HYPOTHESIS AND THEORY article
Front. Trop. Dis.
Sec. Neglected Tropical Diseases
This article is part of the Research TopicAlternative and Innovative Strategies to Accelerate the Elimination of Neglected Tropical Diseases: Opportunities and ChallengesView all articles
When Discovery Meets Neglect: Rethinking Disease Emergence in Cutaneous Leishmaniasis and Other Neglected Tropical Diseases
Provisionally accepted
- Institut de Recherche Pour le Développement (IRD), Marseille, France
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Recent reports of Leishmania donovani causing cutaneous leishmaniasis (CL) in Nepal have revived a key question in disease ecology: when does a disease truly emerge, and when is it simply newly recognized? Apparent emergence likely reflects underdiagnosis rather than parasite evolution. These cases have likely gone unnoticed because surveillance programs and clinical awareness have historically centered on VL in this L. donovani–endemic region. As leishmaniasis expands into previously non-endemic areas, physicians encountering unfamiliar lesions are prompted to investigate and identify the etiological agent, revealing not a new parasite variant, but the geographic and diagnostic expansion of a known one previously unrecognized by the healthcare system. Epidemiological “emergence,” in this context, stems less from parasite evolution than from the intersection of changing disease ecology, improved diagnostics, and shifting clinical attention. We hypothesize that cutaneous leishmaniasis due to L. donovani in Nepal represents a detection-driven phenomenon rather than a novel biological event.
Keywords: cutaneous leishmaniasis, emergence, Epidemiology, Leishmania donovani, Nepal, surveillance, Tissue tropism, Visceral leishmaniasis
Received: 12 Nov 2025; Accepted: 08 Dec 2025.
Copyright: © 2025 Sereno. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
* Correspondence: Denis Sereno
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