Prevalence and associated factors of asymptomatic leishmaniasis: a systematic review and meta-analysis

• Published in: Parasitology international Vol. 81; p. 102229
• Main Authors: Mannan, Shahnewaj Bin, Elhadad, Heba, Loc, Tran Thai Huu, Sadik, Mohamed, Mohamed, Muawia Yousif Fadlelmola, Nam, Nguyen Hai, Thuong, Nguyen Dinh, Hoang-Trong, Bao-Long, Duc, Nguyen Tran Minh, Hoang, An Nguyen, Elhusseiny, Khaled Mosaad, Minh, Le Huu Nhat, Quynh, Tran Thuy Huong, Nghia, Thai Le Ba, Mai Nhu, Y., Tieu, Thuan Minh, Hirayama, Kenji, Huy, Nguyen Tien, Hamano, Shinjiro
• Format: Journal Article
• Language: English
• Published: Netherlands Elsevier B.V 01.04.2021
• Subjects: Associated factors; Asymptomatic; Leishmaniasis; Meta-analysis; Prevalence; Associated factors; Asymptomatic; Prevalence; Leishmaniasis; Meta-analysis
• ISSN: 1383-5769; 1873-0329
• DOI: 10.1016/j.parint.2020.102229

Asymptomatic leishmaniasis is believed to play important role in maintaining the transmission of Leishmania spp. within endemic communities. Therefore, the efforts to eliminate leishmaniasis are daunting if we cannot manage asymptomatic leishmaniasis well. To clarify the global prevalence and factors associated with the asymptomatic Leishmania infection, we assessed the prevalence of asymptomatic leishmaniasis by a systematic review followed by meta-analyses. In addition, factors associated with the asymptomatic leishmaniasis versus symptomatic were also analyzed. We included all of the original articles alluding to the human asymptomatic leishmaniasis that was confirmed by at least one laboratory diagnosis method regardless of age, sex, race, and ethnicity of the patients, study design, publication date or languages. In total, 111 original articles were chosen for the data extraction. Based on our meta-analyses of the original articles reporting asymptomatic leishmaniasis mostly in endemic areas, the prevalence of asymptomatic leishmaniasis was 11.2% [95% confidence interval (CI) 8.6%‐14.4%] in general population, 36.7% [95% CI 27.6%‐46.8%] in inhabitants living in the same or neighboring household to the symptomatic patients, and 11.8% [95% CI 7.1%-19%] in HIV infected patients. Among individuals with leishmaniasis, 64.9% [95% CI 54.7%-73.9%] were asymptomatic and males were more susceptible to develop symptoms, with OR=1.88, 95% CI 1.19-2.99, P=0.007. Meta-regression analysis showed no significant change in the prevalence of asymptomatic leishmaniasis during the last 40 years. [Display omitted] •Prevalence of asymptomatic leishmaniasis is 11.2% mostly in endemic area.•Among the Leishmania infected individuals 64.9% are asymptomatic.•Male are more susceptible to develop symptomatic disease.•Trends of infection is unchanged in last 40 years.