Prevalence of human leishmaniasis in Sudan: A systematic review and meta-analysis

BACKGROUND: There are three main forms of leishmaniasis in humans: cutaneous leishmaniasis (CL), visceral leishmaniasis (VL), and mucocutaneous leishmaniasis. The prevalence of human leishmaniasis varies widely in different countries and different regions of the same country. To date, there is no overall estimation of the prevalence of human leishmaniasis in Sudan. AIM: To determine the pooled prevalence of human leishmaniasis and the disease risk factors among Sudanese citizens. METHODS: From all articles written in English or Arabic languages conducted before the 4th of August 2021 from [Scopus, Web of Science, PubMed, and MEDLINE, African Journals Online (AJOL), ResearchGate, direct Google search, Google Scholar, and universities websites], just 20 articles with a total of 230960 participants were eligible for this study. Data synthesis and analysis were done using STATA software, version 16. EndNote citation manager version X9.3.3 and Reference Citation Analysis (RCA) were used to remove the duplicated studies and manage the citation respectively. RESULTS: The overall pooled prevalence of human leishmaniasis in Sudan was 21% (with confidence interval 12%-30%). CL was the most common type of leishmaniasis in Sudan, with a pooled prevalence of 26% followed by VL (18%). Nevertheless, the pooled prevalence of human leishmaniasis in Sudan was higher in males compared with females (60% vs 40%). The current results revealed that the people in the age group between 15 and 44 were the most affected group (60%), and central Sudan has the highest pooled prevalence of human leishmaniasis (27%) compared with other regions of Sudan. Finally, the prevalence of human leishmaniasis seems to decrease with time. CONCLUSION: This study showed that human leishmaniasis infection is still endemic in many regions in Sudan and highly prevalent in central and eastern Sudan, and CL is the most prevalent in the country. Males and adults were more susceptible to infection compared with females and children. However, the human leishmaniasis prevalence decreased relatively over time.