This paper reviews the current knowledge of leishmaniasis epidemiology in 
Venezuela, Colombia, Ecuador, Peru, and Bolivia. In all 5 countries 
leishmaniasis is endemic in both the Andean highlands and the Amazon basin. The 
sandfly vectors belong to subgenera Helcocyrtomyia, Nyssomiya, Lutzomyia, and 
Psychodopygus, and the Verrucarum group. Most human infections are caused by 
Leishmania in the Viannia subgenus. Human Leishmania infections cause cutaneous 
lesions, with a minority of L. (Viannia) infections leading to mucocutaneous 
leishmaniasis. Visceral leishmaniasis and diffuse cutaneous leishmaniasis are 
both rare. In each country a significant proportion of Leishmania transmission 
is in or around houses, often close to coffee or cacao plantations. Reservoir 
hosts for domestic transmission cycles are uncertain. The paper first addresses 
the burden of disease caused by leishmaniasis, focusing on both incidence rates 
and on the variability in symptoms. Such information should provide a rational 
basis for prioritizing control resources, and for selecting therapy regimes. 
Secondly, we describe the variation in transmission ecology, outlining those 
variables which might affect the prevention strategies. Finally, we look at the 
current control strategies and review the recent studies on control.