Volume 94, Issue 3
  • ISSN: 0002-9637
  • E-ISSN: 1476-1645



Leishmaniasis continues to pose a major public health problem worldwide. With new epidemics occurring in endemic areas and the spread of the disease to previously free areas because of migration, tourism, and military activities, there is a great need for the development of an effective vaccine. Leishmaniasis is a disease of the poor, occurring mostly in remote rural villages with poor housing and little or no access to modern health-care facilities. In endemic areas, diagnosis of any form of leishmaniasis puts a huge financial strain on an already meagre financial resource at both the individual and community levels. Most often families need to sell their assets (land and livestock) or take loans from informal financial outfits with heavy interest rates to pay for the diagnosis and treatment of leishmaniasis. Here, we discuss the disease with special emphasis on its socioeconomic impact on the affected individual and community. In addition, we highlight the reasons why continued research aimed at developing an effective vaccine is necessary.


Article metrics loading...

The graphs shown below represent data from March 2017
Loading full text...

Full text loading...



  1. Schroeder J, Aebischer T, , 2011. Vaccine for leishmaniasis from proteome to vaccine candidates. Hum Vaccin 7 (Suppl 1): 6. [Google Scholar]
  2. Alvar J, Velez ID, Bern C, Herrero M, Desjeux P, Cano J, Jannin J, den Boer M, WHO Leishmaniasis Control Team; , 2012. Leishmaniasis worldwide and global estimates of its incidence. PLoS One 7: e35671.[Crossref] [Google Scholar]
  3. Singh SP, Reddy DC, Rai M, Sundar S, , 2006. Serious underreporting of visceral leishmaniasis through passive case reporting in Bihar, India. Trop Med Int Health 11: 899905.[Crossref] [Google Scholar]
  4. Singh VP, Ranjan A, Topno RK, Verma RB, Siddique NA, Ravidas VN, Kumar N, Pandey K, Das P, , 2010. Estimation of under-reporting of visceral leishmaniasis cases in Bihar, India. Am J Trop Med Hyg 82: 911.[Crossref] [Google Scholar]
  5. WHO, 2014. Leishmaniasis: Magnitude of the Problem. Available at: http://www.who.int/leishmaniasis/burden/magnitude/burden_magnitude/en/. [Google Scholar]
  6. Wagstaff A, , 2002. Poverty and health sector inequalities. Bull World Health Organ 80: 97105. [Google Scholar]
  7. Yamey G, Torreele E, , 2002. The world's most neglected diseases. BMJ 325: 176177.[Crossref] [Google Scholar]
  8. Alvar J, Yactayo S, Bern C, , 2006. Leishmaniasis and poverty. Trends Parasitol 22: 552557.[Crossref] [Google Scholar]
  9. Rijal S, Koirala S, Van der Stuyft P, Boelaert M, , 2006. The economic burden of visceral leishmaniasis for households in Nepal. Trans R Soc Trop Med Hyg 100: 838841.[Crossref] [Google Scholar]
  10. Adhikari SR, Maskay NM, Sharma BP, , 2009. Paying for hospital-based care of Kala-azar in Nepal: assessing catastrophic, impoverishment and economic consequences. Health Policy Plan 24: 129139.[Crossref] [Google Scholar]
  11. Uranw S, Meheus F, Baltussen R, Rijal S, Boelaert M, , 2013. The household costs of visceral leishmaniasis care in south-eastern Nepal. PLoS Negl Trop Dis 7: e2062.[Crossref] [Google Scholar]
  12. Sarnoff R, Desai J, Desjeux P, Mittal A, Topno R, Siddiqui NA, Pandey A, Sur D, Das P, , 2010. The economic impact of visceral leishmaniasis on rural households in one endemic district of Bihar, India. Trop Med Int Health 15 (Suppl 2): 4249.[Crossref] [Google Scholar]
  13. Okwa OO, , 2007. Tropical parasitic diseases and women. Ann Afr Med 6: 157163.[Crossref] [Google Scholar]
  14. Velez ID, Hendrickx E, Robledo SM, del Pilar Agudelo S, , 2001. Gender and cutaneous leishmaniasis in Colombia [in Spanish]. Cad Saude Publica 17: 171180.[Crossref] [Google Scholar]
  15. Rathgeber EM, Vlassoff C, , 1993. Gender and tropical diseases: a new research focus. Soc Sci Med 37: 513520.[Crossref] [Google Scholar]
  16. Vlassoff C, Manderson L, , 1998. Incorporating gender in the anthropology of infectious diseases. Trop Med Int Health 3: 10111019. [Google Scholar]
  17. Vlassoff C, , 2007. Gender differences in determinants and consequences of health and illness. J Health Popul Nutr 25: 4761. [Google Scholar]
  18. Ranjan A, Sur D, Singh VP, Siddique NA, Manna B, Lal CS, Sinha PK, Kishore K, Bhattacharya SK, , 2005. Risk factors for Indian kala-azar. Am J Trop Med Hyg 73: 7478. [Google Scholar]
  19. Bern C, Hightower AW, Chowdhury R, Ali M, Amann J, Wagatsuma Y, Haque R, Kurkjian K, Vaz LE, Begum M, Akter T, Cetre-Sossah CB, Ahluwalia IB, Dotson E, Secor WE, Breiman RF, Maguire JH, , 2005. Risk factors for kala-azar in Bangladesh. Emerg Infect Dis 11: 655662.[Crossref] [Google Scholar]
  20. Barnett PG, Singh SP, Bern C, Hightower AW, Sundar S, , 2005. Virgin soil: the spread of visceral leishmaniasis into Uttar Pradesh, India. Am J Trop Med Hyg 73: 720725. [Google Scholar]
  21. Sheets D, Mubayi A, Kojouharov HV, , 2010. Impact of socio-economic conditions on the incidence of visceral leishmaniasis in Bihar, India. Int J Environ Health Res 20: 415430.[Crossref] [Google Scholar]
  22. Costa CH, Werneck GL, Rodrigues L, Jr Santos MV, Araújo IB, Moura LS, Moreira S, Gomes RB, Lima SS, , 2005. Household structure and urban services: neglected targets in the control of visceral leishmaniasis. Ann Trop Med Parasitol 99: 229236.[Crossref] [Google Scholar]
  23. Tesh RB, , 1995. Control of zoonotic visceral leishmaniasis: is it time to change strategies? Am J Trop Med Hyg 52: 287292. [Google Scholar]
  24. Desjeux P, , 2004. Leishmaniasis: current situation and new perspectives. Comp Immunol Microbiol Infect Dis 27: 305318.[Crossref] [Google Scholar]
  25. Reithinger R, Aadil K, Kolaczinski J, Mohsen M, Hami S, , 2005. Social impact of leishmaniasis, Afghanistan. Emerg Infect Dis 11: 634636.[Crossref] [Google Scholar]
  26. Pascual Martinez F, Picado A, Roddy P, Palma P, , 2012. Low castes have poor access to visceral leishmaniasis treatment in Bihar, India. Trop Med Int Health 17: 666673.[Crossref] [Google Scholar]
  27. Homsi Y, Makdisi G, , 2010. Leishmaniasis: a forgotten disease among neglected people. Int J Health 11: 2. [Google Scholar]
  28. Mondal D, Singh SP, Kumar N, Joshi A, Sundar S, Das P, Siddhivinayak H, Kroeger A, Boelaert M, , 2009. Visceral leishmaniasis elimination programme in India, Bangladesh, and Nepal: reshaping the case finding/case management strategy. PLoS Negl Trop Dis 3: e355.[Crossref] [Google Scholar]
  29. Zaph C, Uzonna J, Beverley SM, Scott P, , 2004. Central memory T cells mediate long-term immunity to Leishmania major in the absence of persistent parasites. Nat Med 10: 11041110.[Crossref] [Google Scholar]
  30. Peters NC, Kimblin N, Secundino N, Kamhawi S, Lawyer P, Sacks DL, , 2009. Vector transmission of Leishmania abrogates vaccine-induced protective immunity. PLoS Pathog 5: e1000484.[Crossref] [Google Scholar]
  31. Uzonna JE, Wei G, Yurkowski D, Bretscher P, , 2001. Immune elimination of Leishmania major in mice: implications for immune memory, vaccination, and reactivation disease. J Immunol 167: 69676974.[Crossref] [Google Scholar]
  32. Okwor I, Kuriakose S, Uzonna J, , 2010. Repeated inoculation of killed Leishmania major induces durable immune response that protects mice against virulent challenge. Vaccine 28: 54515457.[Crossref] [Google Scholar]
  33. Bhowmick S, Mazumdar T, Sinha R, Ali N, , 2010. Comparison of liposome based antigen delivery systems for protection against Leishmania donovani . J Control Release 141: 199207.[Crossref] [Google Scholar]
  34. Doroud D, Zahedifard F, Vatanara A, Najafabadi AR, Taslimi Y, Vahabpour R, Torkashvand F, Vaziri B, Rafati S, , 2011. Delivery of a cocktail DNA vaccine encoding cysteine proteinases type I, II and III with solid lipid nanoparticles potentiate protective immunity against Leishmania major infection. J Control Release 153: 154162.[Crossref] [Google Scholar]
  35. Doroud D, Zahedifard F, Vatanara A, Najafabadi AR, Rafati S, . Cysteine proteinase type I, encapsulated in solid lipid nanoparticles induces substantial protection against Leishmania major infection in C57BL/6 mice. Parasite Immunol 33: 335348.[Crossref] [Google Scholar]
  36. van Thiel PP, Leenstra T, de Vries HJ, van der Sluis A, van Gool T, Krull AC, van Vugt M, de Vries PJ, Zeegelaar JE, Bart A, van der Meide WF, Schallig HD, Faber WR, Kager PA, , 2010. Cutaneous leishmaniasis (Leishmania major infection) in Dutch troops deployed in northern Afghanistan: epidemiology, clinical aspects, and treatment. Am J Trop Med Hyg 83: 12951300.[Crossref] [Google Scholar]
  37. Glennie JS, Bailey MS, , 2010. UK Role 4 military infectious diseases at Birmingham Heartlands Hospital in 2005–9. J R Army Med Corps 156: 162164.[Crossref] [Google Scholar]
  38. Pavli A, Maltezou HC, , 2010. Leishmaniasis, an emerging infection in travelers. Int J Infect Dis 14: e1032e1039.[Crossref] [Google Scholar]
  39. Herbinger KH, Siess C, Nothdurft HD, von Sonnenburg F, Loscher T, , 2011. Skin disorders among travellers returning from tropical and non-tropical countries consulting a travel medicine clinic. Trop Med Int Health 16: 14571464.[Crossref] [Google Scholar]
  40. Field V, Gautret P, Schlagenhauf P, Burchard GD, Caumes E, Jensenius M, Castelli F, Gkrania-Klotsas E, Weld L, Lopez-Velez R, de Vries P, von Sonnenburg F, Loutan L, Parola P, EuroTravNet Network; , 2010. Travel and migration associated infectious diseases morbidity in Europe, 2008. BMC Infect Dis 10: 330.[Crossref] [Google Scholar]
  41. den Boer M, Argaw D, Jannin J, Alvar J, , 2011. Leishmaniasis impact and treatment access. Clin Microbiol Infect 17: 14711477.[Crossref] [Google Scholar]
  42. DutchNews, 2008. Dutch Doctors Uncover Fake Bangladesh Medicine. Available at: DutchNews.nl. Accessed March 29, 2014. [Google Scholar]
  43. Sundar S, , 2001. Drug resistance in Indian visceral leishmaniasis. Trop Med Int Health 6: 849854.[Crossref] [Google Scholar]
  44. Bastien P, , 2011. Leishmaniases control: what part for development and what part for research? Clin Microbiol Infect 17: 14491450.[Crossref] [Google Scholar]
  45. Alvar J, Croft S, Olliaro P, , 2006. Chemotherapy in the treatment and control of leishmaniasis. Adv Parasitol 61: 223274.[Crossref] [Google Scholar]
  46. Desjeux P, , 2001. The increase in risk factors for leishmaniasis worldwide. Trans R Soc Trop Med Hyg 95: 239243.[Crossref] [Google Scholar]
  47. Adhikari SR, Supakankunti S, , 2010. A cost benefit analysis of elimination of kala-azar in Indian subcontinent: an example of Nepal. J Vector Borne Dis 47: 127139. [Google Scholar]
  48. Ahluwalia IB, Bern C, Wagatsuma Y, Costa C, Chowdhury R, Ali M, Amann J, Haque R, Breiman R, Maguire JH, , 2004. Visceral leishmaniasis: consequences to women in a Bangladeshi community. J Womens Health (Larchmt) 13: 360364.[Crossref] [Google Scholar]
  49. WHO, 2010. Control of the Leishmaniasis: WHO Expert Committee on the Control of Leishmaniasis. Geneva, Switzerland: World Health Organization. [Google Scholar]
  50. Saberi S, Zamani A, Motamedi N, Nilforoushzadeh MA, Jaffary F, Rahimi E, Hejazi SH, , 2012. The knowledge, attitude, and prevention practices of students regarding cutaneous leishmaniasis in the hyperendemic region of the Shahid Babaie Airbase. Vector Borne Zoonotic Dis 12: 306309.[Crossref] [Google Scholar]
  51. Gouveia C, de Oliveira RM, Zwetsch A, Motta-Silva D, Carvalho BM, de Santana AF, Rangel EF, , 2012. Integrated tools for American cutaneous leishmaniasis surveillance and control: intervention in an endemic area in Rio de Janeiro, RJ, Brazil. Interdiscip Perspect Infect Dis 2012: 568312. [Google Scholar]
  • Received : 02 Jun 2015
  • Accepted : 17 Nov 2015
  • Published online : 02 Mar 2016

Most Cited This Month

This is a required field
Please enter a valid email address
Approval was a Success
Invalid data
An Error Occurred
Approval was partially successful, following selected items could not be processed due to error