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      Leishmaniasis en Navarra (1976-2018): actualización Translated title: Leishmaniasis in Navarra, Spain (1976-2018): an update

      research-article
      1 , 2 , 1 , 2
      Anales del Sistema Sanitario de Navarra
      Gobierno de Navarra. Departamento de Salud
      Leishmaniasis, Epidemiología, Navarra, Leishmaniasis, Epidemiology, Navarra

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          Resumen

          La leishmaniasis es endémica en países de la cuenca mediterránea. En el presente estudio se revisa la información disponible sobre la leishmaniasis en Navarra y en regiones limítrofes en el periodo 1976-2018, y se aporta una visión general de la situación de esta enfermedad a nivel nacional, desde el vector hasta el hombre.

          La tasa de incidencia de leishmaniasis disminuyó en Aragón entre 2008 y 2018 respecto a la década anterior, mientras que en Navarra y La Rioja casi se duplicaron los casos por 100.000 habitantes; el País Vasco también presentó un aumento en la incidencia.

          El incremento de casos a nivel nacional ha sido significativo desde 2015, en parte debido a la inclusión de la leishmaniasis como enfermedad de declaración obligatoria. Si bien su incidencia en humanos no parece preocupante, la leishmaniasis es hoy una realidad en España, por lo que es necesario vigilar globalmente su evolución.

          Abstract

          Leishmaniasis is endemic in countries of the Mediterranean area. In this study, the information available on leishmaniasis in Navarra in the period 1976-2018 and in the bordering regions was collected, along with an overview of the situation of this disease at the national level, from the vector to humans.

          Aragón exhibited a lower incidence rate in the last ten years (2008-2018) compared to the previous decade, while Navarra and La Rioja have almost doubled the number of cases per 100,000 inhabitants and, likewise, incidence in the Basque Country has also increased.

          At the national level, since 2015, such an increase has become significant due to the inclusion of human leishmaniasis as a mandatory notifiable disease. Currently in Spain, although the incidence of human leishmaniasis is not a situation of high concern, it is however a reality. Therefore, it is necessary to monitor its evolution.

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          Most cited references35

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          Leishmaniasis Worldwide and Global Estimates of Its Incidence

          As part of a World Health Organization-led effort to update the empirical evidence base for the leishmaniases, national experts provided leishmaniasis case data for the last 5 years and information regarding treatment and control in their respective countries and a comprehensive literature review was conducted covering publications on leishmaniasis in 98 countries and three territories (see ‘Leishmaniasis Country Profiles Text S1, S2, S3, S4, S5, S6, S7, S8, S9, S10, S11, S12, S13, S14, S15, S16, S17, S18, S19, S20, S21, S22, S23, S24, S25, S26, S27, S28, S29, S30, S31, S32, S33, S34, S35, S36, S37, S38, S39, S40, S41, S42, S43, S44, S45, S46, S47, S48, S49, S50, S51, S52, S53, S54, S55, S56, S57, S58, S59, S60, S61, S62, S63, S64, S65, S66, S67, S68, S69, S70, S71, S72, S73, S74, S75, S76, S77, S78, S79, S80, S81, S82, S83, S84, S85, S86, S87, S88, S89, S90, S91, S92, S93, S94, S95, S96, S97, S98, S99, S100, S101’). Additional information was collated during meetings conducted at WHO regional level between 2007 and 2011. Two questionnaires regarding epidemiology and drug access were completed by experts and national program managers. Visceral and cutaneous leishmaniasis incidence ranges were estimated by country and epidemiological region based on reported incidence, underreporting rates if available, and the judgment of national and international experts. Based on these estimates, approximately 0.2 to 0.4 cases and 0.7 to 1.2 million VL and CL cases, respectively, occur each year. More than 90% of global VL cases occur in six countries: India, Bangladesh, Sudan, South Sudan, Ethiopia and Brazil. Cutaneous leishmaniasis is more widely distributed, with about one-third of cases occurring in each of three epidemiological regions, the Americas, the Mediterranean basin, and western Asia from the Middle East to Central Asia. The ten countries with the highest estimated case counts, Afghanistan, Algeria, Colombia, Brazil, Iran, Syria, Ethiopia, North Sudan, Costa Rica and Peru, together account for 70 to 75% of global estimated CL incidence. Mortality data were extremely sparse and generally represent hospital-based deaths only. Using an overall case-fatality rate of 10%, we reach a tentative estimate of 20,000 to 40,000 leishmaniasis deaths per year. Although the information is very poor in a number of countries, this is the first in-depth exercise to better estimate the real impact of leishmaniasis. These data should help to define control strategies and reinforce leishmaniasis advocacy.
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            LeishVet guidelines for the practical management of canine leishmaniosis

            The LeishVet group has formed recommendations designed primarily to help the veterinary clinician in the management of canine leishmaniosis. The complexity of this zoonotic infection and the wide range of its clinical manifestations, from inapparent infection to severe disease, make the management of canine leishmaniosis challenging. The recommendations were constructed by combining a comprehensive review of evidence-based studies, extensive clinical experience and critical consensus opinion discussions. The guidelines presented here in a short version with graphical topic displays suggest standardized and rational approaches to the diagnosis, treatment, follow-up, control and prevention of canine leishmaniosis. A staging system that divides the disease into four stages is aimed at assisting the clinician in determining the appropriate therapy, forecasting prognosis, and implementing follow-up steps required for the management of the leishmaniosis patient.
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              Prevalence of Leishmania infantum infection in dogs living in an area of canine leishmaniasis endemicity using PCR on several tissues and serology.

              We studied and compared the prevalence of Leishmania infection and the seroprevalence and the prevalence of canine leishmaniasis in an area where canine leishmaniasis is endemic. One hundred dogs living on the island of Mallorca (Spain) were studied. In this study, we clinically examined each dog for the presence of symptoms compatible with leishmaniasis, determined the titer of anti-Leishmania antibodies, and investigated the presence of Leishmania DNA by PCR in skin, conjunctiva, and bone marrow samples of each dog. The prevalence of the disease and the seroprevalence were 13 and 26%, respectively. In 63% of the dogs, Leishmania DNA could be detected by PCR in at least one of the tissues studied. The results of positive PCR in the bone marrow, the conjunctiva, and the skin were 17.8, 32, and 51%, respectively. The prevalence of the infection, 67%, was calculated using all animals that were seropositive and/or positive by PCR with any tissue. The results showed that the majority of dogs living in an area where canine leishmaniasis is endemic are infected by Leishmania and that the prevalence of infection is much greater than the prevalence of overt Leishmania-related disease.
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                Author and article information

                Journal
                An Sist Sanit Navar
                An Sist Sanit Navar
                assn
                Anales del Sistema Sanitario de Navarra
                Gobierno de Navarra. Departamento de Salud
                1137-6627
                2340-3527
                28 April 2022
                Jan-Apr 2022
                : 45
                : 1
                : e0981
                Affiliations
                [1 ] original Universidad de Navarra. Instituto de Salud Tropical (ISTUN). Departamento de Microbiología y Parasitología. Pamplona. España. normalizedUniversidad de Navarra orgnameUniversidad de Navarra orgdiv1Instituto de Salud Tropical (ISTUN) orgdiv2Departamento de Microbiología y Parasitología Pamplona, Spain
                [2 ] originalIdiSNA (Instituto de Investigación Sanitaria de Navarra). Pamplona. España. orgnameIdiSNA (Instituto de Investigación Sanitaria de Navarra) Pamplona, España
                Author notes
                [Correspondencia ]Paul Nguewa. Universidad de Navarra, ISTUN, Instituto de Salud Tropical, Departamento de Microbiología y Parasitología Irunlarrea, 1, 31008, Pamplona. E-mail: panguewa@ 123456unav.es

                Conflictos de interés: Los autores declaran no tener conflictos de intereses.

                Article
                10.23938/ASSN.0981
                10114043
                34726669
                98fd6383-d0fc-49d5-84de-b03c6108d30b

                Este es un artículo publicado en acceso abierto bajo una licencia Creative Commons

                History
                : 26 February 2021
                : 07 April 2021
                : 01 June 2021
                Page count
                Figures: 3, Tables: 1, Equations: 0, References: 32, Pages: 0
                Funding
                Funded by: Fundación La Caixa
                Award ID: LCF/PR/PR13/11080005
                Funded by: Fundación Caja Navarra, Departamento de Salud del Gobierno Navarra
                Award ID: 12/2017
                Funded by: Fundación Roviralta, Ubesol, Gobierno de Navarra, Laser Ebro, Inversores Garcilaso de la Vega S.L. y Ministerio de Ciencia e Innovación de España
                Award ID: PID2020-112713RB-C21
                Nuestras investigaciones han recibido el apoyo de la Fundación La Caixa (LCF/PR/PR13/11080005) y Fundación Caja Navarra, Departamento de Salud del Gobierno Navarra (12/2017), Fundación Roviralta, Ubesol, Gobierno de Navarra, Laser Ebro, Inversores Garcilaso de la Vega S.L. y Ministerio de Ciencia e Innovación de España (PID2020-112713RB-C21).
                Categories
                Revisiones

                leishmaniasis,epidemiología,navarra,epidemiology
                leishmaniasis, epidemiología, navarra, epidemiology

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