{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,22]],"date-time":"2026-07-22T18:42:32Z","timestamp":1784745752121,"version":"3.55.0"},"reference-count":55,"publisher":"MDPI AG","issue":"11","license":[{"start":{"date-parts":[[2022,10,29]],"date-time":"2022-10-29T00:00:00Z","timestamp":1667001600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"name":"Italian Ministry of Health","award":["IZS PLV 04\/20 RC"],"award-info":[{"award-number":["IZS PLV 04\/20 RC"]}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["TropicalMed"],"abstract":"<jats:p>Historically, visceral leishmaniasis (VL) in Italy was constrained to Mediterranean areas. However, in the last 20 years, sand fly vectors and human cases of VL have been detected in northern Italy, traditionally classified as a cold area unsuitable for sand fly survival. We aim to study the spatio-temporal pattern and climatic determinants of VL incidence in Italy. National Hospital Discharge Register records were used to identify incident cases of VL between 2009 and 2016. Incident rates were computed for each year (N = 8) and for each province (N = 110). Data on mean temperature and cumulative precipitation were obtained from the ERA5-Land re-analysis. Age- and sex-standardized incidence rates were modeled with Bayesian spatial and spatio-temporal conditional autoregressive Poisson models in relation to the meteo-climatic parameters. Statistical inference was based on Monte Carlo\u2013Markov chains. We identified 1123 VL cases (incidence rate: 2.4 cases\/1,000,000 person-years). The highest incidence rates were observed in southern Italy, even though some areas of northern Italy experienced high incidence rates. Overall, in the spatial analysis, VL incidence rates were positively associated with average air temperatures (\u03b2\u00a0 for 1 \u00b0C increase in average mean average temperature: 0.14; 95% credible intervals (CrI): 0.01, 0.27) and inversely associated with average precipitation (\u03b2 for 20 mm increase in average summer cumulative precipitation: \u22120.28, 95% CrI: \u22120.42, \u22120.13). In the spatio-temporal analysis, no association between VL cases and season-year specific temperature and precipitation anomalies was detected. Our findings indicate that VL is endemic in the whole Italian peninsula and that climatic factors, such as air temperature and precipitation, might play a relevant role in shaping the geographical distribution of VL cases. These results support that climate change might affect leishmaniasis distribution in the future.<\/jats:p>","DOI":"10.3390\/tropicalmed7110337","type":"journal-article","created":{"date-parts":[[2022,10,30]],"date-time":"2022-10-30T10:47:57Z","timestamp":1667126877000},"page":"337","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":21,"title":["Spatio-Temporal Pattern and Meteo-Climatic Determinants of Visceral Leishmaniasis in Italy"],"prefix":"10.3390","volume":"7","author":[{"given":"Giovenale","family":"Moirano","sequence":"first","affiliation":[{"name":"Cancer Epidemiology Unit and CPO-Piemonte, Department of Medical Sciences, University of Torino, 10126 Torino, Italy"},{"name":"Post Graduate School of Medical Statistics, Department of Public Health and Paediatrics, University of Torino, 10126 Torino, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Marta","family":"Ellena","sequence":"additional","affiliation":[{"name":"Department Environmental Sciences, Informatics, and Statistics, Universit\u00e0 Ca\u2019Foscari Venezia, 30172 Mestre, Italy"},{"name":"Regional Models and Geo-Hydrological Impact Division, Fondazione Centro Euro-Mediterraneo Sui Cambiamenti Climatici (CMCC), 81100 Caserta, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7236-010X","authenticated-orcid":false,"given":"Paola","family":"Mercogliano","sequence":"additional","affiliation":[{"name":"Regional Models and Geo-Hydrological Impact Division, Fondazione Centro Euro-Mediterraneo Sui Cambiamenti Climatici (CMCC), 81100 Caserta, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0316-9402","authenticated-orcid":false,"given":"Lorenzo","family":"Richiardi","sequence":"additional","affiliation":[{"name":"Cancer Epidemiology Unit and CPO-Piemonte, Department of Medical Sciences, University of Torino, 10126 Torino, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2142-1288","authenticated-orcid":false,"given":"Milena","family":"Maule","sequence":"additional","affiliation":[{"name":"Cancer Epidemiology Unit and CPO-Piemonte, Department of Medical Sciences, University of Torino, 10126 Torino, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2022,10,29]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","unstructured":"Alvar, J., V\u00e9lez, I.D., Bern, C., Herrero, M., Desjeux, P., Cano, J., Jannin, J., den Boer, M., and The Who Leishmaniasis Control the Team (2012). 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