Human leishmaniasis in Morocco: a systematic review and meta-analysis of epidemiological, clinical and species-distribution data

Leishmaniasis is a WHO-listed neglected tropical disease and remains endemic and notifiable in Morocco, where cutaneous forms caused by Leishmania major and L. tropica predominate in the pre-Saharan and central regions and visceral forms caused by L. infantum predominate in the north. Despite decades of national surveillance and a large body of Moroccan primary research, no systematic review with meta-analysis of human leishmaniasis in Morocco has been published; existing syntheses are narrative reviews, or systematic reviews restricted to canine leishmaniasis or to phlebotomine vectors. This review will systematically identify, appraise and pool observational data on human leishmaniasis in Morocco in order to estimate (1) the pooled proportion of each clinical form (cutaneous, mucocutaneous, visceral) among reported cases, and (2) the relative distribution of L. major, L. tropica and L. infantum among typed isolates, overall and by region and time period. Secondary outcomes include sex ratio, age distribution, diagnostic methods used, geographical distribution by province, reported treatment regimens and temporal trends. Searches of PubMed, Scopus and ScienceDirect, together with the Moroccan national thesis repository Toubkal (IMIST) as a source of grey literature, were run on 5 September 2026 and yielded 891 records (528 after de-duplication). The inclusion of 48 unpublished Moroccan academic theses, which do not overlap with any indexed reference, is intended to reduce publication bias; their influence on the pooled estimates will be quantified in a pre-specified sensitivity analysis.