An updated systematic review with meta-analysis and meta-regression of the factors associated with human visceral leishmaniasis in the Americas
Abstract Background Human visceral leishmaniasis (VL) is a systemic disease with high case-fatality rates and a widespread distribution. Continuous evaluation of the risk factors for VL is essential to ensure the effective implementation of prevention and control measures. The present study reviews...
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BMC
2025-01-01
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| Series: | Infectious Diseases of Poverty |
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| Online Access: | https://doi.org/10.1186/s40249-025-01274-z |
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| author | Anna Gabryela Sousa Duarte Guilherme Loureiro Werneck Sarah de Farias Lelis Thays Santos Mendonça Daniela Dias Vasconcelos Tiago Silveira Gontijo Álisson Oliveira dos Santos Lucas Edel Donato Vinícius Silva Belo |
| author_facet | Anna Gabryela Sousa Duarte Guilherme Loureiro Werneck Sarah de Farias Lelis Thays Santos Mendonça Daniela Dias Vasconcelos Tiago Silveira Gontijo Álisson Oliveira dos Santos Lucas Edel Donato Vinícius Silva Belo |
| author_sort | Anna Gabryela Sousa Duarte |
| collection | DOAJ |
| description | Abstract Background Human visceral leishmaniasis (VL) is a systemic disease with high case-fatality rates and a widespread distribution. Continuous evaluation of the risk factors for VL is essential to ensure the effective implementation of prevention and control measures. The present study reviews the factors associated with VL in the Americas. Methods This systematic review updates a previous 2013 report by including cross-sectional, cohort and case-control studies published between July 2011 and April 2024. Associations between VL and risk factors were analyzed using random-effects meta-analysis, subgroup analysis, and meta-regression models. Studies were classified according to level of evidence using the GRADE approach and the evolution in the quality of investigations was assessed. Results Forty-six studies were included in the review and 21 variables were evaluated in the meta-analyses. Combination of all study types revealed that men had greater chances of VL than women, but the association was strong and significant only in case-control studies. Although higher chances of VL in children and in households with dogs or chickens/other fowl were identified in case-control studies, an inverse association was observed in cross-sectional and cohort studies. Higher chances of VL were associated with poor economic/living conditions, individuals living in domiciles with backyards or with seropositive dogs, and individuals with prior contact with infected household members/relatives/neighbors. The level of evidence for associations of VL with sex and age was classified as moderate whilst that for all other associations was either low or very low. The methodological quality of recent studies showed a positive progression but shortcomings were still evident regarding selection criteria and methods of data analysis. Conclusion While there is a higher incidence of symptomatic VL among men and children, the likelihood of infection is similar between the groups. There is insufficient evidence to support the claim that the presence of dogs or fowl at the domicile increases the chances of VL. However, socioeconomic and living conditions, as well as previous occurrence of human and canine VL, are influential factors. Future research should be conducted with greater statistical power and using molecular diagnostic techniques, preferably involving cohort studies in diverse Latin American countries. Graphical Abstract |
| format | Article |
| id | doaj-art-bbb61391cccc404d8060a99980ee4b7d |
| institution | Kabale University |
| issn | 2049-9957 |
| language | English |
| publishDate | 2025-01-01 |
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| series | Infectious Diseases of Poverty |
| spelling | doaj-art-bbb61391cccc404d8060a99980ee4b7d2025-02-02T12:47:42ZengBMCInfectious Diseases of Poverty2049-99572025-01-0114112210.1186/s40249-025-01274-zAn updated systematic review with meta-analysis and meta-regression of the factors associated with human visceral leishmaniasis in the AmericasAnna Gabryela Sousa Duarte0Guilherme Loureiro Werneck1Sarah de Farias Lelis2Thays Santos Mendonça3Daniela Dias Vasconcelos4Tiago Silveira Gontijo5Álisson Oliveira dos Santos6Lucas Edel Donato7Vinícius Silva Belo8Universidade Federal de São João del Rei (UFSJ)Departamento de Epidemiologia, Universidade Do Estado Do Rio de JaneiroUniversidade Federal de São João del Rei (UFSJ)Universidade Federal de São João del Rei (UFSJ)Prefeitura Municipal de Divinópolis-Minas Gerais, Secretaria Municipal de SaúdeUniversidade Federal de São João del Rei (UFSJ)Campus de Três Lagoas (CPTL), Universidade Federal de Mato Grosso Do Sul (UFMS)Ministério da Saúde Do Brasil, Secretaria de Vigilância Em Saúde E AmbienteUniversidade Federal de São João del Rei (UFSJ)Abstract Background Human visceral leishmaniasis (VL) is a systemic disease with high case-fatality rates and a widespread distribution. Continuous evaluation of the risk factors for VL is essential to ensure the effective implementation of prevention and control measures. The present study reviews the factors associated with VL in the Americas. Methods This systematic review updates a previous 2013 report by including cross-sectional, cohort and case-control studies published between July 2011 and April 2024. Associations between VL and risk factors were analyzed using random-effects meta-analysis, subgroup analysis, and meta-regression models. Studies were classified according to level of evidence using the GRADE approach and the evolution in the quality of investigations was assessed. Results Forty-six studies were included in the review and 21 variables were evaluated in the meta-analyses. Combination of all study types revealed that men had greater chances of VL than women, but the association was strong and significant only in case-control studies. Although higher chances of VL in children and in households with dogs or chickens/other fowl were identified in case-control studies, an inverse association was observed in cross-sectional and cohort studies. Higher chances of VL were associated with poor economic/living conditions, individuals living in domiciles with backyards or with seropositive dogs, and individuals with prior contact with infected household members/relatives/neighbors. The level of evidence for associations of VL with sex and age was classified as moderate whilst that for all other associations was either low or very low. The methodological quality of recent studies showed a positive progression but shortcomings were still evident regarding selection criteria and methods of data analysis. Conclusion While there is a higher incidence of symptomatic VL among men and children, the likelihood of infection is similar between the groups. There is insufficient evidence to support the claim that the presence of dogs or fowl at the domicile increases the chances of VL. However, socioeconomic and living conditions, as well as previous occurrence of human and canine VL, are influential factors. Future research should be conducted with greater statistical power and using molecular diagnostic techniques, preferably involving cohort studies in diverse Latin American countries. Graphical Abstracthttps://doi.org/10.1186/s40249-025-01274-zLeishmaniasisEpidemiologyRisk factorSystematic reviewQuality data reporting |
| spellingShingle | Anna Gabryela Sousa Duarte Guilherme Loureiro Werneck Sarah de Farias Lelis Thays Santos Mendonça Daniela Dias Vasconcelos Tiago Silveira Gontijo Álisson Oliveira dos Santos Lucas Edel Donato Vinícius Silva Belo An updated systematic review with meta-analysis and meta-regression of the factors associated with human visceral leishmaniasis in the Americas Infectious Diseases of Poverty Leishmaniasis Epidemiology Risk factor Systematic review Quality data reporting |
| title | An updated systematic review with meta-analysis and meta-regression of the factors associated with human visceral leishmaniasis in the Americas |
| title_full | An updated systematic review with meta-analysis and meta-regression of the factors associated with human visceral leishmaniasis in the Americas |
| title_fullStr | An updated systematic review with meta-analysis and meta-regression of the factors associated with human visceral leishmaniasis in the Americas |
| title_full_unstemmed | An updated systematic review with meta-analysis and meta-regression of the factors associated with human visceral leishmaniasis in the Americas |
| title_short | An updated systematic review with meta-analysis and meta-regression of the factors associated with human visceral leishmaniasis in the Americas |
| title_sort | updated systematic review with meta analysis and meta regression of the factors associated with human visceral leishmaniasis in the americas |
| topic | Leishmaniasis Epidemiology Risk factor Systematic review Quality data reporting |
| url | https://doi.org/10.1186/s40249-025-01274-z |
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