Strengthening cutaneous leishmaniasis control in Guatemala: policy recommendations

The country incidence rate of cutaneous leishmaniasis (CL) in Guatemala has increased from 3.14 per 100,000 inhabitants in 2011 to 6.24 per 100,000 inhabitants in 2019, (Fig.1) (1), probably due to a combination of improved active surveillance (2), climate changes (3,4), and occupational activities involving continued forest contact (5) among others. A national control program has been in place since 2003, but continued efforts are generating uneven results for the different endemic communities. Nationwide actions for CL control include active and passive surveillance, diagnosis and treatment offered free of cost by the Ministry of Health (MoH) and awareness-raising activities. We explored barriers and facilitators of CL control in Guatemala as experienced and perceived by service users and providers in order to inform evidence-based strategies to strengthen CL control in the country.