Visceral Leishmaniasis in West Africa: Clinical Characteristics, Vectors, and Reservoirs.

Abdoulaye K Kone,Martine Piarroux,Renaud Piarroux,Doumbo Safiatou Niaré,Matthew B Laurens,Pierre Marty,Mahamadou A Thera,Ogobara K Doumbo,Arezki Izri

doi:10.1155/2019/9282690

Abstract

Visceral leishmaniasis (VL) is the most serious form of human leishmaniasis. VL is understudied in West Africa. The increasing number of patients at-risk, including persons living with HIV and other chronic immunosuppressive diseases, and likely underreporting of VL related to diagnostic challenges advocate for review of existing data to understand VL regional epidemiology. Our review aims to describe the clinical characteristics and epidemiology of Human VL (HVL) in West Africa. We conducted a literature search to identify peer-reviewed articles and grey literature sources using the search terms “Visceral leishmaniasis West Africa”, “Leishmania donovani West Africa”; and “Leishmania infantum West Africa”. Thirty published articles report HVL from seven countries, including The Gambia, Niger, Nigeria, Ivory Coast, Togo, Burkina Faso, and Guinea Bissau. Three countries report cases of Canine Visceral Leishmaniasis (CVL), including The Gambia, Senegal, and Burkina Faso. Niger, Nigeria, and Ivory Coast report the greatest number of HVL cases. As VL is present in West Africa, active surveillance, increased diagnostic capacity, and studies of vectors and reservoirs are essential to better understand VL epidemiology in the region.

Highlights

Visceral leishmaniasis (VL) is caused by a flagellated protozoan of the genus Leishmania spp. (Trypanosomatida, Trypanosomatidae) and is transmitted by the infective bite of female sandflies (Diptera, Psychodidae) of the genus Phlebotomus in the Old World and Lutzomyia in the New World
According to the World Health Organization (WHO) report 2017, four of the six West African countries not providing data are endemic for VL, Ivory Coast, Niger, Mauritania, and Senegal, and the ten remaining nations are free from VL, but most nations in the region did not provide data on VL in 2016
From 2005 to 2017, 60 cases of VL were reported from West African nations to WHO, and 57 of these cases occurred in Nigeria in 2012 [3]

Summary

Introduction

VL is caused by a flagellated protozoan of the genus Leishmania spp. (Trypanosomatida, Trypanosomatidae) and is transmitted by the infective bite of female sandflies (Diptera, Psychodidae) of the genus Phlebotomus in the Old World and Lutzomyia in the New World. VL is caused by a flagellated protozoan of the genus Leishmania spp. An estimated 50,000 to 90,000 new cases of VL occur worldwide every year, causing fatality in over 95% of cases if left untreated [1]. From 2004 to 2008, 56,700 cases of HVL have been reported in East Africa, but few cases have been reported in West Africa [2]. From 2005 to 2017, 60 cases of VL were reported from West African nations to WHO, and 57 of these cases occurred in Nigeria in 2012 [3]. Two species of Leishmania implicated in HVL are found in West Africa: Leishmania donovani, which

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