The Uprise of Human Leishmaniasis in Tuscany, Central Italy: Clinical and Epidemiological Data from a Multicenter Study
Human leishmaniasis is facing important epidemiological changes in Southern Europe, driven by increased urbanization, climate changes, emerging of new animal reservoirs, shifts in human behavior and a growing population of immunocompromised and elderly individuals. In this evolving epidemiological landscape, we analyzed the clinical and epidemiological characteristics of human leishmaniasis in the Tuscany region of Central Italy. Through a multicentric retrospective analysis, we collected clinical and demographic data about all cases of leishmaniasis recorded between 2018 and 2023. We observed 176 cases of human leishmaniasis, with 128 (72.7%) visceral leishmaniasis (VL) and 47 (26.7%) cutaneous leishmaniasis (CL). Among these, 92.2% of VL and 85.1% of CL cases were autochthonous. The cumulative incidence of autochthonous human leishmaniasis was 0.22 cases per 100,000 inhabitants in 2018, but reached 1.81/100,000 in 2023. We identified three main areas of transmission: around the city of Florence (North-East Tuscany), around Grosseto city (South-West Tuscany) and Elba Island. Our findings confirm that the epidemiology of leishmaniasis is undergoing significant changes in Central Italy. Awareness towards this emerging health threat and surveillance strategies need to be improved in order to reliably assess the disease's burden. Further research is needed in a "One-Health" perspective, to clarify the epidemiological dynamics at the environmental, reservoir, vector and human levels. The role of climate change and specific climatic factors affecting the epidemiological patterns of human leishmaniasis should be assessed. Further knowledge in these fields would promote targeted control and prevention strategies at regional and national levels.
Authors
- Alessandro Lanari
- Giulia Montorzi
- Daniela Massi (ORCID: https://orcid.org/0000-0002-5688-5923)
- Michele Spinicci (ORCID: https://orcid.org/0000-0002-5377-7118)
- Michela Brogi
- Sara Moneta
- Gian María Rossolini (ORCID: https://orcid.org/0000-0002-9386-0434)
- Elisabetta Venturini (ORCID: https://orcid.org/0000-0002-0048-3933)
- Pierluigi Blanc (ORCID: https://orcid.org/0000-0003-4544-9349)
- Roberta Maria Antonello (ORCID: https://orcid.org/0000-0003-1533-441X)
- Maria Grazia Cusi (ORCID: https://orcid.org/0000-0001-8869-8164)
- Cecília Costa (ORCID: https://orcid.org/0000-0001-9985-2729)
- Marco Falcone (ORCID: https://orcid.org/0000-0003-3813-8796)
- Fabrizio Bruschi (ORCID: https://orcid.org/0000-0001-8701-3290)
- Filippo Bartalesi (ORCID: https://orcid.org/0000-0002-1166-3323)
- Sílvia Regina de Toledo Valentini (ORCID: https://orcid.org/0000-0003-0614-4999)
- Anna Barbiero (ORCID: https://orcid.org/0009-0004-4152-9346)
- Lorenzo Zammarchi (ORCID: https://orcid.org/0000-0003-0892-8404)
- Francesco Amadori (ORCID: https://orcid.org/0000-0003-1316-1033)
- Mario Tumbarello (ORCID: https://orcid.org/0000-0002-9519-8552)
- Valentina Mangano (ORCID: https://orcid.org/0000-0002-2021-6162)
- Federica Ceriegi
- Tamara Brunelli (ORCID: https://orcid.org/0000-0002-9365-688X)
- G Formica
- Sauro Luchi (ORCID: https://orcid.org/0000-0002-7646-4464)
- Maria Rosaria Nardone
- Silvia Fabiani (ORCID: https://orcid.org/0000-0002-9158-5491)
- Fabrizio Gemmi (ORCID: https://orcid.org/0000-0002-1266-8433)
- Iacopo Vellere (ORCID: https://orcid.org/0000-0003-3883-0766)
- Fabio Voller (ORCID: https://orcid.org/0000-0002-1063-415X)
- Cesira Nencioni (ORCID: https://orcid.org/0000-0002-9133-8562)
- Donatella Aquilini (ORCID: https://orcid.org/0000-0002-7962-307X)
- Maria Antonietta Vincenti (ORCID: https://orcid.org/0000-0001-6698-2973)
- Barbara Rossetti
- Eva Maria Parisio (ORCID: https://orcid.org/0000-0002-2883-669X)
- Alessandro Bartoloni (ORCID: https://orcid.org/0000-0001-9758-1523)
- Andrea Aiello
- Giada Rinninella
- Martina Maruotto
- Patrizia Isola
- Luisa Galli
- Loria Bianchi
- Matteo Piccica
- Danilo Tacconi
- Margherita Sambo
- Spartaco Sani
Institutions
- University of Siena (IT)
- University of Pisa (IT)
- Santa Maria Nuova Hospital (IT)
- Marconi University (IT)
- Meyer Children's Hospital (IT)
- Azienda Ospedaliero-Universitaria Careggi (IT)
- Azienda Ospedaliera Universitaria Senese (IT)
- Ospedale Misericordia - Grosseto (IT)
- Ospedale San Donato (IT)
- Ospedale di Livorno (IT)
- Ospedale di Prato Santo Stefano (IT)
- Azienda Usl Toscana Centro (IT)
- Hospital of Prato (IT)
- University of Florence (IT)
Publication Details
- Journal
- Microorganisms
- Published
- 2024-09-27
- DOI
- https://doi.org/10.3390/microorganisms12101963
- Citations
- 10
- Primary Topic
- Research on Leishmaniasis Studies
- Type
- article
- Field-Weighted Citation Impact
- 5.43