Mapping the Burden of Tegumentary Leishmaniasis in South America: A Systematic Review and Meta-Analysis.

Introduction: In recent years, the global burden of tegumentary leishmaniasis (TL) has significantly increased in the Americas.

Objective: To estimate the prevalence of TL in South America based on publications from the past 13 years.

Methods: Three databases were searched, and articles were selected based on inclusion criteria and methodological relevance. The random effects model was used to calculate pooled prevalence, and heterogeneity was assessed with the I² statistic.

Results: Out of the 225 articles initially identified, six studies remained eligible for review and meta-analysis. No publication bias was found. TL prevalence in South America ranged from 0.2% to 87.7%, showing significant heterogeneity (I² = 99.83%, p < 0.001). Colombia and Ecuador had the highest prevalence rates (> 76.6%). The pooled prevalence in the general population was 0.4% (95% CI: 0.1-1.0), and 81.8% (95% CI: 75.4-87.4) in symptomatic patients attending health units.

Conclusions: TL prevalence varied widely across countries, reflecting national epidemiological disparities. High positivity rates in suspicious samples and molecular detection in samples confirmed by microscopy underscore the importance of accurate diagnosis and clinical expertise. This meta-analysis emphasises the need for tailored health policies and accessible laboratory diagnoses to guide disease control strategies.