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Surveillance of leishmaniasis cases from 15 European centres, 2014 to 2019: a retrospective analysis
- Gert Van der Auwera1 , Leigh Davidsson2 , Pierre Buffet3 , Marie-Thérèse Ruf4,5 , Marina Gramiccia6 , Stefania Varani7,8 , Carmen Chicharro9 , Aldert Bart10 , Gundel Harms11 , Peter L. Chiodini12 , Hanne Brekke13 , Florence Robert-Gangneux14 , Sofia Cortes15 , Jaco J Verweij16 , Alessandra Scarabello17 , Sara Karlsson Söbirk18 , Romain Guéry19 , Saskia van Henten1 , Trentina Di Muccio6 , Elena Carra20 , Pieter van Thiel10 , Martin Vandeputte1 , Valeria Gaspari7 , Johannes Blum4,5 , LeishMan Surveillance network21
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View Affiliations Hide AffiliationsAffiliations: 1 Institute of Tropical Medicine, Antwerp, Belgium 2 The Public Health Agency of Sweden, Solna, Sweden 3 Service des maladies infectieuses et tropicales, AP-HP, Hopital Necker, Paris, France 4 Swiss Tropical and Public Health Institute, Basel, Switzerland 5 University of Basel, Basel, Switzerland 6 Istituto Superiore di Sanità, Rome, Italy 7 IRCCS Azienda Ospedaliero-Universitaria di Bologna, Bologna, Italy 8 Department of Experimental, Diagnostic and Specialty Medicine, University of Bologna, Bologna, Italy 9 Instituto de Salud Carlos III, Madrid, Spain 10 Amsterdam University Medical Centre, Amsterdam, the Netherlands 11 Institute of Tropical Medicine and International Health, Charité – Universitätsmedizin Berlin, corporate member of Freie Universität Berlin and Humboldt – Universität zu Berlin, Berlin, Germany 12 Hospital for Tropical Diseases, London, United Kingdom 13 Oslo University Hospital, Oslo, Norway 14 Univ Rennes, CHU Rennes, Inserm, EHESP, Irset - UMR_S 1085, Rennes, France 15 Global Health and Tropical Medicine, Instituto de Higiene e Medicina Tropical, Universidade NOVA de Lisboa, Lisbon, Portugal 16 Microvida Laboratory for Medical Microbiology and Immunology, Elisabeth-TweeSteden Hospital, Tilburg, the Netherlands 17 National Institute for Infectious Diseases ‘Lazzaro Spallanzani’, Rome, Italy 18 Division of Infection Medicine, Lund University, Lund, Sweden 19 Hôpital privé du Confluent, Nantes, France 20 Istituto Zooprofilattico Sperimentale della Lombardia e dell' Emilia-Romagna ‘Bruno Ubertini’, Brescia, Italy 21 The members of the network are listed under InvestigatorsGert Van der Auweragvdauwera itg.be
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LeishMan Surveillance Network members who contributed to this article (in addition to authors above): Emmanuel Bottieau, Jan Clerinx, Lieselotte Cnops, José Manuel Cristovão, Jean-Claude Dujardin, Eleonora Fiorentino, Jean-Pierre Gangneux, Luigi Gradoni, Andreas K Lindner, Diana Lockwood, Stephen Walker, Aldo Scalone, Johan van GriensvenView Citation Hide Citation
Citation style for this article: Van der Auwera Gert, Davidsson Leigh, Buffet Pierre, Ruf Marie-Thérèse, Gramiccia Marina, Varani Stefania, Chicharro Carmen, Bart Aldert, Harms Gundel, Chiodini Peter L., Brekke Hanne, Robert-Gangneux Florence, Cortes Sofia, Verweij Jaco J, Scarabello Alessandra, Karlsson Söbirk Sara, Guéry Romain, van Henten Saskia, Di Muccio Trentina, Carra Elena, van Thiel Pieter, Vandeputte Martin, Gaspari Valeria, Blum Johannes, LeishMan Surveillance network. Surveillance of leishmaniasis cases from 15 European centres, 2014 to 2019: a retrospective analysis. Euro Surveill. 2022;27(4):pii=2002028. https://doi.org/10.2807/1560-7917.ES.2022.27.4.2002028 Received: 29 Nov 2020; Accepted: 14 Sept 2021
Abstract
Surveillance of human leishmaniasis in Europe is mostly limited to country-specific information from autochthonous infections in the southern part. As at the end of 2021, no integrated analysis has been performed for cases seen across centres in different European countries.
To provide a broad perspective on autochthonous and imported leishmaniasis cases in endemic and non-endemic countries in Europe.
We retrospectively collected records from cutaneous, mucosal and visceral leishmaniasis cases diagnosed in 15 centres between 2014 and 2019. Centres were located in 11 countries: Belgium, France, Germany, Italy, the Netherlands, Norway, Portugal, Spain, Sweden, Switzerland and the United Kingdom. Data on country of infection, reason for travelling, infecting species, age and sex were analysed.
We obtained diagnostic files from 1,142 cases, of which 76%, 21% and 3% had cutaneous, visceral, and mucosal disease, respectively. Of these, 68% were men, and 32% women, with the median age of 37 years (range: 0–90) at diagnosis. Visceral leishmaniasis was mainly acquired in Europe (88%; 167/190), while cutaneous leishmaniasis was primarily imported from outside Europe (77%; 575/749). Sixty-two percent of cutaneous leishmaniasis cases from outside Europe were from the Old World, and 38% from the New World. Geographic species distribution largely confirmed known epidemiology, with notable exceptions.
Our study confirms previous reports regarding geographic origin, species, and traveller subgroups importing leishmaniasis into Europe. We demonstrate the importance of pooling species typing data from many centres, even from areas where the aetiology is presumably known, to monitor changing epidemiology.
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