Life cycle of the Leishmaniasis parasite. Source: CDC
Find information on thousands of medical conditions and prescription drugs.


Leishmaniasis is a disease caused by parasites that belong to the genus Leishmania and is transmitted by the bite of certain species of sandfly, including flies in the genus Lutzomyia in the new world and Phlebotomus in the old world. Synonyms for leishmaniasis include kala azar, black fever, sandfly disease, Dum-Dum fever and espundia. The disease is named for the Scottish pathologist William Boog Leishman. more...

Amyotrophic lateral...
Bardet-Biedl syndrome
Lafora disease
Landau-Kleffner syndrome
Langer-Giedion syndrome
Laryngeal papillomatosis
Lassa fever
LCHAD deficiency
Leber optic atrophy
Ledderhose disease
Legg-Calvé-Perthes syndrome
Legionnaire's disease
Lemierre's syndrome
Lennox-Gastaut syndrome
Lesch-Nyhan syndrome
Leukocyte adhesion...
Li-Fraumeni syndrome
Lichen planus
Limb-girdle muscular...
Lipoid congenital adrenal...
Lissencephaly syndrome...
Liver cirrhosis
Lobster hand
Locked-In syndrome
Long QT Syndrome
Long QT syndrome type 1
Long QT syndrome type 2
Long QT syndrome type 3
Lung cancer
Lupus erythematosus
Lyell's syndrome
Lyme disease
Lysinuric protein...

Most forms of the disease are transmittable only from animals (zoonosis), but some can be spread between humans. Human infection is caused by about 21 of 30 species that infect mammals. These include the L. donovani complex with 3 species (L. donovani, L. infantum, and L. chagasi); the L. mexicana complex with 3 main species (L. mexicana, L. amazonensis, and L. venezuelensis); L. tropica; L. major; L. aethiopica; and the subgenus Viannia with 4 main species (L. (V.) braziliensis, L. (V.) guyanensis, L. (V.) panamensis, and L. (V.) peruviana). The different species are morphologically indistinguishable, but they can be differentiated by isoenzyme analysis, molecular methods, or monoclonal antibodies.

Geography and epidemiology

Leishmaniasis can be transmitted in many tropical and sub-tropical countries, and is found in parts of about 88 countries. Approximately 350 million people live in these areas. The settings in which leishmaniasis is found range from rain forests in Central and South America to deserts in West Asia. More than 90 percent of the world's cases of visceral leishmaniasis are in India, Bangladesh, Nepal, Sudan, and Brazil.

Leishmaniasis is found in Mexico, Central America, and South America—from northern Argentina to southern Texas (not in Uruguay, Chile, or Canada), southern Europe (leishmaniasis is not common in travelers to southern Europe), Asia (not Southeast Asia), the Middle East, and Africa (particularly East and North Africa, with some cases elsewhere).

Leishmaniasis is present in Iraq and was contracted by a number of the troops involved in the 2003 invasion of that country and the subsequent occupation. The soldiers nicknamed the disease the Baghdad boil. It has been reported by the Agence France-Presse that more than 650 U.S. soldiers may have experienced the disease between the start of the invasion in March 2003 and late 2004.

During 2004, it is calculated that some 3,400 troops from the Colombian army, operating in the jungles near the south of the country (in particular around the Meta and Guaviare departments), were infected with Leishmaniasis. Apparently, a contributing factor was that many of the affected soldiers did not use the officially provided insect repellent, because of its allegedly disturbing odor. It is estimated that nearly 13,000 cases of the disease were recorded in all of Colombia throughout 2004, and about 360 new instances of the disease among soldiers had been reported in February 2005.

In September 2005 the disease was contracted by at least four Dutch marines who were stationed in Mazar-e-Sharif, Afghanistan and subsequently repatriated for treatment.


[List your site here Free!]

Cutaneous leishmaniasis, Northern Afghanistan
From Emerging Infectious Diseases, 5/1/04 by Richard Reithinger

To the Editor: In Afghanistan, most cutaneous leishmaniasis cases are caused by Leishmania tropica, which is transmitted anthroponotically by the sandfly Phlebotomus sergenti (1). Cutaneous leishmaniasis can have devastating effects on local communities because of its clinical symptoms, i.e., large, multiple, or both, disfiguring lesions, that can lead to social ostracism of affected persons (e.g., women are often deemed unsuitable for marriage or to raise children) (2). Cutaneous leishmaniasis is considered a low priority disease by international donor agencies because treatment costs are high and the disease does not cause death (3).

Data on the effects of cutaneous leishmaniasis in Afghanistan previously have been available only for Kabul city; recent studies have reported an estimated 67,500 cases (4). Because of the migration of an estimated 4.5 million infected Afghan refugees returning home from other countries, the sporadic treatment of patients infected with cutaneous leishmaniasis, and limited control of the sandfly vector, L. tropica has spread to areas that were previously nonendemic for the disease, e.g., northeastern Afghanistan.

A survey in Faizabad city, Badakhshan Province, was conducted in June 2003 by HealthNet International to collect data on the impact of cutaneous leishmaniasis. Leishmaniasis in this region is transmitted from April to October. The city was divided into 10 districts, and 20 households were surveyed along a randomly chosen transect drawn from the center of each district. A team of experienced medical staff clinically diagnosed cutaneous leishmaniasis (based on the presence or absence of cutaneous leishmaniasis lesions or scars, number of lesions, date of lesion onset) in household members and interviewed them to collect demographic data (gender, age). Because of logistic constraints, parasitologic diagnosis of cutaneous leishmaniasis lesions (i.e., microscopic examination or parasite culture) was not conducted. However, in Afghanistan, skin lesions attributed to causes other than cutaneous leishmaniasis are rare, and experience has shown that clinical diagnosis has a sensitivity and specificity of >80% and >90%, respectively (Reithinger et al., unpub, data). Written approval to conduct the study was obtained from the Ministry of Health. Informed consent was obtained from study participants; all study participants with active cases of the disease were offered free anti-leishmanial treatment at the HealthNet International leishmaniasis clinic.

We surveyed 1,832 people from 200 households; 8.3% (152/1,832) and 7.8% (142/1,832) had active cutaneous leishmaniasis lesions or scars, respectively. Of those persons with cutaneous leislnnaniasis lesions, the mean lesion nurnber was 2.4 (range 1-14), the mean lesion size was 2.4 cm (range 1-5.5), and the mean lesion duration (to survey date) was 5.6 months (range 1-11). Active prevalence was not associated with gender (Yates-corrected [chi square] = 2.16, p = 0.14); 85/152 (56%) of the cutaneous leishmaniasis case-patients were women, and 67/152 (44%) of cutaneous leishmaniasis case-patients were men. Data showed that persons aged [greater than or equal to] 15 years were at higher risk of contracting the disease than were persons aged >15 years (odds ratio 2.23, 95% CI 1.54 to 3.24, Yates-corrected [chi square] = 19.44, p < 0.001).

Based on population estimates of 65,000 people and observed prevalence, approximately 5,395 cutaneous leishmaniasis case-patients would be found in Faizabad. The low prevalence of scars, compared to the high prevalence of disease, shows that cutaneous leishmaniasis has been introduced into Faizabad only recently (1,4). Local Ministry of Health records show that the disease was virtually absent (<50 annual cases) in Badakhshan 3 years ago; this information is corroborated by the observation that the mean time since the recovery of surveyed people with cutaneous leishmaniasis scars was 1.5 years (range 0.3-15). Although no attempts were made to identfy circulating Leishmania sp., the current epidemic is likely caused by L. tropica because both men and women are equally affected and younger age groups are at higher risk for cutaneous leishmaniasis than older age groups (1,4). Current analyses are under way to establish risk factors (e.g., presence or absence of animals, type of house construction) for contracting the disease.

With support from HealthNet International, three leishmaniasis clinics have been established in Faizabad to increase the total number of patients whose illness is diagnosed and treated; to reduce the risk to susceptible persons through the subsidized sale of insecticide-impregnated bed nets; to train and supervise the Ministry of Health staff in diagnosis, treatment and prevention of the disease; and to implement health education campaigns for patients attending the clinics and the community at large. Hopefully, these activities will prevent the current cutaneous leishmaniasis outbreak from becoming an epidemic, as it has been in Kabul over the past 15 years (4,5).


We thank the Afghan Ministry of Health and the HealthNet International survey team staff for logistical support.

This study was supported by the United Nations Mission to Afghanistan.


(1.) Ashford R, Kohestany K, Karimzad M. Cutaneous leishmaniasis in Kabul: observations on a prolonged epidemic. Ann Trop Med Parasitol 1992;86:361-71.

(2.) Griffiths WDA. Old World cutaneous leishmaniasis. In: Peters W, Killick-Kendrick R, editors. The lcishmaniascs in biology and medicine. London: Academic Press; 1987. p. 617-43.

(3.) Trouiller R Torreele E, Olliaro P, White N, Foster S, Wirth D, et al. Drugs for neglected diseases: a failure of the market and a public health failure? Trop Med Int Health 2001;6:945-51.

(4.) Reithinger R. Mohsen M, Aadil K, Sidiqi M, Erasmus P, Coleman PG: The burden of anthroponotic cutaneous leishmaniasis in Kabul, Afghanistan. Emerg Infect Dis 2003;9:727-9.

(5.) Reybum H, Rowland M, Mohsen M, Khan B, Davies CR. The prolonged epidemic of anthroponotic cutaneous leishmaniasis in Kabul, Afghanistan: "bringing down the neighbourhood." Trans R Soc Trop Med Hyg 2003;97,170-6.

Address for correspondence: Richard Reithinger, Disease Control and Vector Biology Unit, Department of Infectious and Tropical Medicine, London School of Hygiene and Tropical Medicine, Keppel Street, London WCIE 7HT, UK; tax: +44 207 927 2164; email:

Richard Reithinger, * ([dagger]) Khoksar Aadil, ([dagger]) Samad Hami, ([dagger]) and Jan Kolaczinski * ([dagger])

* London School of Hygiene and Tropical Medicine, London, United Kingdom; and ([dagger]) HealthNet International, Peshawar, Pakistan

COPYRIGHT 2004 U.S. National Center for Infectious Diseases
COPYRIGHT 2004 Gale Group

Return to Leishmaniasis
Home Contact Resources Exchange Links ebay