The global burden and trends of cutaneous leishmaniasis from 1990 to 2021 with projections to 2036: a...

Cutaneous leishmaniasis (CL) poses unique therapeutic challenges and imposes a substantial burden. Yet data on its burden and trends are limited. To analyze the global disease burden and epidemic trend of CL from 1990 to 2021 and to project its change to 2036.

The data utilized in the analysis are sourced from the Global Health Exchange Database. The database covers 204 countries and territories. All the analysis procedures and graphic representation were undertaken by R statistical software and GraphPad Prism 9. Incidence, prevalence, disability-adjusted life years (DALYs), age-standardized incidence rate (ASIR), age-standardized prevalence rate (ASPR) and age-standardized years lived with disability rate (ASDR) were calculated per 100,000 population.

The global burden of CL increased significantly during this period, with consistently higher rates observed in males compared with females. The trends exhibited dynamic fluctuations, including a temporary decline in the ASIR in the early years. Meanwhile, both the ASPR and ASDR continued to rise significantly, with an average annual percentage change (AAPC) of 0.8%. Population analysis revealed a bimodal age distribution, characterized by high incidence among children under five years of age and males over 70 years old with males experiencing a higher burden across all age groups. Geographically, the distribution of the disease burden was highly uneven. The global burden can be mostly attributed to population growth and aging. Significant uneven regional disparities grouped by socio-demographic index were observed. ARIMA model projections predict that the ASIR is expected to plateau after 2025, and both the ASPR and ASDR are projected to continue rising linearly by 2036.

These findings highlight rising absolute burdens, significant gender and age disparities, and pronounced geographic inequalities in CL. Enhanced monitoring and intervention are needed to address this growing public health challenge.