International journal of infectious diseases : IJID : official publication of the International Society for Infectious Diseases · 2026
Recorded Human Leishmaniasis and Notification Gaps in Central Tuscany, Italy, 2014-2024: a Multisource Surveillance Study.
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Cosma Claudia, Maia Carla, Ray Nicolas, Ferroglio Ezio, Rader Benjamin, Bonanni Paolo, Lorini Chiara, Bonaccorsi Guglielmo, Fanfani Alice, Aiello Andrea, Bianchi Loria, Infantino Maria, Manfredi Mariangela, Veneziani Francesca, Contini Elisa, D'Agosto Andrea, Venturini Elisabetta, Ricci Silvia, Galli Luisa, Spinicci Michele, Petrini Valentina, Zammarchi Lorenzo, Bartoloni Alessandro, Barbiero Anna, Profili Francesco, Voller Fabio, Cacini Margherita, Rossi Barbara, Bianco Giovanna, Loretti Enrico, Del Riccio Marco
Аннотация
OBJECTIVES: To assess whether mandatory notification adequately captures recorded human leishmaniasis in Central Tuscany, Italy, by describing source-specific trends during 2014-2024 and evaluating notification completeness for 2022-2024.
METHODS: We conducted a retrospective multisource surveillance study using laboratory-positive records, mandatory notifications and first leishmaniasis-coded hospital discharge records. For 2022-2024, records from the three sources were deterministically linked at the individual level; observed notification completeness was defined as the proportion of linked individuals identified in at least one source who were present in the notification source, and three-source log-linear capture-recapture was performed.
RESULTS: During 2014-2024, 280 laboratory records, 89 notifications and 157 first leishmaniasis-coded hospital discharge records were identified. Counts increased from 2021, peaked in 2023 and remained elevated in 2024. In 2022-2024, linkage identified 185 unique individuals across the three sources; 65 (35.1%) were present in the notification source, 179 (96.8%) in laboratory records and 91 (49.2%) in hospital discharge records. Children aged 0-9 years were prominent, ranking first in notification and hospital sources. Capture-recapture estimated 214 cases (95% CI: 185-1,078), with imprecise estimates of unobserved cases.
CONCLUSIONS: Mandatory notification incompletely represented individuals identified across the available routine data sources in this endemic Italian setting. Laboratory-linked notification and routine reconciliation of routine data sources could strengthen surveillance; recent increases should be interpreted as increases in recorded cases rather than as evidence of increased local transmission.
METHODS: We conducted a retrospective multisource surveillance study using laboratory-positive records, mandatory notifications and first leishmaniasis-coded hospital discharge records. For 2022-2024, records from the three sources were deterministically linked at the individual level; observed notification completeness was defined as the proportion of linked individuals identified in at least one source who were present in the notification source, and three-source log-linear capture-recapture was performed.
RESULTS: During 2014-2024, 280 laboratory records, 89 notifications and 157 first leishmaniasis-coded hospital discharge records were identified. Counts increased from 2021, peaked in 2023 and remained elevated in 2024. In 2022-2024, linkage identified 185 unique individuals across the three sources; 65 (35.1%) were present in the notification source, 179 (96.8%) in laboratory records and 91 (49.2%) in hospital discharge records. Children aged 0-9 years were prominent, ranking first in notification and hospital sources. Capture-recapture estimated 214 cases (95% CI: 185-1,078), with imprecise estimates of unobserved cases.
CONCLUSIONS: Mandatory notification incompletely represented individuals identified across the available routine data sources in this endemic Italian setting. Laboratory-linked notification and routine reconciliation of routine data sources could strengthen surveillance; recent increases should be interpreted as increases in recorded cases rather than as evidence of increased local transmission.