To date, there are about a dozen studies that have reported the presence of Leishmania species in different geographic regions in Colombia, most of them with a small number of isolates: 340 , 511 , 76 , 137 , 16 , 35 , 81 , 327 , 93 , 273  and 96 . Here we report the geographical distribution of 1,833 isolates of Leishmania from patients we have diagnosed from 29 departments in all geographic regions of the country. In this work no isolates from Vichada department were reported.
Our study confirms that leishmaniasis is present in almost the entire country with only two departments with apparently no reports of autochthonous cases of leishmaniasis: San Andres and Providencia and Quindío departments, despite some foci study conducted by us in those departments where no cases were not detected nor infected phlebotomine or reservoirs. The highest percentage of patients were mainly from the department of Antioquia followed by Meta, Chocó, Caquetá, and Caldas. This abundance of cases are because our laboratory is located in Medellín, the capital city of Antioquia department and close foci patients come to our consulting room and also because in these regions we have carried out the largest number of foci studies and clinical trials of the "leishvacin" vaccine between 1998 - 2008  or some therapeutic alternatives such as miltefosine , thermotherapy  and Anfoleish® , or the implementation of the Leishmaniasis Control Program in military forces conducted by us from 2005-2008.
Results showed here agree with results previously reported by other authors, in which the department of Antioquia contributes the largest number of tegumentary leishmaniasis cases in Colombia but also with the highest number of Leishmania species (all identified species except L. guyanensis and L. infantum). Other departments with high numbers of cases in this work were Chocó and Meta followed by Córdoba, Caquetá and Caldas. Several factors explain why Antioquia is the department that reports the highest number of CL cases and they are related to human activities such as deforestation, mining, illicit crops and also as a consequence of the war against illicit crops and groups on the margins of the law.
We also confirm that L. panamensis and L. braziliensis coexist in the same regions in Colombia but in different proportions according to regions. Thus, L. panamensis predominates in the Pacific and Andean regions, whereas L. braziliensis predominates in the Orinoquian and Amazonian regions. The presence of L. panamensis in the Northwestern Colombia and, L. braziliensis in Southwestern Colombia, is understandable because it can be assumed that these species have gradually spread from Panama and Brazil to Colombia, respectively. It can be also assumed that the expansion of both species has found the barrier of the Andean and therefore the expansion has not been perhaps faster to the rest of Colombian territory. However, there are zones with mixture presence of L. panamensis and L. braziliensis in the central area of Colombia. How the presence of both species of parasite was achieved in the same territory is something that needs to be determined; it could be likely due to migration in both routes of infected domestic reservoirs, through gallery forests that cross valleys and mountains. On the other hand, the higher prevalence of a species in a given area may be due to the presence and greater abundance of the main vector species in each geographic area or to the presence of new vectors of these Leishmania species in these areas. Nonetheless, these hypotheses remain to be validated.
The third most reported species is L. infantum which is present in 14 departments where cases of VL has been documented, with predominance in the Caribbean and Andean region but also in the departments of Meta (Orinoquian region) and Putumayo (Amazonian region) (Table 2). Recently, a first case of urban canine VL caused by L. infantum was described in Cali, Colombia (Valle department, Pacific region) .
The presence of L. mexicana and L. amazonensis are reported 14 departments of Colombia (Table 2). Both species co-circulating in almost the same departments, with the exception of Nariño, Caldas and Risaralda where only L. mexicana circulates and Chocó, Huila and Boyacá where only L. amazonensis has been reported [31, 32, 35]. There are no reports of L. mexicana nor L. amazonensis in the Caribbean region. This work reports L. amazonensis in Antioquia, with a strain identified in a patient from Anorí in 1991, maybe representing the first report for Antioquia. L. mexicana was reported in Antioquia in 2006 in a patient . Notably, L. mexicana has been reported as causative agents of CL, but also as responsible of one case of diffuse CL  and other case of transfusion-transmitted VL in a immunocompromised patient .
L. guyanensis is reported in 12 departments in Colombia, especially those located in the Andean and Amazonian region but also in the departments of Cordoba and Sucre in the Caribbean region (Table 2). It is notorious that in the Amazon, only L. guyanensis has been reported  and there are no new reports since then. A recent publication that compiled the scientific literature available for Leishmania species identified in Colombia between 1985 and 2017 declares the presence of L. guyanensis in Valle, Guajira and Antioquia Departments ; nevertheless, it is not clear which authors are responsible for those reports. Few cases of L. guyanensis have been reported in Colombia; this could be due to the difficulties in taxonomic differentiation between L. panamensis and L. guyanensis .
Although L. colombiensis was identified early in the 80`s in samples from patients from the municipalities of Apartadó and San Carlos in the department of Antioquia , and in the sandfly P. shannoni from Santander in three individuals belonging to the sample bank of the Colombian National Institute of Health , in the present study this species of Leishmania was not found in any of the 138 isolates from San Carlos or the 181 isolates from Apartadó. Because no new reports of this species in Colombia have occur since long time ago, it is suggested that the taxonomic classification of this species is controversial.
It is not clear how other new species such as L. lainsoni or L. equatorensis arrived in some areas of the interior of the country. This does not seem to be due to geographic expansion of these species, as occurs with L. panamensis and L. braziliensis. Most probably the arrival could be occurred through a human or a reservoir. There is very few information about L. lainsoni. Since the description of this species has been recorded in three states of brazilian amazon basin , Perú , Bolivia [48, 49] and Ecuador .
It was expected that this species should be found in the Colombian Amazonian, as Araracuara, Caquetá where Lu. ubiquitalis, the insect vector of L. lainsoni  has been described . Nevertheless, the presence of this species in Antioquia that is intriguing because no incrimination or occurrence of L.ubiquitalis has been recorded.
Leishmania and phlebotominae classification remain controversial and currently there is an increasing number of species described and phylogenetic analyses show difficulties with the current classification . For example, the taxonomic classification of L. archibaldi as a species following its initial identification as a causative species of VL in Sudan remains controversial. Similarly, even though many authors have accepted that L. chagasi is synonymous with L. infantum based on its isoenzyme classification, other authors consider the parasite a different species or perhaps a subspecies of L. infantum.
In conclusion, this work reports the presence of Leishmania species in 30 departments and confirm that San Andres and Providencia and Quindio apparently remained free of transmission. Our finding also concludes that at least ten Leishmania species circulate in Colombia thus validating the great biodiversity of Leishmania species in this country. In addition, this work complements previous reports by other researchers and increase the area of distribution of Leishmania species in Colombia.