Prevalence and associated risk factors of human leishmaniasis in sub-Saharan Africa: an umbrella review.

BACKGROUND: Leishmaniasis is a neglected tropical disease caused by the flagellate protozoa leishmania. Leishmaniasis has spread or reemerged in various countries, causing global health and economic problems. Thus, comprehensive information on the pooled prevalence of human leishmaniasis played an important role in reducing its impact. OBJECTIVE: This review aimed to assess the pooled prevalence of human leishmaniasis and associated risk factors. METHODS: A comprehensive search was conducted for potential articles using the Web of Science, PubMed, Science Direct databases, Semantic Scholar, and Google Scholar search. Seven relevant articles about leishmaniasis prevalence and related determinants were found for the final umbrella review. Utilizing Microsoft Excel, data was extracted using separate sheets for leishmaniasis prevalence and related factors. Version 17.0 of the STATA software was used for analyzing the extracted data. The contribution of each research to the final results was ascertained by a sensitivity analysis. Egger's test and a funnel plot were used to determine publication bias. Inverse of variance statistics were used to check for heterogeneity across studies; major heterogeneity was taken into consideration, and subgroup analysis and meta-regression analysis were used if the I2 value was ≥ 50%. RESULTS: The systematic search yielded 8,534 articles, of which 7 studies were included in this umbrella review. The pooled prevalence of human leishmaniasis in this review was 19.54% (95% CI: 13.78-25.30), indicating significant variation in the prevalence of human leishmaniasis, with I2 statistics indicating values more than or equal to 99.96% at P = 0.00. There were significant differences in the pooled prevalence of human leishmaniasis, according to the subgroup analysis based on sample size (P = 0.00). Presence of termite hills (AOR = 4.35, 95% CI:1.06,7.64), presence of domestic animals (AOR = 2.33, 95% CI:2.02,2.64)), past history of leishmaniasis in the family (AOR = 3.51, 95% CI:3.27,3.76), and sleeping under an acacia tree (AOR = 2.03, 95% CI:1.16,2.90) were associated with the pooled prevalence of human leishmaniasis. Moreover, gender, age, family size, farmers, housewives, military personnel, sleeping outside, and the presence of a water source or pathway close to home were some of the risk factors involved in human leishmaniasis. CONCLUSIONS: This umbrella review showed that human leishmaniasis is prevalent in sub-Saharan Africa. The reported increase in the incidence of human leishmaniasis emphasizes the necessity of better monitoring systems and infection control methods to lower the burden and spread of the disease in sub-Saharan Africa. Addressing the causes of human leishmaniasis and lowering its negative effects on public health also requires coordinated actions. CLINICAL TRIAL NUMBER: Not applicable.