Epidemiology

Leishmaniasis occurs in 101 countries and territories – tropics and subtropics – globally. While the population at risk is estimated to be over 350 million, 0.2-0.4 million VL and 0.7-1.2 million CL new cases occur every year.

Visceral leishmaniasis, also called kala-azar, is observed to occur in about 70 countries and 200million population at risk. Annually 20,000 to 30,000 deaths occur. Ninety percent of the case load is reported from six countries – India, Bangladesh, Sudan, South Sudan, Ethiopia and Brazil (see Map 1). The term Kala-azar is from Hindu for “black fever” as the disease causes darkening of the skin which is historically related to the massive outbreaks in the region in the past.

VL is found in five administrative regions in Ethiopia – Amhara, Tigray, Southern nations, nationalities and people’s, Oromia and Somalia regions (see Map 2).

Exact burden of the diseases is not known due to the under reporting and poor surveillance system. But the estimated annual incidence is 2000-4500 cases. The main endemic spot is the Northwest low land areas bordering Sudan. Young adult (age range from 20-30years) male populations are mainly affected in this region. Population migration related to daily labor work in cash crop farm land areas in this region is the main risk factor for infection. Estimates of 300,000 to 500,000 highlanders move to the VL endemic lowlands seasonally every year. Non immune high landers migrate to the low land VL endemic areas searching for job. In contrast, children are predominantly affected in the other endemic areas in the country like Omo Valley among stable residents. There is no mass population movement seen in this region.