02814nas a2200265   4500000000100000008004100001260001200042653003400054653001400088653001800102653003200120653001700152100001600169700001400185700001400199700001100213700001400224700001200238245010200250856007700352300001200429490000700441520208600448022001402534       2021                            d  c01/202110aeconomic-psychosocial impacts10akala-azar10aleishmaniasis10aNeglected Tropical Diseases10arisk factors1 aGrifferty G1 aShirley H1 aMcGloin J1 aKahn J1 aOrriols A1 aWamai R00aVulnerabilities to and the Socioeconomic and Psychosocial Impacts of the Leishmaniases: A Review.  uhttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC8236266/pdf/rrtm-12-135.pdf  a135-1510 v123 a<p>The leishmaniases are a group of four vector-borne neglected tropical diseases (NTDs) with 1.6 billion people in some 100 countries at risk. They occur in certain eco-epidemiological foci that reflect manipulation by human activities, such as migration, urbanization and deforestation, of which poverty, conflict and climate change are key drivers. Given their synergistic impacts, risk factors and the vulnerabilities of poor populations and the launch of a new 2030 roadmap for NTDs in the context of the global sustainability agenda, it is warranted to update the state of knowledge of the leishmaniases and their effects. Using existing literature, we review socioeconomic and psychosocial impacts of leishmaniasis within a framework of risk factors and vulnerabilities to help inform policy interventions. Studies show that poverty is an overarching primary risk factor. Low-income status fosters inadequate housing, malnutrition and lack of sanitation, which create and exacerbate complexities in access to care and treatment outcomes as well as education and awareness. The co-occurrence of the leishmaniases with malnutrition and HIV infection further complicate diagnosis and treatment, leading to poor diagnostic outcomes and therapeutic response. Even with free treatment, households may suffer catastrophic health expenditure from direct and indirect medical costs, which compounds existing financial strain in low-income communities for households and healthcare systems. The dermatological presentations of the leishmaniases may result in long-term severe disfigurement, leading to stigmatization, reduced quality of life, discrimination and mental health issues. A substantial amount of recent literature points to the vulnerability pathways and burden of leishmaniasis on women, in particular, who disproportionately suffer from these impacts. These emerging foci demonstrate a need for continued international efforts to address key risk factors and population vulnerabilities if leishmaniasis control, and ultimately elimination, is to be achieved by 2030.</p>  a1179-7282