**1. Introduction**

In the Mediterranean basin region, both cutaneous leishmaniasis (CL) and visceral leishmaniasis (VL) are well established diseases with an estimated annual incidence ranges from 239,500

© 2017 The Author(s). Licensee InTech. This chapter is distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/3.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. © 2017 The Author(s). Licensee InTech. This chapter is distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/3.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

to 393,600 and from 1200 to 2000 cases, respectively. In Tunisia (North Africa, South Mediterranean basin), leishmaniases are largely spread causing a serious public health problem. Clinically, both CL and VL are encountered in this region. Nevertheless, the cutaneous form is most prevalent and largely distributed. Visceral leishmaniasis is less prevalent in this region with a zoonotic transmission of the causative agent.

In Tunisia, leishmaniases are historical. Indeed, the first documented cutaneous case was reported in 1884, while the first VL case was in 1904. Nevertheless, these infectious diseases were stayed neglected for a long period and the epidemiological investigations were scarce. Indeed, an analysis of the published research on leishmaniases in Tunisia over about a century (1884–1980) showed around 20 published items. From the beginning of 1980s of the last century, the number of publications has increased from 5 publications (1981–1985), to 14 publications (1991–1995), 41 publications (2001–2005), and 85 publications (2011–2015).

The aim of this chapter is to review the history of leishmaniases in Tunisia and to present the new insights into the epidemiological features of this disease. This includes clinical forms, transmission cycles, and geographical distribution.
