Leishmaniasis is a disease caused by protozoan parasites and transmitted to humans by the bite of infected female phlebotomine sandflies. The disease is found across much of SW Asia and the Middle East, partly because of poor sanitation and uncollected waste, which provides a suitable breeding environment for sandflies

The symptoms of leishmaniasis are skin sores which erupt weeks to months after the person affected is bitten by sandflies. Other consequences, which can become manifest anywhere from a few months to years after the infection, include fever, damage to the liver, and spleen including a markedly enlarged spleen, and anemia. There are four main types of leishmaniasis:

Cutaneous leishmaniasis – the most common form which causes a sore at the bite site which heals in a few months to a year and can cause unpleasant scarring. This type can progress to any of the other three forms listed below.
Diffuse cutaneous leishmaniasis – this form produces widespread skin lesions which resemble those of leprosy and is particularly difficult to treat
Mucocutaneous leishmaniasis – commences with skin ulcers which spread, causing tissue damage, particularly to the nose and throat
Visceral leishmaniasis – the most serious form if left untreated; can cause potentially fatal damage to internal organs

Medicines called antimony-containing compounds are the main drugs used to treat leishmaniasis. Plastic surgery may be needed to correct disfigurement by destructive facial lesions (cutaneous leishmaniasis). Removal of the spleen (splenectomy) may be required in drug-resistant cases of visceral leishmaniasis.