The epidemiology of hospital admissions due to leishmaniasis in Spain (1999-2003)

OBJECTIVE. The aim of this study was to determine the epidemiology of patients hospitalized for leishmaniasis during the period 1999 to 2003. PATIENTS AND METHODS. This is a retrospective study using the Minimum Data Set for Hospital Discharge (CMBD, Conjunto Minimo Basico de Datos al alta hospitalaria), a national surveillance system database. RESULTS. There were 1180 hospital admissions with a primary diagnosis of leishmaniasis, 34% of which were readmissions, yielding a total of 786 new cases of leishmaniasis and an incidence rate of 0.4 per 100 000 population/year. The disease mainly affected children under five years of age and adults between 25 and 44. The most frequent form of presentation was visceral leishmaniasis, which was documented in 83.6% of hospitalizations. Among the autonomous communities of Spain, Madrid and Castilla-La Mancha showed the highest incidence rates, whereas Galicia and Extremadura presented the lowest rates. Patients coinfected with HIV accounted for 42% of hospital admissions for leishmaniasis. Nonetheless, between 2000 and 2003, a decrease was observed in the number of hospitalizations in this subgroup and an increase of patients without HIV coinfection. CONCLUSION. The increase in hospitalization rates for leishmaniasis in Spain indicates that this avoidable zoonosis remains a considerable public health problem in our country.