Preface

Leishmaniasis is a particularly diverse disease with a wide range of physical manifestations. As a vector-borne disease, it exhibits a complex life cycle as well. The diversity of this dis‐ ease, especially as it relates to the multiple parasite species which serve as causative agents, has allowed the disease to adapt to a variety of habitats throughout the world. In Central and South America, the disease is often associated with jungle or other heavily vegetated environments, but in the Middle East it is adapted to the desert and its reservoir of rodent hosts. As a result, the disease is quite widespread, affecting humans in Europe, Asia, Africa and the Americas. There is zoonotic infection in Australia though, at present, no evidence of human disease.

Not surprisingly, the clinical manifestations of leishmaniasis are quite varied. They range from relatively minor, self-limiting cutaneous lesions to deadly visceral infections. Other types may cause a mucocutaneous form that, though often not fatal, can result in extreme disfiguration. These clinical manifestations are linked to the specific parasite species causing the infections, but in recent years, researchers have noted that species thought to be limited to cutaneous manifestations may also elicit visceral disease.

The diversity of this disease requires that researchers, physicians, and public health workers address this disease in a way that is appropriate to the region-specific epidemiology and medical needs of the local population. Diagnosis, treatment and prevention may vary de‐ pending on the particular parasite species involved, not to mention the biology of the local sand fly vector. Recent developments in the diagnosis and treatment of leishmaniasis, both human and veterinary, have been extensive. This book presents many of these develop‐ ments along with discussions of possible future utilization of new technologies in the diag‐ nosis and control of leishmaniasis.

A perusal of the chapters in this book will reveal an emphasis on diagnosis and clinical treatment of the disease. Much research remains to be done in these fields, but perhaps even more is left to do in the prevention of the disease. Despite a great deal of research on the subject, there is still a noticeable lack of an effective and available vaccine. Recent experien‐ ces by western military forces in Iraq also demonstrate that much remains unknown about effective vector control and personal protection as they apply to prevention of leishmaniasis. This situation will mandate future updates on research and application of technologies for diagnosis, prevention and treatment of this disease.

> **David M. Claborn** Master of Public Health Program, College of Health and Human Services, Missouri State University, Springfield, MO, USA

**Epidemiology and Ecology of Leishmaniasis**
