ABSTRACT
Leishmaniasis are worldwide vector-borne diseases due to protozoan flagellates of the genus Leishmania [L.], transmitted by Phlebotomine sandflies to human and mammalians. These affections are endemic in tropical and temperate-climate regions where over 350 millions of people are at risk. The clinical spectrum of leishmaniasis is wide, including asymptomatic infection and 3 main clinical forms: visceral leishmaniasis [VL], potentially fatal when untreated; cutaneous leishmaniasis, usually benign; and mucosal leishmaniasis, a conversely severe mutilating disease[2,3]. Visceral leishmaniasis is caused by L, donovani complex, including L. donovani in the Indian subcontinent and Eastern Africa, and L. infantum in the Mediterranean area, Middle East and Latin America[2,4]. These species are able to spread to internal organs, primarily the liver then the spleen, the bone marrow and the lymph nodes[2,3]. Over 90% of VL cases ensue in the Indian subcontinent and East Africa, and are due to L. donovani with the predominant anthroponotic way of transmission[2]. In the Mediterranean basin, as well in the Middle East, China and South America, VL is caused by the zoonotic species L. infantum[5,6] In North African [NA] countries, VL has been described since the beginning of the 20[th] century. The first case was described in 1904 by Laveran and Cathoire in a child from La Goulette, Tunisia[4]. Since the eighties, there is a clear tendency towards increase with a large-scale spread of emerging cases as observed in several areas of the world[7,9]. Currently, VL is emergent and represents a significant health problem in Algeria, Morocco and Tunisia because of the case-fatality rate, estimated between 5 and 8% [even in treated patients], and regarding the economic burden concerning the cost of treatment and hospitalization[10]. In the present review, the authors updated the epidemiological situation of VL in Morroco, Algeria, Tunisia, Lybia and Egypt. Clinical presentation of the disease and the current strategy for diagnosis and treatment were summarized and discussed