Social Determinants of Health Influencing Leishmaniasis Worldwide: A Systematic Review

Abstract

Background: Leishmaniasis is a neglected tropical disease influenced by a complex interplay of biological, environ­mental, and social factors. This study aimed to review the evidence on social determinants of health SDH associated with leishmaniasis worldwide.

Methods: This systematic review was conducted in accordance with the Preferred Reporting Items for Systematic Re­views and Meta-Analyses (PRISMA) guidelines. A search was carried out in national databases (IranMedex and Magi­ran), the Google Scholar search engine, as well as international databases (PubMed, Scopus and Web of Science). The quality of the studies was assessed using the Newcastle–Ottawa Scale (NOS).

Results: Out of 5538 retrieved articles, 36 studies met the inclusion criteria. The findings indicated that poverty, inade­quate housing conditions, residence in rural or marginalized areas, low educational attainment, and limited access to healthcare services were among the influential SDH associated with a risk of leishmaniasis. Analysis within the WHO SDH framework revealed that social determinants, particularly those at the structural level (socioeconomic status) and intermediary level (housing conditions, health behaviors, and access to services), played a critical role in shaping the incidence and spatial distribution of leishmaniasis in the studied populations.

Conclusion: The available evidence underscores that leishmaniasis is not solely an infectious disease but also a condi­tion deeply rooted in social and economic inequalities. Strengthening health equity policies, improving living condi­tions, enhancing educational opportunities, and expanding access to healthcare services can substantially contribute to the global prevention and control of leishmaniasis.