Leishmaniasis and poverty.
ABSTRACT Leishmaniasis, a neglected tropical disease, has strong but complex links with poverty. The burden of leishmaniasis falls disproportionately on the poorest segments of the global population. Within endemic areas, increased infection risk is mediated through poor housing conditions and environmental sanitation, lack of personal protective measures and economically driven migration and employment that bring nonimmune hosts into contact with infected sand flies. Poverty is associated with poor nutrition and other infectious diseases, which increase the risk that a person (once infected) will progress to the clinically manifested disease. Lack of healthcare access causes delays in appropriate diagnosis and treatment and accentuates leishmaniasis morbidity and mortality, particularly in women. Leishmaniasis diagnosis and treatment are expensive and families must sell assets and take loans to pay for care, leading to further impoverishment and reinforcement of the vicious cycle of disease and poverty. Public investment in treatment and control would decrease the leishmaniasis disease burden and help to alleviate poverty.
SourceAvailable from: Annette M DavidEquity, social determinants and public health programmes, Edited by Anand Sivasankara Kurup, Eric Blas, 01/2010: chapter 11: pages 199-210; World Health Organization., ISBN: 978 92 4 156397 0
ISOPS VIII International Symposium on Phlebotomine Sandflies, Puerto Iguazù, Argentina; 09/2014
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ABSTRACT: Leishmaniasis is a vector borne disease caused by protozoa of the genus Leishmania. Human leishmaniasis is not endemic in Australia though imported cases are regularly encountered. This study aimed to provide an update on the molecular epidemiology of imported leishmaniasis in Australia. Of a total of 206 biopsies and bone marrow specimens submitted to St Vincent's Hospital Sydney for leishmaniasis diagnosis by PCR, 55 were found to be positive for Leishmania DNA. All PCR products were subjected to restriction fragment length polymorphism analysis for identification of the causative species. Five Leishmania species/species complexes were identified with Leishmania tropica being the most common (30/55). Travel or prior residence in a Leishmania endemic region was the most common route of acquisition with ~47% of patients having lived in or travelled to Afghanistan. Cutaneous leishmaniasis was the most common manifestation (94%) with only 3 cases of visceral leishmaniasis and no cases of mucocutaneous leishmaniasis encountered. This report indicates that imported leishmaniasis is becoming increasingly common in Australia due to an increase in global travel and immigration. As such, Australian clinicians must be made aware of this trend and consider leishmaniasis in patients with suspicious symptoms and a history of travel in endemic areas. This study also discusses the recent identification of a unique Leishmania species found in native kangaroos and a potential vector host which could create the opportunity for the establishment of a local transmission cycle within humans.PLoS ONE 03/2015; 10(3):e0119212. DOI:10.1371/journal.pone.0119212 · 3.53 Impact Factor