Volume 80, Issue 5
  • ISSN: 0002-9637
  • E-ISSN: 1476-1645


The leishmaniases are protozoan, zoonotic diseases transmitted to human and other mammal hosts by the bite of phlebotomine sandflies. Bolivia has the highest incidence of cutaneous leishmaniasis (CL) in Latin America (LA), with 33 cases per 100,000 population reported in 2006. CL is endemic in seven of the country’s nine administrative departments. Visceral leishmaniasis (VL) is comparatively rare and is restricted to one single focus. Most CL cases are caused by () (85% cases); VL is caused by Seven sandfly species are incriminated as vectors and infections have been detected in several non-human mammal hosts. Transmission is associated with forest-related activities, but recently, cases of autochthonous, urban transmission were reported. Because most cases are caused by Bolivia reports the greatest ratio (i.e., up to 20% of all cases) of mucosal leishmaniasis to localized CL cases in LA. Per national guidelines, both CL and VL cases are microscopically diagnosed and treated with pentavalent antimony.


Article metrics loading...

Loading full text...

Full text loading...



  1. Reithinger R, Dujardin JC, Louzir H, Pirmez C, Alexander B, Brooker S, 2007. Cutaneous leishmaniasis. Lancet Infect Dis 7 : 581–596.
  2. Chappuis F, Sundar S, Hailu A, Ghalib H, Rijal S, Peeling RW, Alvar J, Boelaert M, 2007. Visceral leishmaniasis: what are the needs for diagnosis, treatment and control? Nat Rev Microbiol 5 : 873–882.
  3. Bern C, Maguire JH, Alvar J, 2008. Complexities of assessing the disease burden attributable to leishmaniasis. PLoS Negl Trop Dis 2 : e313.
  4. World Health Organization, 2004. The World Health Report 2004. Changing History. Geneva: World Health Organization.
  5. Altamirano-Enciso AJ, Marzochi MC, Moreira JS, Schubach AO, Marzochi KB, 2003. On the origin and spread of cutaneous and mucosal leishmaniasis, based on pre- and post-Colombian historical source. Hist Cienc Saude Manguinhos 10 : 852–882.
  6. Garrett AJ, 1983. La espundia en Bolivia, observaciones del Dr. Manuel Antonio Vaca Diez. Comentario Histórico. Boletin Informativo de CENETROP IX : 1–5.
  7. Sagarnaga E, 1909. Recuerdos de la Campaña de Acre de 1903. Mis Notas de Viaje. La Paz, Bolivia: Talleres graficos la prensa de J.L. Calderon.
  8. Ministerio de Saúde, 2007. Available at: http://portal.saude.gov.br/portal/arquivos/pdf/tabela_lva_casos_brasil.pdf. Accessed March 3, 2009.
  9. Ministerio de Saúde, 2007. Available at: http://portal.saude.gov.br/portal/arquivos/pdf/tabela_lva_deteccao.pdf. Accessed March 3, 2009.
  10. Anonymous, 2007. Leishmaniasis. Guía Operativa para el Control en Bolivia. Serie: Documentos Técnico-Normativos. La Paz, Bolivia: Ministerio de Salud.
  11. Lawn SD, Whetham J, Chiodini PL, Kanagalingam J, Watson J, Behrens RH, Lockwood DN, 2004. New world mucosal and cutaneous leishmaniasis: an emerging health problem among British travellers. QJM 97 : 781–788.
  12. Davies CR, Reithinger R, Campbell-Lendrum D, Feliciangeli D, Borges R, Rodriguez N, 2000. The epidemiology and control of leishmaniasis in Andean countries. Cad Saude Publica 16 : 925–950.
  13. Desjeux P, 2001. The increase in risk factors for leishmaniasis worldwide. Trans R Soc Trop Med Hyg 95 : 239–243.
  14. Yadon ZE, Quigley MA, Davies CR, Rodrigues LC, Segura EL, 2001. Assessment of leishmaniasis notification system in Santiago del Estero, Argentina, 1990–1993. Am J Trop Med Hyg 65 : 27–30.
  15. Copeland HW, Arana BA, Navin TR, 1990. Comparison of active and passive case detection of cutaneous leishmaniasis in Guatemala. Am J Trop Med Hyg 43 : 257–259.
  16. Desjeux P, Mollinedo S, Le Pont F, Paredes A, Ugarte G, 1987. Cutaneous leishmaniasis in Bolivia. A study of 185 human cases from Alto Beni (La Paz Department). Isolation and isoenzyme characterization of 26 strains of Leishmania braziliensis braziliensis. Trans R Soc Trop Med Hyg 81 : 742–746.
  17. Espejo JM, Pratlong F, le Pont F, Mouchet J, Desjeux P, Rioux JA, 1989. Leishmaniasis in Bolivia. V. Human strains of Leishmania (V.) braziliensis from the Department of Pando. Mem Inst Oswaldo Cruz 84 : 583.
  18. La Fuente C, Recacoechea M, Tibayrenc M, Urjel R, Darras C, Cardozo L, 1986. Leishmaniasis en Bolivia: presencia de dos complejos de Leishmania en los Llanos Orientales del Departamento de Santa Cruz-Bolivia. Bol Científico Centro Enfermedades Trop 12 : 1–15.
  19. Revollo S, Dimier-David L, David C, Lyevre P, Camacho C, Dedet JP, 1992. Isoenzyme characterization of Leishmania braziliensis braziliensis isolates obtained from Bolivian and Peruvian patients. Trans R Soc Trop Med Hyg 86 : 388–391.
  20. Dimier-David L, David C, Ravisse P, Bustillos R, Revollo S, Lyevre P, Munoz M, Vargas F, Dedet JP, 1991. Parasitological diagnosis of mucocutaneous leishmaniasis due to Leishmania b. braziliensis in Bolivia. Rev Soc Bras Med Trop 24 : 231–234.
  21. Desjeux P, Le Pont F, Mollinedo S, Tibayrenc M, 1986. Les Leishmania de Bolivie. I. Leishmania braziliensis Vianna, 1911 dans les Départements de La Paz et du Beni. Premiers isolements de souches d’origine humaine. Caractérisation enzymatique. Roux JA, ed. Leishmania. Taxonomie et Phylogenése. Montpellier: Institut Méditerranéen d’Etudes Epidemiologiques et Ecologiques, pp. 401–410.
  22. Garcia AL, Tellez T, Parrado R, Rojas E, Bermudez H, Dujardin JC, 2007. Epidemiological monitoring of American tegumentary leishmaniasis: molecular characterization of a peridomestic transmission cycle in the Amazonian lowlands of Bolivia. Trans R Soc Trop Med Hyg 101 : 1208–1213.
  23. Urjel R, Recacoechea M, La Fuenta C, Orellana H, 1983. A simple method for the collection of material from cutaneous and mucocutaneous leishmaniasis lesions. Trans R Soc Trop Med Hyg 77 : 882–883.
  24. Urjel R, Recacoechea M, Desjeux P, Bermudez H, Villaroel G, Balderrama S, Carrasco J, Aguilar O, Dujardin JC, Le Reay D, 1987. Leishmaniasis en los Llanos de Bolivia: VI. Caracterización preliminar de once aislados de Leishmania. Bol Científico Centro Enfermedades Trop 13 : 38–44.
  25. Rojas E, Parrado R, Delgado R, Reithinger R, Garcia AL. Leishmaniasis in Chaparé, Bolivia [letter]. Emerg Infect Dis [serial on the Internet]. 2009 Apr [date cited]. Available at: http://www.cdc.gov/EID/content/15/4/678.htm. DOI: 10.3201/eid1504.081257
  26. Martinez E, Le Pont F, Torrez M, Telleria J, Vargas F, Munoz M, De Doncker S, Dujardin JC, Dujardin JP, 1998. A new focus of cutaneous leishmaniasis due to Leishmania amazonensis in a Sub Andean region of Bolivia. Acta Trop 71 : 97–106.
  27. Martinez E, Le Pont F, Mollinedo S, Cupolillo E, 2001. A first case of cutaneous leishmaniasis due to Leishmania (Viannia) lainsoni in Bolivia. Trans R Soc Trop Med Hyg 95 : 375–377.
  28. Bastrenta B, Buitrago R, Vargas F, Le Pont F, Torrez M, Flores M, Mita N, Breniere SF, 2002. First evidence of transmission of Leishmania (Viannia) lainsoni in a Sub Andean region of Bolivia. Acta Trop 83 : 249–253.
  29. Garcia AL, Parrado R, De Doncker S, Bermudez H, Dujardin JC, 2007. American tegumentary leishmaniasis: direct species identification of Leishmania in non-invasive clinical samples. Trans R Soc Trop Med Hyg 101 : 368–371.
  30. Martinez E, Mollinedo S, Torrez M, Munoz M, Banuls AL, Le Pont F, 2002. Co-infection by Leishmania amazonensis and L. infantum/L. chagasi in a case of diffuse cutaneous leishmaniasis in Bolivia. Trans R Soc Trop Med Hyg 96 : 529–532.
  31. Desjeux P, Aranda E, Aliaga O, Mollinedo S, 1983. Human visceral leishmaniasis in Bolivia: first proven autochthonous case from ‘Los Yungas’. Trans R Soc Trop Med Hyg 77 : 851–852.
  32. Dimier-David L, Inofuentes A, Carrasco M, David C, Vargas F, Revollo S, Dedet JP, 1991. A new case of autochthonous visceral leishmaniasis in Bolivia. Ann Soc Belg Med Trop 71 : 275–278.
  33. Flores MD, Bastrenta B, Postigo JR, Mendoza NM, Cruz I, Alvar J, 2003. Leishmaniasis visceral subclinica en 123 individuos de un canton de la provincial Caranavi-La Paz. Rev Chil Pediatr 75 : 285–293.
  34. Le Pont F, Mollinedo S, Mouchet J, Desjeux P, 1989. Leishmaniasis in Bolivia. IV. The dog in the cycles of leishmaniasis in Bolivia. Mem Inst Oswaldo Cruz 84 : 417–421.
  35. Grimaldi G Jr, Tesh RB, McMahon-Pratt D, 1989. A review of the geographic distribution and epidemiology of leishmaniasis in the New World. Am J Trop Med Hyg 41 : 687–725.
  36. Le Pont F, Desjeux P, 1985. Leishmaniasis in Bolivia. I. Lutzomyia longipalpis (Lutz & Neiva, 1912) as the vector of visceral leishmaniasis in Los Yungas. Trans R Soc Trop Med Hyg 79 : 227–231.
  37. De Muynck A, 1979. CENETROP: a joint Belgian-Bolivian medical development project in Santa Cruz, Bolivia. Ann Soc Belg Med Trop 59 : 325–327.
  38. Le Ray D, 1990. The LEISHBOL Project: a bilateral experience in multidisciplinary and integrated biomedical research in Bolivia. Ann Soc Belg Med Trop 70 (Suppl 1): 38–39.
  39. Torres Espejo JM, Le Pont F, Mouchet J, Desjeux P, Richard A, 1989. Epidemiology of cutaneous leishmaniasis in Bolivia. 1. Description of study zone and prevalence of the disease. Ann Soc Belg Med Trop 69 : 297–306.
  40. Le Pont F, Mouchet J, Desjeux P, Torres Espejo JM, Richard A, 1989. Epidemiology of cutaneous leishmaniasis in Bolivia. 2. Transmission patterns. Ann Soc Belg Med Trop 69 : 307–312.
  41. Bermudez H, Torrico F, Rojas E, Balderrama F, Le Ray D, Guerra H, Arevalo J, 1993. Leishmaniasis in the lowlands of Bolivia, prevalence of the disease in two groups of localities with different settlement ages in Carrasco Tropical, Cochabamba. Arch Inst Pasteur Tunis 70 : 443–453.
  42. Computer-aided Identification of Phlebotomine Sandflies of the Americas. Available at: http://cipa.snv.jussieu.fr/. Accessed March 3, 2009.
  43. Le Pont F, Breniere FS, Mouchet J, Desjeux P, 1988. Leishmaniasis in Bolivia. 3. Psychodopygus carrerai carrerai (Barretto, 1946), new sylvatic vector of Leishmania braziliensis braziliensis in lowland Subandean region. Comptes Rendus L’Acad Sci Ser III-Sci Vie-Life Sciences 307 : 279–282.
  44. Le Pont F, Desjeux P, 1986. Leishmaniasis in Bolivia. II. The involvement of Psychodopygus yucumensis and Psychodopygus llanosmartinsi in the selvatic transmission cycle of Leishmania braziliensis braziliensis in a lowland subandean region. Mem Inst Oswaldo Cruz 81 : 311–318.
  45. Torrez M, Lopez M, Le Pont F, Martinez E, Munoz M, Hervas D, Yaksic N, Arevalo J, Sossa D, Dedet JP, Dujardin JP, 1998. Lutzomyia nuneztovari anglesi (Diptera: Psychodidae) as a probable vector of Leishmania braziliensis in the Yungas, Bolivia. Acta Trop 71 : 311–316.
  46. Le Pont F, Mouchet J, Desjeux P, 1989. Leishmaniasis in Bolivia–VI. Observations on Lutzomyia nuneztovari anglesi Le Pont & Desjeux, 1984 the presumed vector of tegumentary leishmaniasis in the Yungas focus. Mem Inst Oswaldo Cruz 84 : 277–278.
  47. Martinez E, Le Pont F, Torrez M, Telleria J, Vargas F, Dujardin JC, Dujardin JP, 1999. Lutzomyia nuneztovari anglesi (Le pont & Desjeux, 1984) as a vector of Leishmania amazonensis in a sub-Andean leishmaniasis focus of Bolivia. Am J Trop Med Hyg 61 : 846–849.
  48. Marcondes CB, Le Pont F, Lozovei AL, 1998. Lutzomyia neivai (Pinto, 1926) in Bolivia (Diptera, Psychodidae, Phlebotominae). Mem Inst Oswaldo Cruz 93 : 203–204.
  49. Mollinedo S, Torrez M, Le Pont F, 2000. Re-emergencia de la leishmaniasis en Tarija, Frontera con la Argentina. Instituto Nacional de Laboratorios de Salud. Informe Técnico No. 7, pp. 1–2.
  50. Bermudez H, Garcia AL, Troncoso F, 1993. Leishmaniasis in the lowlands of Bolivia. Entomological studies on sandflies of the “Valle del Sacta”. Tropical Carrasco of the Department of Cochabamba. Arch Inst Pasteur Tunis 70 : 455–463.
  51. Le Pont F, Mouchet J, Desjeux P, 1989. Leishmaniasis in Bolivia. VII. Infection of sentinel porcupines (Coendou prehensilis, L.) by Leishmania (Le.) chagasi. Mem Inst Oswaldo Cruz 84 : 575.
  52. Telleria J, Bosseno MF, Tarifa T, Buitrago R, Martinez E, Torrez M, Le Pont F, Breniere SF, 1999. Putative reservoirs of Leishmania amazonensis in a sub-andean focus of Bolivia identified by kDNA-polymerase chain reaction. Mem Inst Oswaldo Cruz 94 : 5–6.
  53. Kerr SF, Emmons LH, Melby PC, Liu C, Perez LE, Villegas M, Miranda R, 2006. Leishmania amazonensis infections in Oryzomys acritus and Oryzomys nitidus from Bolivia. Am J Trop Med Hyg 75 : 1069–1073.
  54. Reithinger R, Espinoza JC, Davies CR, 2003. The transmission dynamics of canine American cutaneous leishmaniasis in Huánuco, Peru. Am J Trop Med Hyg 69 : 473–480.
  55. Weigle K, Saravia NG, 1996. Natural history, clinical evolution, and the host-parasite interaction in New World cutaneous leishmaniasis. Clin Dermatol 14 : 433–450.
  56. Dimier-David L, David C, Munoz M, Vargas F, Bustillos R, Valda L, Dedet JP, 1993. Epidemiological, clinical and biological features of mucocutaneous leishmaniasis in Bolivia after a 221 patient sample. Bull Soc Pathol Exot 86 : 106–111.
  57. Walton BC, Valverde L, 1979. Racial differences in espundia. Ann Trop Med Parasitol 73 : 23–29.
  58. Alcais A, Abel L, David C, Torrez ME, Flandre P, Dedet JP, 1997. Risk factors for onset of cutaneous and mucocutaneous leishmaniasis in Bolivia. Am J Trop Med Hyg 57 : 79–84.
  59. Alcais A, Abel L, David C, Torrez ME, Flandre P, Dedet JP, 1997. Evidence for a major gene controlling susceptibility to tegumentary leishmaniasis in a recently exposed Bolivian population. Am J Hum Genet 61 : 968–979.
  60. Anonymous, 1998. Manual de Procedimientos de Laboratorio para el Diagnostico de la Leishmaniosis. La Paz, Bolivia: Ministerio de Salud y Prevención Social.
  61. Escobar MA, Martinez F, Scott Smith D, Palma GI, 1992. American cutaneous and mucocutaneous leishmaniasis (tegumentary): a diagnostic challenge. Trop Doct 22 (Suppl 1): 69–78.
  62. Bastrenta B, Mita N, Buitrago R, Vargas F, Flores M, Machane M, Yacsik N, Torrez M, Le Pont F, Breniere F, 2003. Human mixed infections of Leishmania spp. and Leishmania-Trypanosoma cruzi in a sub Andean Bolivian area: identification by polymerase chain reaction/hybridization and isoenzyme. Mem Inst Oswaldo Cruz 98 : 255–264.
  63. Garcia L, Kindt A, Bermudez H, Llanos-Cuentas A, De Doncker S, Arevalo J, Wilber Quispe Tintaya K, Dujardin JC, 2004. Culture-independent species typing of neotropical Leishmania for clinical validation of a PCR-based assay targeting heat shock protein 70 genes. J Clin Microbiol 42 : 2294–2297.
  64. Garcia AL, Kindt A, Quispe-Tintaya KW, Bermudez H, Llanos A, Arevalo J, Bañuls AL, De Doncker S, Le Ray D, Dujardin JC, 2005. American tegumentary leishmaniasis: antigene polymorphism, taxonomy and clinical pleomorphism. Infect Genet Evol 5 : 109–116.
  65. Deborggraeve S, Laurent T, Espinosa D, Van der Auwera G, Mbuchi M, Wasunna M, El-Safi S, Al-Basheer AA, Arévalo J, Miranda-Verástegui C, Leclipteux T, Mertens P, Dujardin JC, Herdewijn P, Büscher P, 2008. A simplified and standardized polymerase chain reaction format for the diagnosis of leishmaniasis. J Infect Dis 198 : 1565–1572.
  66. Soto J, Valda-Rodriquez L, Toledo J, Vera-Navarro L, Luz M, Monasterios-Torrico H, Vega J, Berman J, 2004. Comparison of generic to branded pentavalent antimony for treatment of new world cutaneous leishmaniasis. Am J Trop Med Hyg 71 : 577–581.
  67. Bermudez H, Rojas E, Garcia L, Desjeux P, Dujardin JC, Boelaert M, Chappuis F, 2006. Generic sodium stibogluconate is as safe and effective as branded meglumine antimonate, for the treatment of tegumentary leishmaniasis in Isiboro Secure Park, Bolivia. Ann Trop Med Parasitol 100 : 591–600.
  68. Yardley V, Ortuno N, Llanos-Cuentas A, Chappuis F, Doncker SD, Ramirez L, Croft S, Arevalo J, Adaui V, Bermudez H, Decuypere S, Dujardin JC, 2006. American tegumentary leishmaniasis: is antimonial treatment outcome related to parasite drug susceptibility? J Infect Dis 194 : 1168–1175.
  69. Rodriguez LV, Dedet JP, Paredes V, Mendoza C, Cardenas F, 1995. A randomized trial of amphotericin B alone or in combination with itraconazole in the treatment of mucocutaneous leishmaniasis. Mem Inst Oswaldo Cruz 90 : 525–528.
  70. Soto J, Toledo J, Valda L, Balderrama M, Rea I, Parra R, Ardiles J, Soto P, Gomez A, Molleda F, Fuentelsaz C, Anders G, Sindermann H, Engel J, Berman J, 2007. Treatment of Bolivian mucosal leishmaniasis with miltefosine. Clin Infect Dis 44 : 350–356.
  71. Soto J, Rea J, Balderrama M, Toledo J, Soto P, Valda L, Berman JD, 2008. Efficacy of miltefosine for Bolivian cutaneous leishmaniasis. Am J Trop Med Hyg 78 : 210–211.
  72. Fournet A, Angelo A, Munoz V, Roblot F, Hocquemiller R, Cave A, 1992. Biological and chemical studies of Pera benensis, a Bolivian plant used in folk medicine as a treatment of cutaneous leishmaniasis. J Ethnopharmacol 37 : 159–164.
  73. Fournet A, Barrios AA, Munoz V, 1994. Leishmanicidal and trypanocidal activities of Bolivian medicinal plants. J Ethnopharmacol 41 : 19–37.
  74. Fournet A, Barrios AA, Munoz V, Hocquemiller R, Roblot F, Cave A, 1994. Antileishmanial activity of a tetralone isolated from Ampelocera edentula, a Bolivian plant used as a treatment for cutaneous leishmaniasis. Planta Med 60 : 8–12.
  75. Le Pont F, Padilla JM, Desjeux P, Richard A, Mouchet J, 1989. Impact of the spraying of deltamethrin in a focus of leishmaniasis in Bolivia. Ann Soc Belg Med Trop 69 : 223–232.
  76. Dedet JP, Melogno R, Cardenas F, Valda L, David C, Fernandez V, Torrez ME, Dimier-David L, Lyevre P, Villareal ME, 1995. Rural campaign to diagnose and treat mucocutaneous leishmaniasis in Bolivia. Bull World Health Organ 73 : 39–45.

Data & Media loading...

  • Received : 12 Sep 2008
  • Accepted : 28 Jan 2009

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