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Uncharted territory of the epidemiological burden of cutaneous leishmaniasis in sub-Saharan Africa-A systematic review.
PLoS Negl Trop Dis. 2018 10; 12(10):e0006914.PN

Abstract

INTRODUCTION

Cutaneous leishmaniasis (CL) is the most frequent form of leishmaniasis, with 0.7 to 1.2 million cases per year globally. However, the burden of CL is poorly documented in some regions. We carried out this review to synthesize knowledge on the epidemiological burden of CL in sub-Saharan Africa.

METHODS

We systematically searched PubMed, CABI Global health, Africa Index Medicus databases for publications on CL and its burden. There were no restrictions on language/publication date. Case series with less than ten patients, species identification studies, reviews, non-human, and non-CL focused studies were excluded. Findings were extracted and described. The review was conducted following PRISMA guidelines; the protocol was registered in PROSPERO (42016036272).

RESULTS

From 289 identified records, 54 met eligibility criteria and were included in the synthesis. CL was reported from 13 of the 48 sub-Saharan African countries (3 eastern, nine western and one from southern Africa). More than half of the records (30/54; 56%) were from western Africa, notably Senegal, Burkina Faso and Mali. All studies were observational: 29 were descriptive case series (total 13,257 cases), and 24 followed a cross-sectional design. The majority (78%) of the studies were carried out before the year 2000. Forty-two studies mentioned the parasite species, but was either assumed or attributed on the historical account. Regional differences in clinical manifestations were reported. We found high variability across methodologies, leading to difficulties to compare or combine data. The prevalence in hospital settings among suspected cases ranged between 0.1 and 14.2%. At the community level, CL prevalence varied widely between studies. Outbreaks of thousands of cases occurred in Ethiopia, Ghana, and Sudan. Polymorphism of CL in HIV-infected people is a concern. Key information gaps in CL burden here include population-based CL prevalence/incidence, risk factors, and its socio-economic burden.

CONCLUSION

The evidence on CL epidemiology in sub-Saharan Africa is scanty. The CL frequency and severity are poorly identified. There is a need for population-based studies to define the CL burden better. Endemic countries should consider research and action to improve burden estimation and essential control measures including diagnosis and treatment capacity.

Authors+Show Affiliations

Department of Public Health, Institute of Tropical Medicine, Antwerp, Belgium. Policy Department, Médecins Sans Frontières - Campaign for Access to Medicines, Geneva, Switzerland.Department of Public Health, Institute of Tropical Medicine, Antwerp, Belgium.Faculty of Medicine, University of Khartoum, Khartoum, Sudan.Policy Department, Médecins Sans Frontières - Campaign for Access to Medicines, Geneva, Switzerland.ISGlobal, Barcelona Institute for Global Health, Barcelona, Spain.Department of Public Health, Institute of Tropical Medicine, Antwerp, Belgium.

Pub Type(s)

Journal Article
Research Support, Non-U.S. Gov't
Systematic Review

Language

eng

PubMed ID

30359376

Citation

Sunyoto, Temmy, et al. "Uncharted Territory of the Epidemiological Burden of Cutaneous Leishmaniasis in sub-Saharan Africa-A Systematic Review." PLoS Neglected Tropical Diseases, vol. 12, no. 10, 2018, pp. e0006914.
Sunyoto T, Verdonck K, El Safi S, et al. Uncharted territory of the epidemiological burden of cutaneous leishmaniasis in sub-Saharan Africa-A systematic review. PLoS Negl Trop Dis. 2018;12(10):e0006914.
Sunyoto, T., Verdonck, K., El Safi, S., Potet, J., Picado, A., & Boelaert, M. (2018). Uncharted territory of the epidemiological burden of cutaneous leishmaniasis in sub-Saharan Africa-A systematic review. PLoS Neglected Tropical Diseases, 12(10), e0006914. https://doi.org/10.1371/journal.pntd.0006914
Sunyoto T, et al. Uncharted Territory of the Epidemiological Burden of Cutaneous Leishmaniasis in sub-Saharan Africa-A Systematic Review. PLoS Negl Trop Dis. 2018;12(10):e0006914. PubMed PMID: 30359376.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Uncharted territory of the epidemiological burden of cutaneous leishmaniasis in sub-Saharan Africa-A systematic review. AU - Sunyoto,Temmy, AU - Verdonck,Kristien, AU - El Safi,Sayda, AU - Potet,Julien, AU - Picado,Albert, AU - Boelaert,Marleen, Y1 - 2018/10/25/ PY - 2018/07/11/received PY - 2018/10/11/accepted PY - 2018/11/06/revised PY - 2018/10/26/pubmed PY - 2019/1/10/medline PY - 2018/10/26/entrez SP - e0006914 EP - e0006914 JF - PLoS neglected tropical diseases JO - PLoS Negl Trop Dis VL - 12 IS - 10 N2 - INTRODUCTION: Cutaneous leishmaniasis (CL) is the most frequent form of leishmaniasis, with 0.7 to 1.2 million cases per year globally. However, the burden of CL is poorly documented in some regions. We carried out this review to synthesize knowledge on the epidemiological burden of CL in sub-Saharan Africa. METHODS: We systematically searched PubMed, CABI Global health, Africa Index Medicus databases for publications on CL and its burden. There were no restrictions on language/publication date. Case series with less than ten patients, species identification studies, reviews, non-human, and non-CL focused studies were excluded. Findings were extracted and described. The review was conducted following PRISMA guidelines; the protocol was registered in PROSPERO (42016036272). RESULTS: From 289 identified records, 54 met eligibility criteria and were included in the synthesis. CL was reported from 13 of the 48 sub-Saharan African countries (3 eastern, nine western and one from southern Africa). More than half of the records (30/54; 56%) were from western Africa, notably Senegal, Burkina Faso and Mali. All studies were observational: 29 were descriptive case series (total 13,257 cases), and 24 followed a cross-sectional design. The majority (78%) of the studies were carried out before the year 2000. Forty-two studies mentioned the parasite species, but was either assumed or attributed on the historical account. Regional differences in clinical manifestations were reported. We found high variability across methodologies, leading to difficulties to compare or combine data. The prevalence in hospital settings among suspected cases ranged between 0.1 and 14.2%. At the community level, CL prevalence varied widely between studies. Outbreaks of thousands of cases occurred in Ethiopia, Ghana, and Sudan. Polymorphism of CL in HIV-infected people is a concern. Key information gaps in CL burden here include population-based CL prevalence/incidence, risk factors, and its socio-economic burden. CONCLUSION: The evidence on CL epidemiology in sub-Saharan Africa is scanty. The CL frequency and severity are poorly identified. There is a need for population-based studies to define the CL burden better. Endemic countries should consider research and action to improve burden estimation and essential control measures including diagnosis and treatment capacity. SN - 1935-2735 UR - https://www.unboundmedicine.com/medline/citation/30359376/Uncharted_territory_of_the_epidemiological_burden_of_cutaneous_leishmaniasis_in_sub_Saharan_Africa_A_systematic_review_ L2 - http://dx.plos.org/10.1371/journal.pntd.0006914 DB - PRIME DP - Unbound Medicine ER -