Abstract
We performed a systematic review of the literature published since 1900 about leishmaniasis a neglected vector-borne disease, focused on environmental and social risk factors for visceral (VL) and cutaneous leishmaniasis (CL) to better understand their impact on the incidence of disease. The search terms were “leishmaniasis” AND “risk factors” using Google Scholar, PudMed, and Scielo. We reviewed 177 articles, 95 studies for VL, 75 for CL, and 7 on both forms. We identified 14 categories of risk factors which were divided into three groups: socioeconomic (7), environmental (5), and climate (2) variables. Socioeconomic factors were also associated with disease incidence in vulnerable human populations of arid and tropical developing regions. Environmental and climate factors showed significant associations with the incidence of VL and CL in all the studies that considered them. Proximity to natural vegetation remnants increased disease risk in both the New and Old World while the climate conditions favorable for disease transmission differed among regions. We propose a common conceptual framework for both clinical forms that highlights networks of interaction among risk factors. In both clinical forms, the interplay of these factors played a major role in disease incidence. Although there are similarities in environmental and socioeconomic conditions that mediate the transmission cycle of tropical, arid, and Mediterranean regions, the behavior of vector and reservoirs in each region is different. Special attention should be given to the possibility of vector adaptation to urban environments in developing countries where populations with low socioeconomic status are particularly vulnerable to the disease.
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Acknowledgments
The authors would like to thank Dr. José Dilermando Andrade Filho (Fiocruz) for their valuable comments about leishmaniasis that contributed to the development of this review. We also thank Prof. Ligia Vizeu Barrozo (FLCH-USP), Dr. Paula Ribeiro Prist, Dr. Anaiá da Paixão Sevá and Dr. Elizabeth Nichols for insights that greatly improved the manuscript.
Funding
Nerida H. Valero PhD study was funded by the Brazilian Federal Agency for Support and Evaluation of Graduate Education – CAPES Process: PDSE - 88881.134367/2016-01.
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Valero, N.N.H., Uriarte, M. Environmental and socioeconomic risk factors associated with visceral and cutaneous leishmaniasis: a systematic review. Parasitol Res 119, 365–384 (2020). https://doi.org/10.1007/s00436-019-06575-5
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DOI: https://doi.org/10.1007/s00436-019-06575-5