Leishmaniasis in Colombia, a review.

A review is made of 60 publications on leishmaniasis in Colombia reported between 1889 and the present. A serious source of difficulty in interpreting the literature is the frequent discussion of "cases" (1,536 of 1,865, or 82%) that were never confirmed by observation of the parasite or by positive immunological tests. The apparent distribution of the disease is considerably biased by the real distribution of physicians. Nevertheless, laboratory-confirmed cutaneous leishmaniasis has been reported from most humid, lowland regions, and apparently the disease is endemic in nearly all the administrative sections of the country. Mucocutaneous involvement seems to occur in around 25% of the cases. Visceral leishmaniasis is seldom reported and is known to occur only in the Magdalena River basin. There have been no surveys to identify arthropod vectors or wild reservoir hosts, although two naturally infected dogs were associated with one of the visceral leishmaniasis cases. Leishmaniasis is a seldom diagnosed but major health problem in several regions of Colombia, in terms of the number of persons affected and the difficulty of obtaining treatment.