Global burden of cutaneous leishmaniasis: a cross-sectional analysis from the Global Burden of Disease Study 2013

Chante Karimkhani; Valentine Wanga; Luc E Coffeng; Paria Naghavi; Robert P Dellavalle; Mohsen Naghavi

doi:10.1016/S1473-3099(16)00003-7

Global burden of cutaneous leishmaniasis: a cross-sectional analysis from the Global Burden of Disease Study 2013

Lancet Infect Dis. 2016 May;16(5):584-591. doi: 10.1016/S1473-3099(16)00003-7. Epub 2016 Feb 12.

Authors

Chante Karimkhani¹, Valentine Wanga², Luc E Coffeng³, Paria Naghavi², Robert P Dellavalle⁴, Mohsen Naghavi²

Affiliations

¹ University Hospitals Case Medical Center, Case Western Reserve University, Cleveland, OH, USA. Electronic address: ck2525@caa.columbia.edu.
² Institute for Health Metrics and Evaluation, University of Washington, Seattle, WA, USA.
³ Institute for Health Metrics and Evaluation, University of Washington, Seattle, WA, USA; Department of Public Health, Erasmus MC University Medical Center Rotterdam, CA Rotterdam, Netherlands.
⁴ Department of Dermatology, University of Colorado Anschutz Medical Campus, Aurora, CO, USA; Dermatology Service, United States Department of Veterans Affairs, Eastern Colorado Health Care System, Denver, CO, USA; Department of Epidemiology, Colorado School of Public Health, Aurora, CO, USA.

PMID: 26879176
DOI: 10.1016/S1473-3099(16)00003-7

Abstract

Background: High-quality epidemiological studies evaluating the burden of cutaneous leishmaniasis worldwide are lacking. We compared the burden of cutaneous leishmaniasis in each country to the overall global burden and assessed the equality of cutaneous leishmaniasis burden across different countries and regions.

Methods: Data were extracted from scientific literature, hospital sources, country reports, and WHO sources on the prevalence of sequalae of both acute and chronic cutaneous leishmaniasis. Prevalence data were combined with a disability weight to yield years lived with disability. Disability-adjusted life-years (DALYs) are a sum of the years lived with disability and years of life lost (or mortality, assumed to be zero). We compared DALYs due to cutaneous leishmaniasis for 152 countries using standard Z score analysis with Bonferroni correction (p<0·003) and generation of Lorenz curves with a Gini coefficient.

Findings: In 2013, the global mean age-standardised DALYs for cutaneous leishmaniasis was 0·58 per 100 000 people. Nine countries had significantly greater DALYs from cutaneous leishmaniasis than the mean: Afghanistan (87·0), Sudan (20·2), Syria (9·2), Yemen (6·2), Iraq (6·0), Burkina Faso (4·8), Bolivia (4·6), Haiti (4·1), and Peru (4·0). The Gini coefficient was 0·89. Andean Latin America, North Africa and Middle East, western sub-Saharan Africa, and south Asia had the highest DALYs from cutaneous leishmaniasis. Among males, Palestine had the highest incidence rates (616·2 cases per 100 000 people) followed by Afghanistan (566·4), Syria (357·1), and Nicaragua (354·8). Among females, Afghanistan had the highest incidence rates (623·9) followed by Syria (406·3), Palestine (222·1), and Nicaragua (180·8). Similar proportions of males and females had cutaneous leishmaniasis in most countries with a high incidence.

Interpretation: The burden from cutaneous leishmaniasis mainly falls on countries in Africa and the Middle East. Global and national data on the burden of cutaneous leishmaniasis disease are pivotal to promote field studies and initiate behavioural change.

Funding: Bill & Melinda Gates Foundation.

Publication types

Research Support, Non-U.S. Gov't

MeSH terms

Africa / epidemiology
Cost of Illness
Cross-Sectional Studies
Developing Countries
Disabled Persons
Female
Global Burden of Disease*
Global Health
Humans
Incidence
Leishmaniasis, Cutaneous / epidemiology*
Male
Quality-Adjusted Life Years*
Risk Factors