resources with increased risk of zoonotic infectious disease encounters. As global temperatures continue to increase, they impact on public health, migration, food security and land conflict, and as new environments become favorable, exposure to disease carrying vectors. Increased forests or natural habitat clearance for land repurposing, urbanization, road building, and water management are related to an increase in emerging vector borne parasitic diseases. The East African region remains one of the most impacted regions globally for leishmaniasis, a vector borne disease that impacts significantly on the health, wellbeing and livelihoods of affected communities and for which a lack of reporting and control interventions hinder progress toward elimination of this neglected tropical disease. As our world continues to transform, both politically and climatically, it is essential that measures are put in place to improve surveillance and disease management with implementation of control measures, including vector control, especially in low- and middle-income countries that are expected to be most impacted by changes in climate. Only through effective management, now, can we be sufficiently resilient to preventing the inevitable spread of vectors into suitable habitat and expansion of the geographical range of leishmaniasis. This review offers a current perspective on Leishmaniasis as an endemic disease in East Africa and examines the potential of the recent emergence of Leishmania infection in hitherto unaffected regions to become a public health concern if no disease management is achieved.

Seroprevalence of visceral leishmaniasis and its associated factors among asymptomatic pastoral community of Dire District, Borena zone, Oromia Region, Ethiopia

“…Domestic dogs might be the most important reservoir of both L. donovani and L. infantum in eastern Africa ( 6 , 8 ). However, the transmission of L. donovani is generally thought to be anthroponotic in the East African region, and in Ethiopia, it is thought to be partially zoonotic and anthroponotic, the nature of which varies with geographical areas ( 8 , 9 ). Thus, the decisive reservoir of VL in East Africa and Ethiopia remains to be determined and wellstudied.…”

Moving from control to elimination of Visceral Leishmaniasis in East Africa

“…With the neglected disease considered as low priority for investment in most affected countries, there is minimal funding towards addressing VL and a lack of sustainability in the implementation of current activities. Migration and population displacement resulting partly from climate/environmental changes and civil unrest further contribute to high incidences of VL (18,19). Civil unrest and VL epidemics tend to occur among immunologically naïve migrants entering VL-endemic areas or when Leishmania-infected individuals migrate to new areas and establish additional foci of disease (20).…”

Climate change and environmental influence on visceral leishmaniasis in West Pokot county, Kenya

“…The devastating effect of global warming and climate change coupled with prevalent low individual immune system and social weakness in the visceral leishmaniasis endemic zones, cases of leishmaniasis are expected to get aggravated, thus, the need to undertake epidemiological studies particularly in endemic areas [22][23][24]. The study aimed to contribute to the sustainable development goal number 3.3, World Health Organization's neglected tropical diseases road map target 2021 to 2030, as well as Kenya's ministry of health 2021-2025 strategic plan for control of visceral leishmaniasis and vision 2030.…”