{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,8]],"date-time":"2026-10-08T18:58:32Z","timestamp":1791485912715,"version":"4.3.4"},"update-to":[{"DOI":"10.1371\/journal.pntd.0014787","type":"new_version","label":"New version","source":"publisher","updated":{"date-parts":[[2026,10,8]],"date-time":"2026-10-08T00:00:00Z","timestamp":1791417600000}}],"reference-count":31,"publisher":"Public Library of Science (PLoS)","issue":"10","license":[{"start":{"date-parts":[[2026,10,5]],"date-time":"2026-10-05T00:00:00Z","timestamp":1791158400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/100014013","name":"UK Research and Innovation","doi-asserted-by":"publisher","award":["10038150"],"award-info":[{"award-number":["10038150"]}],"id":[{"id":"10.13039\/100014013","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100014013","name":"UK Research and Innovation","doi-asserted-by":"publisher","award":["10039289"],"award-info":[{"award-number":["10039289"]}],"id":[{"id":"10.13039\/100014013","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100000780","name":"European Commission","doi-asserted-by":"publisher","award":["101057690"],"award-info":[{"award-number":["101057690"]}],"id":[{"id":"10.13039\/501100000780","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["www.plosntds.org"],"crossmark-restriction":false},"short-container-title":["PLoS Negl Trop Dis"],"abstract":"<jats:sec id=\"sec001\">\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Leishmaniasis is endemic in southern Europe with high risks of outbreaks and geographical spread. However, the risk factors for human leishmaniasis are understudied in this region.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"sec002\">\n                    <jats:title>Methodology<\/jats:title>\n                    <jats:p>To evaluate these risk factors, we tested associations between leishmaniasis incidence and an array of variables related to socioeconomics, immunocompetence, climate, land use, biodiversity, and ecology (i.e., the pathogen and its vectors and reservoirs).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"sec003\">\n                    <jats:title>Findings<\/jats:title>\n                    <jats:p>Socioeconomic factors, such as demography, occupation, and housing conditions, were strongly associated with leishmaniasis incidence in endemic regions. The specific factors and the magnitude of their impacts varied among the five countries studied. Human immunosuppressive condition was highly correlated with leishmaniasis risk in Spain and Italy. Climate likely delineated leishmaniasis-free regions from endemic regions in France. Our results suggest that climate change alone may not drive the spread of leishmaniasis within this century. Pathogen hazard and reservoir abundance affected leishmaniasis risk more than vector hazard in countries where data were available. Biodiversity was weakly, negatively related to leishmaniasis.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"sec004\">\n                    <jats:title>Significance<\/jats:title>\n                    <jats:p>\n                      Our results highlight the importance of socioeconomic risk factors and immunosuppression for human leishmaniasis, suggesting potential implications for disease control and prevention policies. Surveillance of\n                      <jats:italic>Leishmania<\/jats:italic>\n                      spp. in humans, vectors, and reservoirs; assessment of reservoir abundance; and data accessibility are crucial for disease prevention and preparedness. Because of possible biodiversity regulation, efforts to understand and control leishmaniasis could benefit from a One Health approach that involves epidemiologists, social scientists, and ecologists, among others.\n                    <\/jats:p>\n                  <\/jats:sec>","DOI":"10.1371\/journal.pntd.0014787","type":"journal-article","created":{"date-parts":[[2026,10,5]],"date-time":"2026-10-05T17:48:53Z","timestamp":1791222533000},"page":"e0014787","update-policy":"https:\/\/doi.org\/10.1371\/journal.pntd.corrections_policy","source":"Crossref","is-referenced-by-count":0,"title":["Socioeconomic risk factors and human immunosuppressive conditions are major drivers of human leishmaniasis in southern Europe"],"prefix":"10.1371","volume":"20","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-0461-3256","authenticated-orcid":true,"given":"Danyang","family":"Wang","sequence":"first","affiliation":[{"name":"Wageningen University & Research","place":["Wageningen, The Netherlands"],"department":["Wildlife Ecology and Conservation"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kevin D.","family":"Matson","sequence":"additional","affiliation":[{"name":"Wageningen University & Research","place":["Wageningen, The Netherlands"],"department":["Wildlife Ecology and Conservation"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Anouschka R.","family":"Hof","sequence":"additional","affiliation":[{"name":"Wageningen University & Research","place":["Wageningen, The Netherlands"],"department":["Wildlife Ecology and Conservation"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Eduardo","family":"Berriatua","sequence":"additional","affiliation":[{"name":"University of Murcia","place":["Murcia, Spain"],"department":["Department of Animal Health, Faculty of Veterinary Medicine"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Carla","family":"Maia","sequence":"additional","affiliation":[{"name":"Universidade NOVA de Lisboa","place":["Lisbon, Portugal"],"department":["Global Health and Tropical Medicine (GHTM) LA-REAL, Instituto de Higiene e Medicina Tropical (IHMT)"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Federica","family":"Bruno","sequence":"additional","affiliation":[{"name":"Istituto Zooprofilattico Sperimentale della Sicilia","place":["Palermo, Italy"],"department":["WOAH Leishmania Reference Laboratory"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Germano","family":"Castelli","sequence":"additional","affiliation":[{"name":"Istituto Zooprofilattico Sperimentale della Sicilia","place":["Palermo, Italy"],"department":["WOAH Leishmania Reference Laboratory"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Pedro","family":"P\u00e9rez Cutillas","sequence":"additional","affiliation":[{"name":"University of Murcia","place":["Murcia, Spain"],"department":["Department of Geography"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jose","family":"Risue\u00f1o Iranzo","sequence":"additional","affiliation":[{"name":"University of Murcia","place":["Murcia, Spain"],"department":["Department of Animal Health, Faculty of Veterinary Medicine"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Elena","family":"Verd\u00fa Serrano","sequence":"additional","affiliation":[{"name":"University of Murcia","place":["Murcia, Spain"],"department":["Department of Animal Health, Faculty of Veterinary Medicine"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Fabrizio","family":"Vitale","sequence":"additional","affiliation":[{"name":"Istituto Zooprofilattico Sperimentale della Sicilia","place":["Palermo, Italy"],"department":["WOAH Leishmania Reference Laboratory"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"\u00c2ngela","family":"Xufre","sequence":"additional","affiliation":[{"name":"DNAtech-Veterinary Clinical Analysis Laboratory","place":["Lisboa, Portugal"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Frank","family":"van Langevelde","sequence":"additional","affiliation":[{"name":"Wageningen University & Research","place":["Wageningen, The Netherlands"],"department":["Wildlife Ecology and Conservation"]}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"340","published-online":{"date-parts":[[2026,10,5]]},"reference":[{"issue":"1","key":"pntd.0014787.ref001","doi-asserted-by":"crossref","first-page":"329","DOI":"10.1186\/s12939-025-02691-0","article-title":"Global burden of leishmaniasis, 1990\u20132021: systematic analysis of the global burden of disease study","volume":"24","author":"S Li","year":"2025","journal-title":"International Journal for Equity in Health"},{"issue":"2","key":"pntd.0014787.ref002","doi-asserted-by":"crossref","first-page":"123","DOI":"10.1111\/j.1365-2915.2012.01034.x","article-title":"Phlebotomine sandflies and the spreading of leishmaniases and other diseases of public health concern","volume":"27","author":"M Maroli","year":"2013","journal-title":"Med Vet Entomol"},{"issue":"2","key":"pntd.0014787.ref003","doi-asserted-by":"crossref","first-page":"365","DOI":"10.1007\/s00436-019-06575-5","article-title":"Environmental and socioeconomic risk factors associated with visceral and cutaneous leishmaniasis: a systematic review","volume":"119","author":"NNH Valero","year":"2020","journal-title":"Parasitology Research"},{"key":"pntd.0014787.ref004","doi-asserted-by":"crossref","first-page":"100971","DOI":"10.1016\/j.lanepe.2024.100971","article-title":"A climatic suitability indicator to support Leishmania infantum surveillance in Europe: a modelling study","volume":"43","author":"BM Carvalho","year":"2024","journal-title":"Lancet Reg Health Eur"},{"issue":"5","key":"pntd.0014787.ref005","doi-asserted-by":"crossref","first-page":"735","DOI":"10.2105\/AJPH.87.5.735","article-title":"Policy research for disease prevention: challenges and practical recommendations","volume":"87","author":"RC Brownson","year":"1997","journal-title":"Am J Public Health"},{"issue":"1722","key":"pntd.0014787.ref006","doi-asserted-by":"crossref","first-page":"20160129","DOI":"10.1098\/rstb.2016.0129","article-title":"Does the impact of biodiversity differ between emerging and endemic pathogens? The need to separate the concepts of hazard and risk","volume":"372","author":"PR Hosseini","year":"2017","journal-title":"Philos Trans R Soc Lond B Biol Sci"},{"key":"pntd.0014787.ref007","doi-asserted-by":"crossref","first-page":"394","DOI":"10.1016\/j.ijppaw.2019.05.011","article-title":"Parasites and wildlife in a changing world: The vector-host- pathogen interaction as a learning case","volume":"9","author":"A Rizzoli","year":"2019","journal-title":"Int J Parasitol Parasites Wildl"},{"key":"pntd.0014787.ref008","author":"E Berriatua","year":"2022"},{"key":"pntd.0014787.ref009","author":"Eurostat"},{"key":"pntd.0014787.ref010","first-page":"539","article-title":"Infective diseases in the urban districts of Cagliari in 1980-1985","volume":"1","author":"P Contu","year":"1989","journal-title":"Ann Ig"},{"key":"pntd.0014787.ref011","volume-title":"Spatial statistics for data science: theory and practice with R","author":"P Moraga","year":"2024"},{"key":"pntd.0014787.ref012","author":"Posit team","year":"2024"},{"issue":"2","key":"pntd.0014787.ref013","doi-asserted-by":"crossref","first-page":"192","DOI":"10.1111\/j.2517-6161.1974.tb00999.x","article-title":"Spatial interaction and the statistical analysis of lattice systems","volume":"36","author":"J Besag","year":"1974","journal-title":"J R Stat Soc Series B Stat Methodol"},{"issue":"4","key":"pntd.0014787.ref014","doi-asserted-by":"crossref","first-page":"423","DOI":"10.1111\/j.1467-9868.2011.00777.x","article-title":"An Explicit Link between Gaussian Fields and Gaussian Markov Random Fields: The Stochastic Partial Differential Equation Approach","volume":"73","author":"F Lindgren","year":"2011","journal-title":"Journal of the Royal Statistical Society Series B: Statistical Methodology"},{"key":"pntd.0014787.ref015","doi-asserted-by":"crossref","first-page":"7","DOI":"10.1017\/CBO9780511491962.003","article-title":"State of the art \u2013 conceptualising environmental policy convergence","volume-title":"Environmental Policy Convergence in Europe","author":"K Holzinger","year":"2008"},{"key":"pntd.0014787.ref016","doi-asserted-by":"crossref","volume-title":"Model Selection and Multimodel Inference: A Practical Information-Theoretic Approach. Second Edition","author":"KP Burnham","DOI":"10.1007\/b97636"},{"issue":"07","key":"pntd.0014787.ref017","doi-asserted-by":"crossref","first-page":"754","DOI":"10.4236\/ojs.2015.57075","article-title":"Variance Inflation Factor: As a Condition for the Inclusion of Suppressor Variable(s) in Regression Analysis","volume":"05","author":"MO Akinwande","year":"2015","journal-title":"OJS"},{"issue":"3","key":"pntd.0014787.ref018","first-page":"357","article-title":"Leishmania\/HIV co-infections in the second decade","volume":"123","author":"I Cruz","year":"2006","journal-title":"Indian J Med Res"},{"issue":"12","key":"pntd.0014787.ref019","doi-asserted-by":"crossref","first-page":"1181","DOI":"10.1016\/j.trstmh.2007.08.003","article-title":"Aspects of the association between leishmaniasis and malignant disorders","volume":"101","author":"P Kopterides","year":"2007","journal-title":"Trans R Soc Trop Med Hyg"},{"issue":"4","key":"pntd.0014787.ref020","first-page":"1371","article-title":"Association between malaria incidence and all cancer mortality in fifty U.S. States and the District of Columbia","volume":"30","author":"S Lehrer","year":"2010","journal-title":"Anticancer Res"},{"issue":"6","key":"pntd.0014787.ref021","doi-asserted-by":"crossref","first-page":"655","DOI":"10.1017\/S0031182021000160","article-title":"Potential therapeutic targets shared between leishmaniasis and cancer","volume":"148","author":"S Rashidi","year":"2021","journal-title":"Parasitology"},{"key":"pntd.0014787.ref022","doi-asserted-by":"crossref","first-page":"1325144","DOI":"10.3389\/fcimb.2023.1325144","article-title":"A novel enemy of cancer: recent investigations into protozoan anti-tumor properties","volume":"13","author":"Z Zheng","year":"2024","journal-title":"Front Cell Infect Microbiol"},{"issue":"3","key":"pntd.0014787.ref023","doi-asserted-by":"crossref","first-page":"295","DOI":"10.1016\/j.chom.2014.02.003","article-title":"Host immune response to infection and cancer: unexpected commonalities","volume":"15","author":"RS Goldszmid","year":"2014","journal-title":"Cell Host Microbe"},{"issue":"2","key":"pntd.0014787.ref024","doi-asserted-by":"crossref","first-page":"157","DOI":"10.2307\/3235676","article-title":"Assembly and response rules: two goals for predictive community ecology","volume":"3","author":"PA Keddy","year":"1992","journal-title":"J Vegetation Science"},{"issue":"5","key":"pntd.0014787.ref025","doi-asserted-by":"crossref","first-page":"113","DOI":"10.3390\/tropicalmed9050113","article-title":"The Role of Environmental Factors in Lyme Disease Transmission in the European Union: A Systematic Review","volume":"9","author":"C Giesen","year":"2024","journal-title":"Trop Med Infect Dis"},{"issue":"205","key":"pntd.0014787.ref026","article-title":"Understanding and predicting the geographic distributions of Phlebotomine sand flies in and around Europe","volume":"178","author":"D Wang","year":"2025","journal-title":"Clim Change"},{"issue":"1","key":"pntd.0014787.ref027","doi-asserted-by":"crossref","first-page":"189","DOI":"10.1186\/s13071-017-2135-3","article-title":"Understanding Phlebotomus perniciosus abundance in south-east Spain: assessing the role of environmental and anthropic factors","volume":"10","author":"J Risue\u00f1o","year":"2017","journal-title":"Parasit Vectors"},{"key":"pntd.0014787.ref028","author":"European Centre for Disease Prevention and Control"},{"issue":"1","key":"pntd.0014787.ref029","doi-asserted-by":"crossref","first-page":"1","DOI":"10.1038\/s41467-019-13049-w","article-title":"Measuring the shape of the biodiversity-disease relationship across systems reveals new findings and key gaps","volume":"10","author":"FW Halliday","year":"2019","journal-title":"Nature Communications"},{"issue":"8","key":"pntd.0014787.ref030","doi-asserted-by":"crossref","first-page":"1817","DOI":"10.1111\/mec.16341","article-title":"Biodiversity and vector-borne diseases: Host dilution and vector amplification occur simultaneously for Amazonian leishmaniases","volume":"32","author":"A Kocher","year":"2023","journal-title":"Mol Ecol"},{"issue":"9343","key":"pntd.0014787.ref031","doi-asserted-by":"crossref","first-page":"1347","DOI":"10.1016\/S0140-6736(02)11403-6","article-title":"Selected major risk factors and global and regional burden of disease","volume":"360","author":"M Ezzati","year":"2002","journal-title":"Lancet"}],"updated-by":[{"DOI":"10.1371\/journal.pntd.0014787","type":"new_version","label":"New version","source":"publisher","updated":{"date-parts":[[2026,10,8]],"date-time":"2026-10-08T00:00:00Z","timestamp":1791417600000}}],"container-title":["PLOS Neglected Tropical Diseases"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/dx.plos.org\/10.1371\/journal.pntd.0014787","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,10,8]],"date-time":"2026-10-08T17:56:37Z","timestamp":1791482197000},"score":1,"resource":{"primary":{"URL":"https:\/\/dx.plos.org\/10.1371\/journal.pntd.0014787"}},"subtitle":[],"editor":[{"given":"Claudia Ida","family":"Brodskyn","sequence":"first","affiliation":[{"name":"Centro de Pesquisa Gon\u00e7alo Moniz-FIOCRUZ\/BA","place":["BRAZIL"]}],"role":[{"vocabulary":"crossref","role":"editor"}]}],"short-title":[],"issued":{"date-parts":[[2026,10,5]]},"references-count":31,"journal-issue":{"issue":"10","published-online":{"date-parts":[[2026,10,5]]}},"URL":"https:\/\/doi.org\/10.1371\/journal.pntd.0014787","relation":{},"ISSN":["1935-2735"],"issn-type":[{"value":"1935-2735","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,10,5]]}}}