Status of endemicity of visceral leishmaniasis, worldwide, 2015

Anthroponotic cutaneous leishmaniasis (where humans are the major reservoir of the parasite) is predominantly urban and periurban, and shows patterns of spatial clustering similar to those of anthroponotic visceral leishmaniasis in South-East Asia. The disease is usually characterized by large outbreaks in densely populated cities, especially in war and conflicts zones, refugee camps and in settings where there are large-scale migration of populations. The epidemiology of cutaneous leishmaniasis in the Region of the Americas is complex, with intra- and inter-specific variation in transmission cycles, reservoir hosts, sandfly vectors, clinical manifestations and response to therapy, and multiple circulating Leishmania species in the same geographical area. Almost 90% of mucocutaneous leishmaniasis cases occurs in the Plurinational State of Bolivia, Brazil and Peru.