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Epidemiology of Imported Leishmaniasis in Italy: Implications for a European Endemic Country.

PLoS One · 2015 · PMC4482607 · PMID 26114938

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an increasing trendno p-value reported
Nevertheless we have observed an increasing trend in Italy, that may be associated with an actual increase of Leishmania importation but also with better awareness among clinicians and improvement of diagnostic tools.

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Quoted from the open-access full text in Europe PMC under the licence the publisher applied. The sentence is reproduced exactly as published; the emphasis is ours.