Epidemiology of Cutaneous Leishmaniasis in Tunisia

In Tunisia, Zoonotic cutaneous leishmaniasis (ZCL) represents the most significant leishmaniasis form. The epidemic of ZCL emerged in Central Tunisia in 1982 and expanded to the whole central and southern parts of the country. Tunisian ZCL is caused by Leishmania (L). major zymodeme MON‐25 and transmitted by Phlebotomus papatasi. Rodents constitute the reservoir for ZCL. They include Psammomys obesus, Meriones shawi and Meriones libycus. ZCL occurs as seasonal epidemics and the annual incidence ranges from 2 to 10 thousand cases. Transmission of L. major by the phlebotomine sandfly vector occurs during the summer months, and active lesions in humans tend to emerge during the autumn and winter months. The symptoms of the disease are rather polymorphic, ranging from benign self‐limited cutaneous sores to more protracted and extensive lesions that may cause severe disfigurement. Asymptomatic infection occurs frequently in endemic areas indicating a high level of immunity of the residents in these regions. The transmission of ZCL, its drastic increase and its spread are influenced by environmental changes affecting the reservoir and vector geographic distributions and by the lack of efficacy of the control tools available.