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• W2589255795 abstract "We appreciate Richard Reithinger's thorough analysis and comments1Reithinger R Global burden of cutaneous leishmaniasis.Lancet Infect Dis. 2016; 16: 1004-1005Summary Full Text Full Text PDF PubMed Scopus (7) Google Scholar regarding our Article.2Karimkhani C Wanga V Coffeng LE Naghavi P Dellavalle RP Naghavi M Global burden of cutaneous leishmaniasis: a cross-sectional analysis from the Global Burden of Disease Study 2013.Lancet Infect Dis. 2016; 16: 584-591Summary Full Text Full Text PDF PubMed Scopus (89) Google Scholar Reithinger states that “some data were inexplicably not included”, specifically citing papers by Pigott and colleagues3Pigott DM Bhatt S Golding N et al.Global distribution maps of the leishmaniases.Elife. 2014; (published online June 27.)https://doi.org/10.7554/eLife.02851Crossref Scopus (16) Google Scholar and Alvar and colleagues.4Alvar J Velez ID Bern C et al.Leishmaniasis worldwide and global estimates of its incidence.PLoS One. 2012; 7: e35671Crossref PubMed Scopus (3560) Google Scholar However, on review of the references for our Article,2Karimkhani C Wanga V Coffeng LE Naghavi P Dellavalle RP Naghavi M Global burden of cutaneous leishmaniasis: a cross-sectional analysis from the Global Burden of Disease Study 2013.Lancet Infect Dis. 2016; 16: 584-591Summary Full Text Full Text PDF PubMed Scopus (89) Google Scholar it can be seen that we cite both of these landmark studies (see references 4 and 19). Additionally, our scientific literature search included other sources that contributed even larger amounts of data such as WHO Leishmaniasis Country Profiles and national hospital inpatient registries (for Brazil, Mexico, Ecuador, the UK, Austria, and the USA). Reithinger mentions that cutaneous leishmaniasis prevalence estimates might “represent an accumulation of untreated patients over several months, if not years, not truly representing force or infection or disease incidence.” The prevalence input data that we use in Global Burden of Disease 2013 comes from cross-sectional studies and hospital and notification data for acute cutaneous leishmaniasis cases. Our methods assume a mean duration of cutaneous leishmaniasis without treatment of 9 months and zero mortality. As such, our methods account for accumulation of untreated patients when calculating cutaneous leishmaniasis annual prevalence. Reithinger mentions that the Article's statement regarding urbanisation as a major contributor to cutaneous leishmaniasis disparity is “misleading”. We list urbanisation as one risk factor for the disparity in cutaneous leishmaniasis burden. The expansion of city margins with new immigrants from rural areas, particularly into desert and forest regions, fosters an environment for the spread of cutaneous leishmaniasis.5WHOUrbanization: an increasing risk factor for leishmaniasis.Wkly Epidemiol Rec. 2002; 77: 365-370PubMed Google Scholar Lastly, Reithinger states that Venezuela, Burkina Faso, and Haiti are “not deemed to be high-burden countries”. Previous incidence studies such as Alvar and colleagues'3Pigott DM Bhatt S Golding N et al.Global distribution maps of the leishmaniases.Elife. 2014; (published online June 27.)https://doi.org/10.7554/eLife.02851Crossref Scopus (16) Google Scholar included WHO data up until 2009. Our publication incorporated these data and data from years 2009–2013. It is possible that our Article highlights changes in the global burden of cutaneous leishmaniasis. We disagree that 1551 cutaneous leishmaniasis cases in Venezuela and 1389 in Burkina Faso comprise “comparatively few cutaneous leishmaniasis cases”. We declare no competing interests. Global burden of cutaneous leishmaniasis: a cross-sectional analysis from the Global Burden of Disease Study 2013The burden from cutaneous leishmaniasis mainly falls on countries in Africa and the Middle East. Global and national data on the burden of cutaneous leishmaniasis disease are pivotal to promote field studies and initiate behavioural change. Full-Text PDF" @default.
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• W2589255795 title "Global burden of cutaneous leishmaniasis" @default.
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