During May–September 2012 WHO made an assessment of visceral leishmaniasis (VL) in natural and recently recognized VL focuses in the Penjikent and Darvaz districts of Tajikistan. The study targeted children aged under 14 years and patients in 2 hospitals in Kalaihumb district and Penjikent town who were aged over 14 years and had signs of VL disease. The project staff made household visits, during which they surveyed children, and interviewed their parents.
WHO/Europe, in collaboration with the National Centre for Disease Control and Public Health of Georgia, carried out a project to improve epidemiological data on leishmaniasis in natural and recently recognized VL foci in Tbilisi and Kutaisi in June–October 2012. The study showed that Tbilisi, capital of Georgia, is an active focus for leishmaniasis, with very high infection prevalence in pet and stray dogs and human beings.
Leishmaniasis is a neglected and poorly reported disease with an underestimated burden in most countries of the Region. The regional incidence of VL and cutaneous leishmaniasis (CL) could be estimated at less than 2% of the global burden. Cases of VL, which is due to Leishmania infantum, are reported in countries of western Europe, the Balkan region, central Asia, South Caucasus and Turkey, with an overwhelming majority (nearly 75%) found in Albania, Georgia, Italy and Spain. The reservoir hosts are domestic dogs, foxes and jackals. The main proven and suspected vectors are thought to be Phlebotomus kandelakii, P. balcanicus, P. sergenti, P. chinensis, P. papatasi, P. syriacus, P. longiductus, P. perfiliewi, P. perniciosus, P. ariasi, P. tobbi, P. arabicus, and P. neglectus.
Since the middle of the 1990s the number of reported VL cases in children aged under 5 years has increased more than ninefold, exceeding 180 in 2007 in Georgia. In recent years, however, the number of adults with VL as a co-infection with HIV has risen. Human (and canine) leishmaniasis is a serious problem in southern Europe, with a steady increase in prevalence, especially of co-infection with HIV, which is difficult to diagnose and manage.
At present the countries in the WHO European Region most affected by cutaneous leishmaniasis (CL) are Turkey, Turkmenistan and Uzbekistan, which account for almost 80% of total cases reported. Cases of anthroponotic CL, which is caused by L. tropica, could be found in Azerbaijan, Israel, Turkey and Uzbekistan. The disease is reported predominantly in densely populated settlements, where person-to-person transmission is maintained by P. sergenti. Cases of zoonotic CL caused by L. major are registered in central Asia, South Caucasus and Kazakhstan, Israel and Turkey, and the disease is prone to epidemics. CL caused by L. infantum is reported in some Balkan, South Caucasus, central Asian and other countries in the WHO European Region.