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. 2024 Sep 27;12(10):1963.
doi: 10.3390/microorganisms12101963.

The Uprise of Human Leishmaniasis in Tuscany, Central Italy: Clinical and Epidemiological Data from a Multicenter Study

Anna Barbiero  1 , Michele Spinicci  1   2 , Andrea Aiello  1 , Martina Maruotto  3 , Roberta Maria Antonello  1 , Giuseppe Formica  1 , Matteo Piccica  4 , Patrizia Isola  5 , Eva Maria Parisio  6 , Maria Nardone  7 , Silvia Valentini  8 , Valentina Mangano  9 , Tamara Brunelli  10 , Loria Bianchi  11 , Filippo Bartalesi  4 , Cecilia Costa  4 , Margherita Sambo  12   13 , Mario Tumbarello  12   13 , Spartaco Sani  14 , Silvia Fabiani  14 , Barbara Rossetti  15 , Cesira Nencioni  15 , Alessandro Lanari  15 , Donatella Aquilini  16 , Giulia Montorzi  16 , Elisabetta Venturini  17 , Luisa Galli  17   18 , Giada Rinninella  17 , Marco Falcone  19 , Federica Ceriegi  19 , Francesco Amadori  20 , Antonella Vincenti  20 , Pierluigi Blanc  21 , Iacopo Vellere  21 , Danilo Tacconi  22 , Sauro Luchi  23 , Sara Moneta  23 , Daniela Massi  24 , Michela Brogi  25 , Fabio Voller  26 , Fabrizio Gemmi  27 , Gian Maria Rossolini  1   28 , Maria Grazia Cusi  12 , Fabrizio Bruschi  9   29 , Alessandro Bartoloni  1   2 , Lorenzo Zammarchi  1   2
Affiliations

The Uprise of Human Leishmaniasis in Tuscany, Central Italy: Clinical and Epidemiological Data from a Multicenter Study

Anna Barbiero et al. Microorganisms. .

Abstract

Human leishmaniasis is facing important epidemiological changes in Southern Europe, driven by increased urbanization, climate changes, emerging of new animal reservoirs, shifts in human behavior and a growing population of immunocompromised and elderly individuals. In this evolving epidemiological landscape, we analyzed the clinical and epidemiological characteristics of human leishmaniasis in the Tuscany region of Central Italy. Through a multicentric retrospective analysis, we collected clinical and demographic data about all cases of leishmaniasis recorded between 2018 and 2023. We observed 176 cases of human leishmaniasis, with 128 (72.7%) visceral leishmaniasis (VL) and 47 (26.7%) cutaneous leishmaniasis (CL). Among these, 92.2% of VL and 85.1% of CL cases were autochthonous. The cumulative incidence of autochthonous human leishmaniasis was 0.22 cases per 100,000 inhabitants in 2018, but reached 1.81/100,000 in 2023. We identified three main areas of transmission: around the city of Florence (North-East Tuscany), around Grosseto city (South-West Tuscany) and Elba Island. Our findings confirm that the epidemiology of leishmaniasis is undergoing significant changes in Central Italy. Awareness towards this emerging health threat and surveillance strategies need to be improved in order to reliably assess the disease's burden. Further research is needed in a "One-Health" perspective, to clarify the epidemiological dynamics at the environmental, reservoir, vector and human levels. The role of climate change and specific climatic factors affecting the epidemiological patterns of human leishmaniasis should be assessed. Further knowledge in these fields would promote targeted control and prevention strategies at regional and national levels.

Keywords: Italy; One Health; climate change; epidemiology; leishmania; phlebo-borne disease.

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Conflict of interest statement

The authors declare no conflicts of interest.

Figures

Figure 1
Figure 1
Absolute number of autochthonous and imported cases recorded each year and annual incidence of autochthonous VL (A) and CL (B) during the study period.
Figure 2
Figure 2
(A) Tuscany region (the study area) is represented in red in the Italian map; (B) overall distribution and Kernel density estimation of VL and CL cases; (C) distribution and Kernel density estimation of VL cases; (D) distribution and Kernel density estimation of CL cases.
Figure 3
Figure 3
Case distribution by age group for autochthonous cases of CL and VL.
See this image and copyright information in PMC

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