Impact of the COVID-19 pandemic on the incidence and socioeconomic inequalities of cutaneous leishmaniasis in Peru, 2017-2024

Arrasco J.; Lizarbe S.Y.M.; Chirinos-Saire J.; Linares E.V.; Garro G. · Anales de la Facultad de Medicina (2026) · DOI: 10.15381/anales.v87i2.33393

Resumen

Introduction. Cutaneous leishmaniasis (CL), a neglected disease, primarily affects rural and jungle populations in Peru. The COVID-19 pandemic impacted its reporting and control, exacerbating geographic and socioeconomic inequalities. Objective. To evaluate the impact of the COVID-19 pandemic on the incidence of CL in Peru during 2017-2024 and to analyze geographic and socioeconomic inequities to guide targeted interventions. Methods. An observational, ecological, and analytical study was conducted using open data published by institutions in the country. Mean annual incidence (AAI) and cumulative incidence (CI) were calculated, and Lorenz curves, Gini index, and concentration curves were used to assess inequalities, along with negative binomial regression to identify factors associated with district incidence. Results. Between 2017-2024, 40 984 cases of CL were reported in 765 districts across 19 departments, affecting 11 867 596 inhabitants (CI = 345.34/100 000). The disease was most prevalent in rural districts (69.3%), jungle districts (61.9%), and areas with higher poverty rates. The highest incidence occurred in Madre de Dios (AAI = 352.4/100 000) and Cusco (AAI= 158.1/100 000). During the pandemic (2020-2022), an apparent reduction in the incidence (AAI) was observed (48.76/100 000), with an increase in the post-pandemic period (2023-2024, AAI = 51.06/100 000). There was evidence of accentuation of geographical (Lorenz curve and Gini index) and socioeconomic inequalities (concentration curve related to the pandemic. IRR ((Incidence Rate Ratio): post-pandemic/pandemic=1.21(95% CI:1.03-1.41), jungle/coast=1.46 (95% CI:1.15-1.84), rural/urban=2.87(2.46-3.33), HDI=0.12(95% CI:0.05-0.28). Conclusion: CL is endemic in Peru, primarily concentrated in rural and jungle districts. The pandemic exacerbated existing demographic and socioeconomic inequalities, highlighting the need for multisectoral, differentiated, and sustainable strategies for the prevention, diagnosis, and timely treatment of the disease. © (2026), (Universidad Nacional Mayor de San Marcos, Facultad de Medicina). All right reserved.

Instituciones: Universidad Peruana de Ciencias Aplicadas