A Global Threat
Leishmaniasis not only affects people who live in countries where the disease is endemic, but it also poses a risk to people who travel in those areas. For example, the cutaneous form of the disease is a growing health problem for U.S. soldiers in sand fly-rich Afghanistan and Iraq—where it has been nicknamed the "Baghdad boil." According to the World Health Organization (WHO), 90 percent of all cutaneous leishmaniasis cases occur in Afghanistan, Brazil, Iran, Peru, Saudi Arabia, and Syria.
Though most of the world's cases of visceral leishmaniasis occur in India, Bangladesh, Nepal, Sudan, and Brazil, the spread of HIV, particularly among intravenous drug users, is bringing this severe disease to new geographical areas. According to WHO, co-infection with HIV and visceral leishmaniasis has been reported in 34 countries in Africa, Asia, Europe, and South America. In southern Europe, an estimated 70 percent of adult cases of visceral leishmaniasis are associated with HIV infection.