1Department of Medicine, College of Medicine, University of Duhok, Duhok, Kurdistan Region, Iraq.
2Department of Biomedical Sciences, College of Medicine, University of Zakho, Zakho independent administration, Kurdistan Region, Iraq
3Department of Medical Education Development, College of Medicine, University of Zakho, Zakho independent administration, Kurdistan Region, Iraq
چکیده
Leishmaniasis remains a significant yet neglected public health challenge in Iraq, where both cutaneous (CL) and visceral leishmaniasis (VL) are endemic. This review explores the persistence and resurgence of leishmaniasis in Iraq, focusing on the complex interplay between endemicity, decades of armed conflict, population displacement, and the deterioration of healthcare infrastructure. The disease disproportionately affects vulnerable populations, including children, rural residents, and internally displaced persons, particularly in areas with poor sanitation and inadequate access to medical care. Epidemiological data reveal increasing case numbers in previously unaffected regions such as Kurdistan, suggesting a shifting geographic pattern likely influenced by climate change, mass displacement, and weakening vector control measures. Diagnostic and treatment efforts are hampered by limited resources, especially in rural and conflict-affected regions. Though intralesional sodium stibogluconate remains an effective treatment for CL, access is often restricted to urban centers. Delayed diagnosis and underreporting further hinder control efforts. Despite these challenges, localized interventions, such as the successful VL control program in Thi Qar province, highlight the potential for targeted, integrated approaches. This review proposes strategic, evidence-based recommendations to reduce the burden of leishmaniasis in Iraq: strengthening surveillance systems; expanding access to accurate diagnostics; decentralizing treatment services; implementing context-sensitive vector control; and delivering culturally appropriate public health education. Special emphasis is placed on addressing the health needs of displaced populations, who remain at heightened risk due to their living conditions and limited healthcare access. Ultimately, controlling leishmaniasis in Iraq requires a multifaceted response that accounts for the ongoing conflict, humanitarian crises, and fragile health systems. Sustained collaboration among governmental entities, non-governmental organizations, and international partners is essential to mitigate the disease’s impact and prevent further spread, both within Iraq and across its borders.