Leishmaniasis in East Asia

Dear Colleagues,

This Special Issue aims to shift our attention to leishmaniasis in East Asia, where this disease has been studied extensively for over a century, rather than focusing on other parts of the world. Leishmaniasis is a sand fly-transmitted disease with variable clinical sequelae, ranging from innocuous self-healing cutaneous lesions to debilitating facial disfigurement due to mucosal involvement to the often-fatal visceral disease. The World Health Organization designated leishmaniasis as a neglected tropical disease (NTD) with an estimated annual incidence of up to 1 million in 2023 (https://www.who.int/news-room/fact-sheets/detail/leishmaniasis). The risk factors for leishmaniasis include poverty, malnutrition, and HIV co-infection.

The causative agents are trypanosomatid flagellated protozoa in the Leishmania genus, of which some 20 different pathogenic species are known to exist and are transmitted by the blood-feeding female sand fly of various species in different endemic sites. Leishmania species, sand fly vectors, and human immune responses to them all contribute to the occurrence of different clinical diseases. The complexity of host–parasite–vector interactions underscores the difficulty of elucidating the epidemiology of leishmaniasis in any endemic site. This is further complicated by the persistence of Leishmania in asymptomatic individuals as well as in domestic and wild animals to serve as the reservoirs. Proven animal reservoirs of human leishmaniasis include rodents and canines, which harbor pathogenic Leishmania often without significant illness. Canine and feline leishmaniasis of veterinary significance is exceptional when visceral Leishmania infects dogs and cats. Additional animal reservoirs include primates, edentates (sloths), marsupials (opossums), armadillos found in the Amazon jungle, and even reptiles (lizards, snakes). There are also non-pathogenic Leishmania found to infect specifically guinea pigs, kangaroos, and lizards (Souraleishmania). Leishmaniasis is thus very widespread worldwide in all continents, except Antarctica.

The disease has been recorded to exist since ancient times in Egypt, the Middle East, and Persia, as well as in pre-Columbian America during the periods of Inca and Maya civilization. The Iberian conquistadors encountered leishmaniasis in Central and South America in the 15th century. The disease was described scientifically in the late 19th and early 20th centuries, during the territorial expansion of the Western powers into endemic areas, such as British colonization of the Indian subcontinent in South Asia, the invasion of Central Asia by Czarist Russia, and the British and French colonial occupation of the Middle East, North Africa, and East Africa. During the subsequent decades, Leishmania and leishmaniasis in all these endemic areas have remained the focal point for investigation, with progress made in both the lab and the field.

Less attention has been devoted to the history, ecology, clinical diseases, and etiological agents of leishmaniasis in East Asia. Western and Chinese medical professionals pioneered the initial study of visceral leishmaniasis there in the early 20th century, when it was rampant on the east coast of China, with diseased dogs frequently seen in the streets of Beijing. Control of this disease was achieved in Eastern China by effective programs implemented in the 1950s. Today, the disease persists and erupts sporadically into epidemic proportions in the western region of Xinjiang. Notably, Leishmaniasis has been reported in Thailand and Taiwan, indicating its likely presence in all nations and territories between these two locations in Southeast Asia.  This Special Issue welcomes the submissions of original research work, reviews, short communications, and commentaries for all aspects of Leishmania and leishmaniasis in East Asia.

Prof. Dr. Kwang Poo Chang
Guest Editor

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• leishmaniasis
• molecular epidemiology
• leishmania evolution
• host–parasite interactions
• pathogenicity
• biotechnology
• molecular science
• drug development
• diagnostics
• vector identification
• vector ecology
• public health
• operational health