Abstract
Background: Visceral leishmaniasis (VL) is a fatal parasitic disease endemic in tropical regions, causing severe complications and high mortality. Challenges such as delayed diagnosis and limited treatment options highlight the urgent need for robust predictive models.
Study Design: A secondary analysis based on cross-sectional data.
Methods: Sex-specific VL epidemiological data from 1990 to 2021 were extracted from the Global Burden of Disease (GBD) and analyzed globally and across 98 endemic countries and regions. We employed an enhanced illness-death model (IDM), accounting for remission, to estimate the age-standardized prevalence rate (ASPR) of VL by 2040.
Results: Globally, the ASPR of VL decreased by 94.68% between 1990 and 2021 and is projected to decrease by an additional 72.55% by 2040, from 0.108 in 2021 to 0.030 (95% CI: 0.020, 0.043) per 100,000. In 2040, the projected ASPR for males will be higher than for females (0.041 vs. 0.019). Tropical Latin America is projected to have the highest regional ASPR at 0.583 (95% CI: 0.565, 0.602). Western Sub-Saharan Africa is the only region expected to see an increase, rising by 417.12%. Of 83 nations, 27 are projected to have increasing trends, with Djibouti having the highest ASPR at 20.32 (95% CI: 5.25, 78.67), a 2050.59% increase from 2021 to 2040.
Conclusion: Although global trends show a decline, significant increases are expected in Western Sub-Saharan Africa and countries like Djibouti, highlighting the need for targeted interventions. Strengthening healthcare systems, improving vector control, and addressing sex-specific risks are crucial to maintaining global progress against VL.