Epidemiology and Control of Leishmaniasis in the Former USSR: A Review Article

BACKGROUND: All types of the Old World’s leishmaniasis were endemic on the territoru of the ex-Soviet Republics in the Central Asia and Transcaucasia. Epidemiological situation was well under control during the USSR era, due to implementation of complex anti-leismaniasis measures. These interventions were dramatically stopped as a result of the collapse of the USSR in 1991. Within next years the incidence of leishmaniasis returned to the level of the 1950s threatening to reach epidemic proportions unless urgent measures are undertaking. METHODS: Most relevant publications on epidemiology and control of leishmaniases in the Republics of Central Asia and Transcaucasia of the ex-USSR were screened. Data from foreign publications, especially from countries with similar or close to that epidemiological situation in respect of leishmaniases were also included. RESULTS: Epidemiological analysis of spatial distribution of leishmaniases in the ex-USSR revealed that the northern borderline of these diseases is determined by the distribution of the vectors (42-460 North latitude). Within the endemic area, the foci of different kinds of leishmaniasis are often overlapped thus calling for deployment of integrated measures. The anthroponotic cutaneous leishmaniasis (ACL) was reported in settlements and towns of Central Asia and Transcaucasia of the ex-USSR. The natural foci of cutaneous leishmaniasis were widespread in the desert of Turkmenistan, Uzbekistan, southern Kazakhstan, and southern Tajikistan. The northern boundary of the zoonotic cutaneous leishmaniasis (ZCL) area coincided with the northern boundary of the distribution of great gerbils – the main reservoir of this infection in the ex-USSR. Visceral leishmaniasis (VL) occurred in the Central Asian Republics and in the republics of the Transcaucasia. The strategies of control and prevention of leishmaniases in the ex-USSR were based on good knowledge of epidemiology of infections. Holistic approach was adopted by the programs targeting the source of infection, vector(s) and man. CONCLUSION: The presence rise in the number of cases of different types of leishmaniasis in the ex-USSR strongly necessitates that health authorities should consider these diseases as an important public health problem. The immediate task would be re-building a comprehensive surveillance system consisting of active and passive case detection mechanism along with immediate treatment of the patients.