Neglected tropical diseases in the Arabian Peninsula: a systematic review of leishmaniasis and rickettsioses.
5 affiliations
- 1Center for Health Research, Northern Border University, Arar, 91431, Saudi Arabia.
- 2Department of Microbiology, Faculty of Medicine, Northern Border University, Arar, 91431, Saudi Arabia.
- 3Department of Microbiology, Faculty of Medicine, Zagazig University, Zagazig, Al-Sharqia Governorate, Zagazig, 44519, Egypt.
- 4Department of Bacteriology Lab, Northern Border Regional Laboratory, Northern Borders Cluster, Arar, 73211, Kingdom of Saudi Arabia.
- 5Department of Pharmacology and Therapeutics, Faculty of Basic Clinical Sciences, College of Health Sciences, Usmanu Danfodiyo University, Sokoto, Sokoto State, 840232, Nigeria. [email protected].
Abstract
Background
Vector-borne neglected tropical diseases are still an underrecognized public health problem in the Arabian Peninsula. Of these, leishmaniasis is endemic in multiple regions, while the epidemiology of rickettsial infections remains incompletely understood. This systematic review synthesizes existing evidence on the epidemiology, distribution, and surveillance of these two diseases in the region.Methods
Following PRISMA 2020 guidelines, a systematic review was performed. The protocol was registered with PROSPERO. We searched PubMed/MEDLINE, Scopus, Web of Science, EMBASE, and relevant grey literature for studies published from January 2000 to December 2025 that describe human cases of leishmaniasis or rickettsioses in countries of the Arabian Peninsula. Two reviewers independently screened studies, extracted data, and assessed methodological quality (risk of bias) using validated tools.Results
A total of 44 studies were included. The majority of studies investigated leishmaniasis (n = 31), with fewer on rickettsioses (n = 9) or mixed febrile illness (n = 4). Most publications originated from Saudi Arabia. In the Arabian Peninsula, particularly in Saudi Arabia, cutaneous leishmaniasis remains endemic, with localized transmission hotspots and the coexistence of multiple Leishmania species, including L. major and L. tropica. Evidence for rickettsial infections remains sparse, primarily derived from case reports and serologic surveys.Conclusion
Leishmaniasis remains a public health challenge in the Arabian Peninsula, particularly in Saudi Arabia. In contrast, rickettsioses are likely underdiagnosed due to limited surveillance and diagnostic capacity. Improved, integrated surveillance systems, paired with febrile illness investigations that include diagnostic testing for rickettsial pathogens, will lead to fewer missed cases, contributing to disease detection and control.
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BibTeX
@article{hudu2026neglected,
title = {{Neglected tropical diseases in the Arabian Peninsula: a systematic review of leishmaniasis and rickettsioses.}},
author = {Shuaibu Abdullahi Hudu and Mohamed Soliman and Naglaa M Shalaby and Emad A Morad and Ghusun M Alhazimi and Abdulgafar Olayiwola Jimoh},
journal = {BMC infectious diseases},
year = {2026},
month = jul,
doi = {10.1186/s12879-026-14012-z},
url = {https://europepmc.org/article/MED/42902238},
note = {CC BY-NC-ND},
}
RIS
TY - JOUR
TI - Neglected tropical diseases in the Arabian Peninsula: a systematic review of leishmaniasis and rickettsioses.
AU - Shuaibu Abdullahi Hudu
AU - Mohamed Soliman
AU - Naglaa M Shalaby
AU - Emad A Morad
AU - Ghusun M Alhazimi
AU - Abdulgafar Olayiwola Jimoh
PY - 2026
DA - 2026/07/01
JO - BMC infectious diseases
DO - 10.1186/s12879-026-14012-z
UR - https://europepmc.org/article/MED/42902238
AB - Background Vector-borne neglected tropical diseases are still an underrecognized public health problem in the Arabian Peninsula. Of these, leishmaniasis is endemic in multiple regions, while the epidemiology of rickettsial infections remains incompletely understood. This systematic review synthesizes existing evidence on the epidemiology, distribution, and surveillance of these two diseases in the region.Methods Following PRISMA 2020 guidelines, a systematic review was performed. The protocol was registered with PROSPERO. We searched PubMed/MEDLINE, Scopus, Web of Science, EMBASE, and relevant grey literature for studies published from January 2000 to December 2025 that describe human cases of leishmaniasis or rickettsioses in countries of the Arabian Peninsula. Two reviewers independently screened studies, extracted data, and assessed methodological quality (risk of bias) using validated tools.Results A total of 44 studies were included. The majority of studies investigated leishmaniasis (n = 31), with fewer on rickettsioses (n = 9) or mixed febrile illness (n = 4). Most publications originated from Saudi Arabia. In the Arabian Peninsula, particularly in Saudi Arabia, cutaneous leishmaniasis remains endemic, with localized transmission hotspots and the coexistence of multiple Leishmania species, including L. major and L. tropica. Evidence for rickettsial infections remains sparse, primarily derived from case reports and serologic surveys.Conclusion Leishmaniasis remains a public health challenge in the Arabian Peninsula, particularly in Saudi Arabia. In contrast, rickettsioses are likely underdiagnosed due to limited surveillance and diagnostic capacity. Improved, integrated surveillance systems, paired with febrile illness investigations that include diagnostic testing for rickettsial pathogens, will lead to fewer missed cases, contributing to disease detection and control.
SN - 1471-2334
ER -