It is found in the eastern half of Africa, from the Sahara in the North to the Equator. It generally affects older children and young adults. It is found primarily in the Mediterranean area, China, and Latin America. Dogs, jackals, foxes, and rats are the potential reservoirs. It is transmitted by sandflies.
Humans are the only known reservoir.
Leishmaniasis occurs in Central America, South America, Africa, India, the Middle East, Mediterranean countries, and Asia. In mucocutaneous leishmaniasis, death usually occurs from secondary infection. Visceral leishmaniasis is progressive. Males are infected more than females, most likely as a result of increased exposure to sandflies. Otherwise, occurrence is proportional to sandfly exposure.