Vulnerabilities to and the Socioeconomic Impacts of the Leishmaniases: A Review

Presenter: Jorja Kahn

Research Category: Health Sciences
College: College of Science
Major(s): Behavioral Neuroscience
Graduation Date: 2021

The leishmaniases are a group of vector-borne neglected tropical diseases (NTDs) with an estimated 1.6 billion people at risk globally. The primary presentations of leishmaniasis – cutaneous (CL) and visceral (VL), along with secondary post kala-azar dermal leishmaniasis (PKDL), are caused by parasites of the Leishmania genus and spread by Phlebotomine sandflies. Given their synergistic impacts, risk factors and vulnerabilities on poor populations, and the launch of a new WHO roadmap for NTDs to 2030, it is warranted to update the state of knowledge of the leishmaniases to help inform policy interventions. 

We provide a contemporary narrative literature review of the socioeconomic and psychosocial impacts within a framework of risk factors and vulnerabilities. We identified and described core themes related to leishmaniasis: financial burden, access to care, comorbidities, psychosocial effects, gender differences, and population migration. Poverty is an overarching risk factor, and catastrophic healthcare expenditure compounds existing financial strain for households and healthcare systems. Low-income status, as well as potential co-occurrence of malnutrition and HIV, exacerbate complexities in access to care and treatment outcomes. Dermatological presentations may result in long-term severe disfigurement, leading to stigmatization, reduced quality of life, and mental health concerns. Recent literature points to vulnerability pathways on women in particular who disproportionately suffer from these impacts. Climate change and political instability are major drivers of population migration. These emerging foci demonstrate a need for continued international efforts to address key risk factors and population vulnerabilities if leishmaniasis control, and ultimately elimination, is to be achieved by 2030.