Leishmaniasis in Sub-Saharan Africa

Visceral leishmaniasis is widespread in East Africa, with several foci in Eritrea, Ethiopia, Kenya, Somalia, South Sudan, Sudan, and Uganda. Outside this sub-region, cases of visceral leishmaniasis have been reported from Burkina Faso, Cameroon, Chad, Ivory Coast, Mauritania, Niger, Nigeria, and the Gambia. It causes frequent outbreaks in the savanna and forest areas where sand flies live around and in termite mounds and soil cracks. Cutaneous leishmaniasis occurs throughout western and eastern Africa. A belt runs from Mauritania, Senegal, Burkina Faso, and Mali in the West, through Niger, Nigeria, and Cameroon, to Chad, Sudan, Ethiopia, and Kenya in the East. Though their recognition as a public health problem is growing, leishmaniases remain one of the most neglected tropical diseases. Their control is still hampered by a lack of safe and efficacious drugs, simple diagnostics, effective vaccines, and vector control tools.