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Review
. 2022 Aug;69(5):395-407.
doi: 10.1111/zph.12977. Epub 2022 May 26.

The current epidemiology of leishmaniasis in Turkey, Azerbaijan and Georgia and implications for disease emergence in European countries

Yusuf Özbel  1 , Seray Töz  1 , Clara Muñoz  2 , Maria Ortuño  2 , Zarima Jumakanova  2 , Pedro Pérez-Cutillas  3 , Carla Maia  4 , Cláudia Conceição  4 , Gad Baneth  5 , André Pereira  4 , Yves Van der Stede  6 , Céline M Gossner  7 , Eduardo Berriatua  2
Affiliations
Review

The current epidemiology of leishmaniasis in Turkey, Azerbaijan and Georgia and implications for disease emergence in European countries

Yusuf Özbel et al. Zoonoses Public Health. 2022 Aug.

Abstract

Leishmania spp. are sand fly-borne protozoan parasites causing leishmaniasis in humans and animals. The aim of the study was to analyse the epidemiology of leishmaniasis in Turkey, Azerbaijan and Georgia from 2005 to 2020 and evaluate the associated risk for disease emergence in European countries. It is based on an analysis of WHO and OIE reported cases between 2005 and 2020, a review of scientific articles published in SCOPUS between 2009 and 2020 and a questionnaire survey to public health and veterinary authorities in these countries. Endemic Leishmania spp. include L. infantum in the three countries, L. major in Azerbaijan and Turkey and L. tropica and L. donovani in Turkey. Leishmaniasis is reported in humans, animals and sand flies and incidence is spatially and temporarily variable. In the southern Caucasus and particularly in Georgia, reported incidence of human visceral leishmaniasis by L. infantum remains high. However, whilst Georgia experienced a gradual decrease from >4.0 cases per 100,000 population in 2005-09 to 1.13 cases per 100,000 population in 2020, the period with highest incidence in Azerbaijan, which ranged between 0.40 and 0.61 cases per 100,000 population, was 2016-2019, and no cases have so far been reported for 2020. Visceral leishmaniasis in the Southern Caucasus affects mostly young children from deprived urban areas and its closely associated to canine leishmaniasis. Turkey reported cases of visceral leishmaniasis between 2005 and 2012 and in 2016 only, and incidence ranged between 0.02 and 0.05 per 100,000 population. In contrast, the reported annual incidence of cutaneous leishmaniasis in Turkey was much greater and peaked at 7.02 cases per 100,000 population in 2013, associated to imported cases from cutaneous leishmaniasis endemic Syria. Leishmaniasis by L. infantum in Azerbaijan and Georgia represents a regional public and animal health challenge that requires support to improve diagnosis, treatment and control. The unprecedented rise of cutaneous leishmaniasis and the spread of L. tropica and L. donovani in Turkey is an important risk factor for their emergence in Europe, especially in Mediterranean countries where competent vectors are widespread.

Keywords: Azerbaijan; Caucasus; Georgia; Leishmania; Turkey; epidemiology.

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Conflict of interest statement

The authors declare no conflict of interest.

Figures

FIGURE 1
FIGURE 1
Annual cumulative incidence per 100,000 population of visceral leishmaniasis in Georgia (left) and Azerbaijan and Turkey (right) between 2005 and 2020. Data based on cases reported to the WHO Global Health Observatory Data Repository
FIGURE 2
FIGURE 2
Annual cumulative incidence per 100,000 population of cutaneous leishmaniasis in Turkey (left) and Azerbaijan and Georgia (right) between 2005 and 2020. Data based on cases reported to the WHO Global Health Observatory Data Repository
FIGURE 3
FIGURE 3
Regional distribution of human and animal leishmaniasis in Turkey, Azerbaijan and Georgia reported in the scientific literature between 2009 and 2020
See this image and copyright information in PMC

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