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da Silva AS, de Medeiros Silva MM, de Oliveira Mendes Aguiar C, Nascimento PRP, da Costa EG, Jeronimo SMB, de Melo Ximenes MDFF. Challenges of animals shelters in caring for dogs infected with Leishmania and other pathogens. Vet Parasitol Reg Stud Reports 2024; 49:100988. [PMID: 38462297 DOI: 10.1016/j.vprsr.2024.100988] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/17/2023] [Revised: 12/30/2023] [Accepted: 01/12/2024] [Indexed: 03/12/2024]
Abstract
The incidence of human Visceral Leishmaniasis (VL) has decreased in Brazil; however, the number of areas reporting human and canine cases has increased, with Leishmania infantum usually preceding human infection. This study aimed to analyze the profile of infectious diseases that are endemic for both human and canine VL, in dogs housed in a shelter located in the state of Rio Grande do Norte, Northeast Brazil. Data was obtained between November/2021 to April/2022. All dogs residing at the shelter (98 dogs) were examined and blood was collected for testing for L. infantum, Ehrlichia canis, and Babesia sp. Statistical analyses considered the clinical and laboratory findings. Of the 98 animals, approximately 43% were positive for L. infantum antibodies, 19% were positive for L. infantum kDNA, and 18% were L. infantum positive by culture. Greater levels of anti-leishmania antibodies were observed in dogs with symptoms suggestive of VL. The dogs tested positive for E. canis (19/98) and B. canis (18/98). Lutzomyia longipalpis was captured inside the shelter, representing 74.25% (n = 225) of whole sandflies in the dog shelter. Concomitant infection by L. infantum and E. canis increased the odds of death. Treatment of VL included the use of allopurinol (n = 48) and miltefosine (n = 8). Treated animals showed more signs of Leishmania infection. Tickborn parasites and Leishmania were prevalent in sheltered dogs in a VL-endemic area, which increases the odds of death and poses an additional challenge for caring for abandoned dogs and at the same time setting protocols to manage reservoirs of L. infantum.
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Affiliation(s)
- Alessandra Salles da Silva
- Postgraduate Program in Development and Environment, Federal University of Rio Grande do Norte, Natal 59078-900, Rio Grande do Norte, Brazil
| | - Marcel Miranda de Medeiros Silva
- Postgraduate Program in Development and Environment, Federal University of Rio Grande do Norte, Natal 59078-900, Rio Grande do Norte, Brazil
| | - Carolina de Oliveira Mendes Aguiar
- Institute of Tropical Medicine of Rio Grande do Norte, Federal University of Rio Grande do Norte, Natal 59078-900, Rio Grande do Norte, Brazil
| | - Paulo Ricardo Petrucio Nascimento
- Institute of Tropical Medicine of Rio Grande do Norte, Federal University of Rio Grande do Norte, Natal 59078-900, Rio Grande do Norte, Brazil
| | - Eliardo Guimarães da Costa
- Department of Statistics, Federal University of Rio Grande do Norte, Natal 59078-900, Rio Grande do Norte, Brazil
| | - Selma M B Jeronimo
- Institute of Tropical Medicine of Rio Grande do Norte, Federal University of Rio Grande do Norte, Natal 59078-900, Rio Grande do Norte, Brazil; Department of Biochemistry, Biosciences Center, Federal University of Rio Grande do Norte, Natal 59078-900, Rio Grande do Norte, Brazil
| | - Maria de Fátima Freire de Melo Ximenes
- Postgraduate Program in Development and Environment, Federal University of Rio Grande do Norte, Natal 59078-900, Rio Grande do Norte, Brazil; Department of Microbiology and Parasitology, Biosciences Center, Federal University of Rio Grande do Norte, Natal 59078-900, Rio Grande do Norte, Brazil.
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Vasconcelos ADO, Bedoya-Pacheco SJ, Cunha E Silva RR, Magalhães MDAFM, de Sá TPSO, Dias CMG, Meneguete PS, de Almeida PMP, Pimentel MIF. Spatial-temporal distribution of visceral leishmaniasis in Rio de Janeiro, Brazil, 2001-2020: expansion and challenges. Trans R Soc Trop Med Hyg 2024:trae009. [PMID: 38517304 DOI: 10.1093/trstmh/trae009] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/21/2023] [Revised: 12/13/2023] [Accepted: 02/29/2024] [Indexed: 03/23/2024] Open
Abstract
BACKGROUND Visceral leishmaniasis results from complex interactions among humans, dogs and environment. Brazil accounts for 97% of cases in the Americas. METHODS Twenty years (2001-2020) of the endemic disease in the state of Rio de Janeiro were studied. Incidence, lethality, sociodemographic and clinical characteristics were investigated, complemented with spatial methodologies (kernel and clusters). RESULTS Ninety-seven human cases and 625 dogs were reported. Of the 92 cities, 22 were human endemic areas. The state had a low incidence level (0.6 per 100 000). Lethality was higher compared with the Brazilian average. More than 90% of infections occurred in urban areas. Most cases (66%) occurred in men. The predominant age groups were 0-4 y (28.7%) and 20-39 y (32.9%). Fever (89.5%), splenomegaly (83.2%) and hepatomegaly (76.8%) were the main clinical manifestations. Spatial analysis showed a displacement of the human endemic: in the first decade (2001-2010), cases were concentrated in the Metropolitan region, and in the second decade (2011-2020) in the Médio Paraíba region of the state. Most of the endemic area (56.4%) had canine infections without reported human cases. CONCLUSIONS Disorderly urbanisation and precarious living conditions favour the transmission of the disease. Changes in the environment and migratory processes contribute to its expansion.
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Affiliation(s)
- Alex de O Vasconcelos
- Laboratório de Pesquisa Clínica e Vigilância em Leishmanioses, Instituto Nacional de Infectologia Evandro Chagas, Fundação Oswaldo Cruz, Av. Brasil, 4365, Manguinhos, Rio de Janeiro, CEP: 21040-900, RJ, Brazil
| | - Sandro J Bedoya-Pacheco
- Departamento de Epidemiologia e Métodos Quantitativos em Saúde, Escola Nacional de Saúde Pública Sérgio Arouca, Fundação Oswaldo Cruz, Rua Leopoldo Bulhões, 1480, Manguinhos, Rio de Janeiro, CEP: 21041-210, RJ, Brazil
| | - Rafael R Cunha E Silva
- Laboratório de Pesquisa Clínica e Vigilância em Leishmanioses, Instituto Nacional de Infectologia Evandro Chagas, Fundação Oswaldo Cruz, Av. Brasil, 4365, Manguinhos, Rio de Janeiro, CEP: 21040-900, RJ, Brazil
| | - Mônica de A F M Magalhães
- Instituto de Comunicação e Informação Científica e Técnológica em Saúde, Fundação Oswaldo Cruz, Av. Brasil 4365, Pavilhão Haity Moussatché, Manguinhos, Rio de Janeiro, CEP 21040-900, RJ, Brazil
| | - Tayana P S O de Sá
- Laboratório de Pesquisa Clínica e Vigilância em Leishmanioses, Instituto Nacional de Infectologia Evandro Chagas, Fundação Oswaldo Cruz, Av. Brasil, 4365, Manguinhos, Rio de Janeiro, CEP: 21040-900, RJ, Brazil
| | - Cristina M G Dias
- Secretaria de Estado de Saúde do Rio de Janeiro, Rua México 128 sala 420, Rio de Janeiro, CEP: 20031-142, RJ, Brazil
| | - Patrícia S Meneguete
- Secretaria de Estado de Saúde do Rio de Janeiro, Rua México 128 sala 420, Rio de Janeiro, CEP: 20031-142, RJ, Brazil
| | - Paula M P de Almeida
- Secretaria de Estado de Saúde do Rio de Janeiro, Rua México 128 sala 420, Rio de Janeiro, CEP: 20031-142, RJ, Brazil
| | - Maria Inês F Pimentel
- Laboratório de Pesquisa Clínica e Vigilância em Leishmanioses, Instituto Nacional de Infectologia Evandro Chagas, Fundação Oswaldo Cruz, Av. Brasil, 4365, Manguinhos, Rio de Janeiro, CEP: 21040-900, RJ, Brazil
- Instituto de Comunicação e Informação Científica e Técnológica em Saúde, Fundação Oswaldo Cruz, Av. Brasil 4365, Pavilhão Haity Moussatché, Manguinhos, Rio de Janeiro, CEP 21040-900, RJ, Brazil
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Braz MS, Sáfadi T, Ferreira RA, Morais MHF, Silva Z, Rocha CMBMD. Temporal relationship between human and canine visceral leishmaniasis in an urban area in southeastern Brazil: An application of the ARIMAX model. Prev Vet Med 2023; 215:105921. [PMID: 37149992 DOI: 10.1016/j.prevetmed.2023.105921] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/18/2022] [Revised: 03/09/2023] [Accepted: 04/11/2023] [Indexed: 05/09/2023]
Abstract
Visceral leishmaniasis (VL) is a neglected disease of public and animal health importance. With the urbanization of the disease, there is evidence of a temporal correlation between the occurrence of human (HVL) and canine (CVL) visceral leishmaniasis, usually with cases in dogs preceding those in humans. In this context, the objective of this study was to develop a time series model suitable for canine-human transmission of Leishmania infantum. Monthly cases of HVL and CVL from 2006 to 2018 in Belo Horizonte, Minas Gerais, Brazil, were evaluated, and monthly health indicators were calculated for HVL and CVL, i.e., incidence coefficient (HVL_IC) and proportion of seropositive dogs (PSD), respectively. The temporal relationship was evaluated using an autoregressive integrated moving average with exogenous variable (ARIMAX) model for two different periods (January 2006-August 2013 and September 2013-December 2018). During the 13 years studied, 1115 new cases of HVL and 103,358 dogs seropositive for CVL were recorded. HVL_IC and PSD exhibited decreasing trends throughout the first study period (January 2006-August 2013). According to the ARIMAX model adjusted for this period, there was a temporal relationship between HVL_IC and PSD, with HVL_IC being influenced by HVL_IC for the last two and five months and by PSD for the third previous month. For the second study period (September 2013-December 2018), it was not possible to fit an ARIMAX model. This study highlights the improvements made by VL surveillance since 2006 in Belo Horizonte and contributes to a better understanding of the epidemiology of the disease by public health policy-makers, doctors and veterinarians involved in the prevention and control of zoonoses.
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Affiliation(s)
- Mirian Silvia Braz
- Faculdade de Zootecnia e Medicina Veterinária, Departamento de Medicina Veterinária, Universidade Federal de Lavras, CEP 37200-900 Lavras, Minas Gerais, Brazil
| | - Thelma Sáfadi
- Instituto de Ciências Exatas, Departamento de Estatística, Universidade Federal de Lavras, CEP 37200-900 Lavras, Minas Gerais, Brazil
| | - Rafael Agostinho Ferreira
- Instituto de Ciências Exatas, Departamento de Estatística, Universidade Federal de Lavras, CEP 37200-900 Lavras, Minas Gerais, Brazil
| | - Maria Helena Franco Morais
- Prefeitura de Belo Horizonte, Secretaria Municipal de Saúde, Diretoria de Zoonoses, CEP 30130-012 Belo Horizonte, Minas Gerais, Brazil
| | - Zoraia Silva
- Rua Dr. Armando Amaral 247, CEP 37203-587 Lavras, Minas Gerais, Brazil
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Chiyo L, Dos Santos AG, de Souza AB, Rivas AV, Valle SB, Sevá ADP, Viana KF. Cross-sectional spatial and epidemiological analysis of canine visceral leishmaniasis cases in the triple border region, Brazil, Argentina and Paraguay, between 2015 and 2020. Acta Trop 2023; 239:106811. [PMID: 36608750 DOI: 10.1016/j.actatropica.2022.106811] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/09/2022] [Revised: 12/27/2022] [Accepted: 12/28/2022] [Indexed: 01/05/2023]
Abstract
Visceral Leishmaniasis is one of the most important vector-borne zoonoses in the world. In 2013, the first autochthonous canine case of the disease in the state of Paraná, southern region of Brazil, was reported in Foz do Iguaçu, on the triple border between Brazil, Argentina and Paraguay. In 2015, the first human case was related. Once the endemic was confirmed, the Zoonoses Control Center (ZCC), an agency of the Municipal Health Department, started actions to implement the Human Visceral Leishmaniasis (HVL) Surveillance and Control Program (VLSCP), of the Ministry of Health. Between 2015 and 2020, 12,205 dog samples were analyzed for the diagnosis of the disease. A prevalence of 37.94% (4,630 samples) was found: 2016 had the highest prevalence, with 46.25%, and the year with the lowest prevalence was 2020, with 25.98%. Possible risk factors for dogs were analyzed, and the results obtained were: whether the request for the exam was performed by the ZCC was a significant protective factor, with a lower prevalence (37.5%) than dogs coming from private clinics (OR = 0.89, p-value = 0.016). Males were significantly more infected than females, with 41.1% and 35.7% positivity, respectively (OR = 1.24, p < 0.0001). Companion dogs and mixed breed dogs were significantly less affected than the other groups tested (OR = 0.44, p < 0.001; OR = 0.79, p = 0.012, respectively). The dogs' dark coat color was a significant risk factor with respect to the other color categories. Short and medium coat sizes were significantly considered risk factors, with 41.3% and 31.3% positivity. Long-haired dogs had only 22.7% positivity. In univariate analyses, giant, large and medium dogs were significantly more affected than small dogs. Dogs up to four years of age were significantly less affected than those in other age groups. There was a coincidence of human and canine cases in the spatial distribution. However, according to the literature, a higher incidence would be expected in humans, due to the high prevalence found in dogs. Therefore, further studies should be carried out to understand the dynamics of the disease in this region.
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Affiliation(s)
- Luciana Chiyo
- Universidade Federal da Integração Latino-Americana, Programa de Pós-graduação em Biociências, Foz do Iguaçu, Paraná, Brazil; Centro de Controle de Zoonoses, Prefeitura Municipal de Foz do Iguaçu, Foz do Iguaçu, Paraná, Brazil
| | - Angelo Gabriel Dos Santos
- Universidade Federal da Integração Latino-Americana, Programa de Pós-graduação em Biociências, Foz do Iguaçu, Paraná, Brazil
| | - Adrieli Barboza de Souza
- Universidade Federal da Integração Latino-Americana, Programa de Pós-graduação em Biociências, Foz do Iguaçu, Paraná, Brazil
| | - Açucena Veleh Rivas
- Universidade Federal da Integração Latino-Americana, Programa de Pós-graduação em Biociências, Foz do Iguaçu, Paraná, Brazil; Centro de Medicina Tropical da Tríplice Fronteira, Foz do Iguaçu, Paraná, Brazil
| | | | | | - Kelvinson Fernandes Viana
- Universidade Federal da Integração Latino-Americana, Programa de Pós-graduação em Biociências, Foz do Iguaçu, Paraná, Brazil.
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de Melo SN, Barbosa DS, Câmara DCP, Simões TC, Buzanovsky LP, Duarte AGS, Maia-Elkhoury ANS, Cardoso DT, Donato LE, Werneck GL, Belo VS. Spatio-temporal relative risks and priority areas for visceral leishmaniasis control in Brazil, between 2001 and 2020. Acta Trop 2023; 242:106912. [PMID: 36990374 DOI: 10.1016/j.actatropica.2023.106912] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/21/2023] [Revised: 03/23/2023] [Accepted: 03/26/2023] [Indexed: 03/30/2023]
Abstract
Visceral leishmaniasis (VL) is a pressing public health problem in Brazil. The proper implementation of disease control programs in priority areas is a challenge for healthcare managers. The present study aimed to analyze the spatio-temporal distribution and identify high risk areas of VL occurrence in the Brazilian territory. We analyzed data regarding new cases with confirmed diagnosis of VL in Brazilian municipalities, from 2001 to 2020, extracted from the Brazilian Information System for Notifiable Diseases. The Local Index of Spatial Autocorrelation (LISA) was used to identify contiguous areas with high incidence rates in different periods of the temporal series. Clusters of high spatio-temporal risk were identified using the scan statistics. The accumulated incidence rate in the analyzed period was 33.53 cases per 100,000 inhabitants. The number of municipalities that reported cases showed an upward trend from 2001 onward, although there was a decrease in 2019 and 2020. According to LISA, the number of municipalities considered a priority increased in Brazil and in most states. Priority municipalities were predominantly concentrated in the states of Tocantins, Maranhão, Piauí, and Mato Grosso do Sul, in addition to more specific areas of Pará, Ceará, Piauí, Alagoas, Pernambuco, Bahia, São Paulo, Minas Gerais, and Roraima. The spatio-temporal clusters of high-risk areas varied throughout the time series and were relatively higher in the North and Northeast regions. Recent high-risk areas were found in Roraima and municipalities in northeastern states. VL expanded territorially in Brazil in the 21st century. However, there is still a considerable spatial concentration of cases. The areas identified in the present study should be prioritized for disease control actions.
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Marcolino Silva D, Passarella Teixeira AI, Sierra Romero GA. Socioeconomic Status of Guardians as a Risk Factor for Canine Visceral Leishmaniasis: A Cohort Study in an Endemic Area of the Federal District, Brazil. Am J Trop Med Hyg 2023; 108:328-334. [PMID: 36535251 PMCID: PMC9896338 DOI: 10.4269/ajtmh.21-1170] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/09/2021] [Accepted: 07/17/2022] [Indexed: 12/23/2022] Open
Abstract
Current control measures of canine visceral leishmaniasis (CVL), a chronic and fatal zoonosis with potential transmission to humans, are not efficient enough to reduce its spread. The search for improved control measures should include studies of risk factors for infection and illness. This study aimed to identify the risk factors for CVL in an endemic locality of the Federal District, Brazil, from June 2016 to December 2018. Biologic samples and data on dog characteristics, owner household characteristics, and dog care were collected. A combination of serological and molecular tests was used to identify infected animals. The 248 dogs screened for inclusion were predominantly asymptomatic/oligosymptomatic. The baseline prevalence of infection was 27.5%. One hundred six of 162 susceptible dogs were monitored for an average period of 10.7 months. The estimated CVL incidence was 1.91 cases/100 dog-months. The multivariate analysis using a proportional Cox model included the potential risk factors, with P ≤ 0.25 in the univariate analyses. Greater purchasing power (hazard ratio [HR], 1.04; 95% CI, 1.01-1.06; P = 0.03) and paved yard (HR, 0.19; 95% CI, 0.13-1.01; P = 0.05) remained in the final model as risk and protection factors, respectively. The use of repellent collars in dogs was associated moderately (P = 0.08) with protection against CVL. Our findings reflect the challenge of identifying strong interventions for reducing CVL incidence. Increased owner wealth had a counterintuitive effect on CVL, making the intervention scenario more complex for a zoonosis traditionally associated with poverty.
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Affiliation(s)
- Debora Marcolino Silva
- Center for Tropical Medicine, University of Brasília, Brasília, Federal District, Brazil
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Díaz-Sáez V, Morillas-Mancilla MJ, Corpas-López V, Rodríguez-Granger J, Sampedro A, Morillas-Márquez F, Martín-Sánchez J. Leishmaniasis vectors in the environment of treated leishmaniasis cases in Spain. Transbound Emerg Dis 2022; 69:3247-3255. [PMID: 35943318 PMCID: PMC10087936 DOI: 10.1111/tbed.14677] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/09/2022] [Revised: 07/18/2022] [Accepted: 07/31/2022] [Indexed: 02/04/2023]
Abstract
Transmission of leishmaniasis in endemic areas is characterized by microfocality related to the presence of the vector. Most entomological studies in southwestern Europe have focused on sylvatic areas and town outskirts, very few have sampled town or urban centres, and no survey has investigated inside households. The aim of this study was to determine the sand fly species diversity and vector density in the surroundings of human leishmaniasis cases compared with environments in which there was no association. Sand flies were captured in 26 households associated with recently treated leishmaniasis patients, 15 neighbouring houses without associated cases, and in others environments. Overall 7495 sand flies belonging to six species were captured. The highest sand fly density was found in farmhouses where there is a great availability of blood sources and breeding sites. In the environment of human leishmaniasis cases, Sergentomyia minuta was the most prevalent species followed by Phlebotomus perniciosus. Nevertheless, lower Leishmania infantum infection rates and lower intensity of infection were detected in S. minuta sand flies than in P. perniciosus. The density of P. perniciosus in households with recently treated leishmaniasis patients varies between 0 and 108 sand flies per light trap/night, with the maximum values corresponding to farmhouses. This species appears to be adapted to both indoors and outdoors domestic biotopes, including urban households.
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Affiliation(s)
- Victoriano Díaz-Sáez
- Department of Parasitology, Faculty of Pharmacy, University of Granada, Granada, Spain
| | | | | | - Javier Rodríguez-Granger
- Department of Microbiology and Parasitology, Hospital Universitario Virgen de las Nieves, Granada, Spain
| | - Antonio Sampedro
- Department of Microbiology and Parasitology, Hospital Universitario Virgen de las Nieves, Granada, Spain
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Climate Change and Environmental Influence on Prevalence of Visceral Leishmaniasis in West Pokot County, Kenya. J Trop Med 2022. [DOI: 10.1155/2022/1441576] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022] Open
Abstract
Kala-azar is a parasitic disease caused by Leishmania species transmitted by sand fly. In Kenya, kala-azar is endemic in thirty subcounties spread over in eleven counties in the arid zones. Climate change-influenced seasonal weather variability and environmental alterations remain important determinants of many vector-borne diseases. The present study focused on climate change and environmental influence on kala-azar in West Pokot. A descriptive cross-sectional and retrospective research design was adapted. Study area was purposively selected. Locations were randomly selected, and households were systematically selected. Three hundred sixty-three household questionnaires, eleven key informant interviews, and five focus group discussions were undertaken. Secondary data were obtained from Kacheliba subcounty hospital records. Statistical Package for the Social Sciences version 24 was used to analyze quantitative data while qualitative data were analyzed to establish connection for interpretation. Kala-azar cases have been on the rise on aggregate and surge towards the end of dry season and just after the rains. Significant environmental factors included the presence of seasonal rain water pathways and rock piles around houses (AOR = 4.7; 95% CI = (2.3-9.6),
), presence of acacia trees in and around homesteads (AOR = 8.5; 95% CI = (2.5-28.6),
), presence of anthills around the homesteads (AOR = 5.2; 95% CI = (1.2-23.4),
), and presence of animal shed within compound (AOR = 2.8; 95% CI = (0.96-8),
). Climate change-induced seasonal weather variability, increased temperature and reduced precipitation as well as environmental alterations influence kala-azar occurrence in West Pokot. Community sensitization on disease prevalence, clearing of vector predilection sites, and improving community environmental risk perception are imperative to promote prevention.
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Ahmed M, Abdulslam Abdullah A, Bello I, Hamad S, Bashir A. Prevalence of human leishmaniasis in Sudan: A systematic review and meta-analysis. World J Methodol 2022; 12:305-318. [PMID: 36159098 PMCID: PMC9350725 DOI: 10.5662/wjm.v12.i4.305] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/06/2021] [Revised: 01/31/2022] [Accepted: 06/27/2022] [Indexed: 02/06/2023] Open
Abstract
BACKGROUND There are three main forms of leishmaniasis in humans: cutaneous leishmaniasis (CL), visceral leishmaniasis (VL), and mucocutaneous leishmaniasis. The prevalence of human leishmaniasis varies widely in different countries and different regions of the same country. To date, there is no overall estimation of the prevalence of human leishmaniasis in Sudan.
AIM To determine the pooled prevalence of human leishmaniasis and the disease risk factors among Sudanese citizens.
METHODS From all articles written in English or Arabic languages conducted before the 4th of August 2021 from [Scopus, Web of Science, PubMed, and MEDLINE, African Journals Online (AJOL), ResearchGate, direct Google search, Google Scholar, and universities websites], just 20 articles with a total of 230960 participants were eligible for this study. Data synthesis and analysis were done using STATA software, version 16. EndNote citation manager version X9.3.3 and Reference Citation Analysis (RCA) were used to remove the duplicated studies and manage the citation respectively.
RESULTS The overall pooled prevalence of human leishmaniasis in Sudan was 21% (with confidence interval 12%-30%). CL was the most common type of leishmaniasis in Sudan, with a pooled prevalence of 26% followed by VL (18%). Nevertheless, the pooled prevalence of human leishmaniasis in Sudan was higher in males compared with females (60% vs 40%). The current results revealed that the people in the age group between 15 and 44 were the most affected group (60%), and central Sudan has the highest pooled prevalence of human leishmaniasis (27%) compared with other regions of Sudan. Finally, the prevalence of human leishmaniasis seems to decrease with time.
CONCLUSION This study showed that human leishmaniasis infection is still endemic in many regions in Sudan and highly prevalent in central and eastern Sudan, and CL is the most prevalent in the country. Males and adults were more susceptible to infection compared with females and children. However, the human leishmaniasis prevalence decreased relatively over time.
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Affiliation(s)
- Musa Ahmed
- Department of Reproductive Health Sciences, Pan African University Life and Earth Sciences Institute, University of Ibadan, Ibadan 119, Oyo state, Nigeria
- Department of Veterinary Surgery and Anaesthesia, Faculty of Veterinary Medicine, ALsalam University, Al-fula 120, West Kordofan state, Sudan
| | - Abdullah Abdulslam Abdullah
- Department of Reproductive Health Sciences, Pan African University Life and Earth Sciences Institute, University of Ibadan, Ibadan 119, Oyo state, Nigeria
- Department of Biomedical Sciences, Faculty of Veterinary Sciences, University of Gadarif, Gadarif 208, Sudan
| | - Idris Bello
- Department of Reproductive Health Sciences, Pan African University Life and Earth Sciences Institute, University of Ibadan, Ibadan 119, Oyo state, Nigeria
- Department of Animal Health and Production Technology, Oyo State College of Agriculture and Technology, Igboora 120, Oyo state, Nigeria
| | - Suad Hamad
- Department of Zoonotic Disease and Disease Control, Ministry of Animal Resources, Al-Hamadi 215, South Kordofan state, Sudan
| | - Aboelgassim Bashir
- Department of Pre-Clinical Sciences, Faculty of Veterinary Medicine, AL-Salam University, Al-Fulla 209, West Kordofan state, Sudan
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de Souza Junior VR, de Araújo PSR, Lopes de Melo F, Iglis de Oliveira M, da Conceição de Barros Correia M, Costa MFH. The pathophysiological hypotheses between visceral leishmaniasis infection and consumptive coagulopathy. Trop Doct 2021; 52:224-225. [PMID: 34878356 DOI: 10.1177/00494755211060134] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Affiliation(s)
| | | | - Fábio Lopes de Melo
- 425910Universidade Federal de Pernambuco, Recife, Brazil
- 425910Fundação Oswaldo Cruz-Fiocruz, Instituto Ageu Magalhães, Recife, Brazil
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Luz JGG, Dias JVL, Carvalho AG, Piza PA, Chávez-Pavoni JH, Bulstra C, Coffeng LE, Fontes CJF. Human visceral leishmaniasis in Central-Western Brazil: Spatial patterns and its correlation with socioeconomic aspects, environmental indices and canine infection. Acta Trop 2021; 221:105965. [PMID: 34029529 DOI: 10.1016/j.actatropica.2021.105965] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/21/2021] [Revised: 05/05/2021] [Accepted: 05/15/2021] [Indexed: 10/21/2022]
Abstract
In this ecological study, we investigated spatial patterns of human visceral leishmaniasis (VL) incidence, its correlation with socioeconomic aspects, environmental indices (obtained through remote sensing) and canine VL during 2011-2016 in the municipality of Rondonópolis, a relevant endemic area for VL in Central-Western Brazil. Human VL cases were georeferenced and point patterns were analyzed by univariate Ripley's K function and Kernel density estimation (KDE). Poisson-based scan statistics were used to investigate spatial and spatiotemporal clusters of human VL incidence at the neighborhood level. Socioeconomic and environmental characteristics were compared between neighborhoods within and outside spatial human VL clusters. Also, we assessed the correlation between smoothed human VL incidence and canine VL seropositivity rates within and between neighborhoods. Human VL cases were clustered up to 2000 m; four hotspots were identified by KDE in peripheral areas. Spatial and spatiotemporal low-risk clusters for human VL were identified in central and southern areas. Neighborhoods within spatial low-risk cluster presented higher mean income, literacy rate, sanitary sewage service coverage and lower altitude, compared to the rest of the municipality. A positive correlation was found between the occurrence of human and canine VL. On the northern outskirts, high human VL incidence was spatially correlated with high canine VL seropositivity in surrounding neighborhoods. In conclusion, human VL demonstrated a heterogeneous, aggregated and peripheral spatial pattern. This distribution was correlated with intra-urban socioeconomic differences and canine VL seropositivity at the neighborhood level.
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dos Santos CVB, Sevá ADP, Werneck GL, Struchiner CJ. Does deforestation drive visceral leishmaniasis transmission? A causal analysis. Proc Biol Sci 2021; 288:20211537. [PMID: 34428972 PMCID: PMC8385339 DOI: 10.1098/rspb.2021.1537] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/06/2021] [Accepted: 07/30/2021] [Indexed: 11/12/2022] Open
Abstract
Vector-borne diseases (VBDs) are important contributors to the global disease burden and are a key factor in perpetuating economic inequality. Although environmental changes are often cited as drivers of VBDs, the link between deforestation and VBD occurrence remains unclear. Here, we examined this relationship in detail using the spread of visceral leishmaniasis (VL) in São Paulo state (Brazil) as the case study. We used a two-step approach to estimate the causal effects (overall, direct, and indirect) of deforestation on the occurrence of the VL vector, canine visceral leishmaniasis (CVL), and human visceral leishmaniasis (HVL). We first estimated the parameters via a double Metropolis-Hastings algorithm and then estimated the causal effects through a Gibbs sampler. We observed that the odds of vector, CVL, and HVL occurrence were 2.63-, 2.07-, and 3.18-fold higher, respectively, in deforested compared with forested municipalities. We also identified a significant influence of the presence of vector, CVL, and HVL in one municipality on disease occurrence in previously naive neighbouring municipalities. Lastly, we found that a hypothetical reduction in deforestation prevalence from 50 to 0% across the state would reduce vector, CVL, and HVL occurrence by 11%, 6.67%, and 29.87%, respectively. Our results suggest that implementing an eco-friendly development strategy that considers trade-offs between agriculture, urbanization, and conservation could be an effective mechanism of controlling VL.
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Affiliation(s)
- Cleber Vinicius Brito dos Santos
- Departamento de Epidemiologia, Instituto de Medicina Social, Universidade do Estado do Rio de Janeiro, Rua São Francisco Xavier 524, Maracanã, Rio de Janeiro, Brazil
| | - Anaiá da Paixão Sevá
- Departamento de Ciência Animal e Agrárias, Universidade Estadual de Santa Cruz, Campus Soane Nazaré de Andrade, Rodovia Jorge Amado Km 16, Salobrinho, Ilhéus, Bahia, Brazil
| | - Guilherme Loureiro Werneck
- Departamento de Epidemiologia, Instituto de Medicina Social, Universidade do Estado do Rio de Janeiro, Rua São Francisco Xavier 524, Maracanã, Rio de Janeiro, Brazil
| | - Cláudio José Struchiner
- Departamento de Epidemiologia, Instituto de Medicina Social, Universidade do Estado do Rio de Janeiro, Rua São Francisco Xavier 524, Maracanã, Rio de Janeiro, Brazil
- Escola de Matemática Aplicada, Fundação Getúlio Vargas, Praia de Botafogo 190, Botafogo, Rio de Janeiro, Brazil
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Luz JGG, Carvalho AG, Naves DB, Dias JVL, Fontes CJF. Are backyard characteristics relevant factors for the occurrence of human visceral leishmaniasis in Central-Western Brazil? Trans R Soc Trop Med Hyg 2021; 114:276-283. [PMID: 31851365 DOI: 10.1093/trstmh/trz110] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/25/2019] [Revised: 09/01/2019] [Accepted: 10/17/2019] [Indexed: 01/20/2023] Open
Abstract
BACKGROUND This retrospective case-control study aimed to investigate the factors associated with the occurrence of human visceral leishmaniasis (VL) in the municipality of Rondonópolis, which is a highly endemic area for VL in Central-Western Brazil. METHODS All VL cases reported in Rondonópolis from 2011 to 2016 were included. For each case, two neighborhood- and age-matched controls with the absence of past and present history of VL and negative rk39-based immunochromatographic test, were recruited. Data were retrospectively collected through interviews that assessed socioeconomic aspects, housing features, backyard characteristics, presence of animals and daily habits. A multivariate conditional logistic regression analysis was used to identify factors associated with human VL. RESULTS During the study period, 81 VL cases were reported in Rondonópolis, of which 37 (45.7%) were included in this study. Seventy controls were also included. The variables associated with VL occurrence were the outdoor location of a bathroom and/or kitchen separated from the rest of the house (OR 7.8; 95% CI 2.1 to 29.5), the presence of a vegetable garden (OR 5.3; 95% CI 1.3 to 21.2) and the presence of decaying fruits (OR 10.7; 95% CI 2.0 to 52.1) in the backyard. CONCLUSIONS Our findings suggest an association between backyard characteristics and VL. This may be useful in guiding preventive and control measures against zoonotic VL worldwide.
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Affiliation(s)
- João Gabriel Guimarães Luz
- School of Medicine, Institute of Exact and Natural Sciences, Federal University of Mato Grosso (UFMT), 5055 dos Estudantes Ave. Rondonópolis, Mato Grosso, 78735-901, Brazil.,School of Medicine, Post-Graduation Program in Health Sciences, Federal University of Mato Grosso (UFMT), 2367 Fernando Corrêa da Costa Ave. Cuiabá, Mato Grosso, 78060-900, Brazil
| | - Amanda Gabriela Carvalho
- School of Medicine, Institute of Exact and Natural Sciences, Federal University of Mato Grosso (UFMT), 5055 dos Estudantes Ave. Rondonópolis, Mato Grosso, 78735-901, Brazil.,School of Medicine, Post-Graduation Program in Health Sciences, Federal University of Mato Grosso (UFMT), 2367 Fernando Corrêa da Costa Ave. Cuiabá, Mato Grosso, 78060-900, Brazil
| | - Danilo Bueno Naves
- School of Medicine, Institute of Exact and Natural Sciences, Federal University of Mato Grosso (UFMT), 5055 dos Estudantes Ave. Rondonópolis, Mato Grosso, 78735-901, Brazil
| | - João Victor Leite Dias
- School of Medicine, Federal University of Jequitinhonha and Mucuri Valleys (UFVJM), 1 Cruzeiro St. Teófilo Otoni, Minas Gerais, 39803-371, Brazil
| | - Cor Jesus Fernandes Fontes
- School of Medicine, Post-Graduation Program in Health Sciences, Federal University of Mato Grosso (UFMT), 2367 Fernando Corrêa da Costa Ave. Cuiabá, Mato Grosso, 78060-900, Brazil.,School of Medicine, Faculty of Biomedical Sciences of Cacoal (FACIMED), 3087 Cuiabá Ave. Cacoal, Rondônia, 76963-665, Brazil
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da Silva Santana Cruz C, Soeiro Barbosa D, Oliveira VC, Cardoso DT, Guimarães NS, Carneiro M. Factors associated with human visceral leishmaniasis cases during urban epidemics in Brazil: a systematic review. Parasitology 2021; 148:639-647. [PMID: 33431094 PMCID: PMC11010180 DOI: 10.1017/s0031182021000019] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/31/2020] [Revised: 12/28/2020] [Accepted: 12/30/2020] [Indexed: 11/06/2022]
Abstract
Visceral leishmaniasis (VL) is endemic in 70 countries and has been reported in 12 countries of Latin America, with over 90% of the cases reported in Brazil, where epidemics have occurred since 1980. The objective of this review is to describe the factors associated with the occurrence of VL epidemics in humans in urban areas. A systematic review was conducted according to the PRISMA-P guidelines. The databases PubMed (by Medline), Cochrane Library, Embase, Amed, LILACS and grey literature [Google Scholar and handsearch of the database of the Information System for Notifiable Diseases (SINAN) of Brazil's Unified Health System] were used. The protocol was registered under PROSPERO (CRD42019128998). Climatic, environmental factors and indicators of urban social structure were described as influencing the outbreaks in the North and Northeast regions. Gender and age characteristics were related to a greater chance of developing VL in the Central-West, Northeast and Southeast regions. Vector indicators showed a positive correlation with the incidence of VL in studies in the Northeast region. In the Southeast and Northeast regions, studies revealed the presence of dogs with positive correlation with VL. Knowledge gaps remain regarding the contribution to the increase in the risk factors described in ecological approaches, as no analysis was performed at the individual level, and it is still necessary to discuss the influence of other associated elements in epidemic episodes in the spread of VL.
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Affiliation(s)
- Cleya da Silva Santana Cruz
- Programa de Pós-graduação em Infectologia e Medicina Tropical, Faculdade de Medicina, Universidade Federal de Minas Gerais, 30130-100, Belo Horizonte, MG, Brazil
| | - David Soeiro Barbosa
- Departamento de Parasitologia, Instituto de Ciências Biológicas, Universidade Federal de Minas Gerais, 31270-901, Belo Horizonte, MG, Brazil
| | - Vinícius Cunha Oliveira
- Pós-graduação em Reabilitação e Desempenho Funcional, Universidade Federal dos Vales do Jequitinhonha e Mucuri, 39100-000, Diamantina, MG, Brazil
| | - Diogo Tavares Cardoso
- Departamento de Parasitologia, Instituto de Ciências Biológicas, Universidade Federal de Minas Gerais, 31270-901, Belo Horizonte, MG, Brazil
| | - Nathália Sernizon Guimarães
- Programa de Pós-graduação em Infectologia e Medicina Tropical, Faculdade de Medicina, Universidade Federal de Minas Gerais, 30130-100, Belo Horizonte, MG, Brazil
| | - Mariângela Carneiro
- Programa de Pós-graduação em Infectologia e Medicina Tropical, Faculdade de Medicina, Universidade Federal de Minas Gerais, 30130-100, Belo Horizonte, MG, Brazil
- Departamento de Parasitologia, Instituto de Ciências Biológicas, Universidade Federal de Minas Gerais, 31270-901, Belo Horizonte, MG, Brazil
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Denlinger DS, Hudson SB, Keweshan NS, Gompert Z, Bernhardt SA. Standing genetic variation in laboratory populations of insecticide-susceptible Phlebotomus papatasi and Lutzomyia longipalpis (Diptera: Psychodidae: Phlebotominae) for the evolution of resistance. Evol Appl 2021; 14:1248-1262. [PMID: 34025765 PMCID: PMC8127718 DOI: 10.1111/eva.13194] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/17/2020] [Revised: 12/30/2020] [Accepted: 01/02/2021] [Indexed: 01/02/2023] Open
Abstract
Insecticides can exert strong selection on insect pest species, including those that vector diseases, and have led to rapid evolution of resistance. Despite such rapid evolution, relatively little is known about standing genetic variation for resistance in insecticide-susceptible populations of many species. To help fill this knowledge gap, we generated genotyping-by-sequencing data from insecticide-susceptible Phlebotomus papatasi and Lutzomyia longipalpis sand flies that survived or died from a sub-diagnostic exposure to either permethrin or malathion using a modified version of the Centers for Disease Control and Prevention bottle bioassay. Multi-locus genome-wide association mapping methods were used to quantify standing genetic variation for insecticide resistance in these populations and to identify specific alleles associated with insecticide survival. For each insecticide treatment, we estimated the proportion of the variation in survival explained by the genetic data (i.e., "chip" heritability) and the number and contribution of individual loci with measurable effects. For all treatments, survival to an insecticide exposure was heritable with a polygenic architecture. Both P. papatasi and L. longipalpis had alleles for survival that resided within many genes throughout their genomes. The implications for resistance conferred by many alleles, as well as inferences made about the utility of laboratory insecticide resistance association studies compared to field observations, are discussed.
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Dahal P, Singh-Phulgenda S, Olliaro PL, Guerin PJ. Gender disparity in cases enrolled in clinical trials of visceral leishmaniasis: A systematic review and meta-analysis. PLoS Negl Trop Dis 2021; 15:e0009204. [PMID: 33725005 PMCID: PMC7963105 DOI: 10.1371/journal.pntd.0009204] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/04/2020] [Accepted: 02/04/2021] [Indexed: 12/15/2022] Open
Abstract
BACKGROUND A higher caseload of visceral leishmaniasis (VL) has been observed among males in community-based surveys. We carried out this review to investigate how the observed disparity in gender distribution is reflected in clinical trials of antileishmanial therapies. METHODS We identified relevant studies by searching a database of all published clinical trials in VL from 1980 through 2019 indexed in the Infectious Diseases Data Observatory (IDDO) VL clinical trials library. The proportion of male participants enrolled in studies eligible for inclusion in this review were extracted and combined using random effects meta-analysis of proportion. Results were expressed as percentages and presented with respective 95% confidence intervals (95% CIs). Heterogeneity was quantified using I2 statistics and sub-group meta-analyses were carried out to explore the sources of heterogeneity. RESULTS We identified 135 published studies (1980-2019; 32,177 patients) with 68.0% [95% CI: 65.9%-70.0%; I2 = 92.6%] of the enrolled participants being males. The corresponding estimates were 67.6% [95% CI: 65.5%-69.7%; n = 91 trials; I2 = 90.5%; 24,218 patients] in studies conducted in the Indian sub-continent and 74.1% [95% CI: 68.4%-79.1%; n = 24 trials; I2 = 94.4%; 6,716 patients] in studies from Eastern Africa. The proportion of male participants was 57.9% [95% CI: 54.2%-61.5%] in studies enrolling children aged <15 years, 78.2% [95% CI: 66.0%-86.9%] in studies that enrolled adults (≥15 years), and 68.1% [95% CI: 65.9%-70.0%] in studies that enrolled patients of all ages. There was a trend for decreased proportions of males enrolled over time: 77.1% [95% CI: 70.2%-82.8%; 1356 patients] in studies published prior to the 1990s whereas 64.3% [95% CI: 60.3%-68.2%; 15,611 patients] in studies published on or after 2010. In studies that allowed the inclusion of patients with HIV co-infections, 76.5% [95% CI: 63.8%-85.9%; 5,123 patients] were males and the corresponding estimate was 64.0% [95% CI: 61.4%-66.5% 17,500 patients] in studies which excluded patients with HIV co-infections. CONCLUSIONS Two-thirds of the participants enrolled in clinical studies in VL conducted in the past 40 years were males, though the imbalance was less in children and in more recent trials. VL treatment guidelines are informed by the knowledge of treatment outcomes from a population that is heavily skewed towards adult males. Investigators planning future studies should consider this fact and ensure approaches for more gender-balanced inclusion.
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Affiliation(s)
- Prabin Dahal
- Infectious Diseases Data Observatory–IDDO, Oxford, United Kingdom
- Centre for Tropical Medicine and Global Health, Nuffield Department of Medicine, University of Oxford, Oxford, United Kingdom
| | - Sauman Singh-Phulgenda
- Infectious Diseases Data Observatory–IDDO, Oxford, United Kingdom
- Centre for Tropical Medicine and Global Health, Nuffield Department of Medicine, University of Oxford, Oxford, United Kingdom
| | - Piero L. Olliaro
- Centre for Tropical Medicine and Global Health, Nuffield Department of Medicine, University of Oxford, Oxford, United Kingdom
| | - Philippe J. Guerin
- Infectious Diseases Data Observatory–IDDO, Oxford, United Kingdom
- Centre for Tropical Medicine and Global Health, Nuffield Department of Medicine, University of Oxford, Oxford, United Kingdom
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Aguiar Martins K, Meirelles MHDA, Mota TF, Abbasi I, de Queiroz ATL, Brodskyn CI, Veras PST, Mothé Fraga DB, Warburg A. Effects of larval rearing substrates on some life-table parameters of Lutzomyia longipalpis sand flies. PLoS Negl Trop Dis 2021; 15:e0009034. [PMID: 33476330 PMCID: PMC7870073 DOI: 10.1371/journal.pntd.0009034] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/08/2020] [Revised: 02/08/2021] [Accepted: 12/03/2020] [Indexed: 11/18/2022] Open
Abstract
Sand flies are the insects responsible for transmitting Leishmania parasites, the causative agents of leishmaniasis in humans. However, the effects of sand fly breeding sites on their biology and ecology remain poorly understood. Herein, we studied how larval nutrition associated with putative breeding sites of the sand fly Lutzomyia longipalpis affects their oviposition, development, microbiome, and susceptibility to Leishmania by rearing L. longipalpis on substrates collected from an endemic area for leishmaniasis in Brazil. The results showed that female L. longipalpis select the oviposition site based on its potential to promote larval maturation and while composting cashew leaf litter hindered the development, larvae reared on chicken feces developed rapidly. Typical gut microbial profiles were found in larvae reared upon cashew leaf litter. Adult females from larvae reared on substrate collected in chicken coops were infected with Leishmania infantum, indicating that they were highly susceptible to the parasite. In conclusion, the larval breeding sites can exert an important role in the epidemiology of leishmaniasis. Sand flies are the insect vectors involved in the transmission of many pathogens, however, the transmission of parasites to humans leading to visceral leishmaniasis is currently the most critical threat caused by this insect. Despite the importance of the vector, many aspects of the biology of sand flies are poorly understood, especially their breeding sites. This study was designed to evaluate the oviposition, life span, microbiome, and parasite infections in the main species of sand fly responsible for visceral leishmaniasis in America. Insects were reared on substrates collected from different putative habitats of sand flies in an endemic area for the disease in Brazil. The results showed that female vectors selected an oviposition site depending on the potential offered to their offspring. Furthermore, the development of immature stages varied according to the type of substrate evaluated, with cashew leaves litter delaying larval development, while chicken shelter promoted larval development. The challenge of females emerging from chicken shelter substrate with the parasite indicates that insects reared in such an environment could successfully sustain the infection. These results suggest that the type of breeding site can affect insect biology as well as the epidemiology of the disease.
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Affiliation(s)
| | - Maria Helena de Athayde Meirelles
- Instituto Gonçalo Moniz-Fundação Oswaldo Cruz, Salvador, Brazil
- Escola de Medicina Veterinária e Zootecnia-Universidade Federal da Bahia, Salvador, Brazil
| | | | - Ibrahim Abbasi
- Kuvin Center for the Study of Infectious & Tropical Diseases, Department of Microbiology and Molecular Genetics, Institute of Medical Research, Israel-Canada, Faculty of Medicine, The Hebrew University of Jerusalem, Jerusalem, Israel
| | | | - Claudia Ida Brodskyn
- Instituto Gonçalo Moniz-Fundação Oswaldo Cruz, Salvador, Brazil
- Escola de Medicina Veterinária e Zootecnia-Universidade Federal da Bahia, Salvador, Brazil
| | | | - Deborah Bittencourt Mothé Fraga
- Instituto Gonçalo Moniz-Fundação Oswaldo Cruz, Salvador, Brazil
- Escola de Medicina Veterinária e Zootecnia-Universidade Federal da Bahia, Salvador, Brazil
| | - Alon Warburg
- Kuvin Center for the Study of Infectious & Tropical Diseases, Department of Microbiology and Molecular Genetics, Institute of Medical Research, Israel-Canada, Faculty of Medicine, The Hebrew University of Jerusalem, Jerusalem, Israel
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Clinical, epidemiological and transmission cycle aspects of leishmaniasis urbanization in Barreiras, Bahia, Brazil. Spat Spatiotemporal Epidemiol 2020; 36:100395. [PMID: 33509434 DOI: 10.1016/j.sste.2020.100395] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/05/2019] [Revised: 10/13/2020] [Accepted: 12/07/2020] [Indexed: 11/22/2022]
Abstract
Leishmaniasis remains one of the world's leading infectious diseases and a public health problem for Bahia and Brazil. We made a retrospective cohort study of leishmaniasis cases reported between 2007 and 2016 in the Barreiras city, an important agribusiness city whose urbanization process was recent. Leishmaniasis presented epidemiological data with similar characteristics of the disease in other regions of the Brazil, that is, with the highest prevalence of visceral leishmaniasis found in children, while cutaneous leishmaniais was found in adults. The disease presented an urban configuration with wide distribution in the Barreiras city. We found the vectors of the different clinical forms of the disease occurring in the urban area of Barreiras city, particularly the sand fly of the Lutzmyia longipalpis, Evandromyia sallesi and Nyssomyia intermedia species. More studies will be necessary to indentify whether these species are really incriminated in the urban transmission of the parasites in the urban areas. This study indicates the places of the spatio-temporal greatest occurrence and transmission of the disease in the urban zones of Barreiras city.
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Charoensakulchai S, Bualert L, Manomat J, Mungthin M, Leelayoova S, Tan-Ariya P, Siripattanapipong S, Naaglor T, Piyaraj P. Risk Factors of Leishmania Infection among HIV-Infected Patients in Trang Province, Southern Thailand: A Study on Three Prevalent Species. Am J Trop Med Hyg 2020; 103:1502-1509. [PMID: 32700674 DOI: 10.4269/ajtmh.20-0332] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/05/2023] Open
Abstract
There are two main species of Leishmania reported in Thailand, that is, Leishmania siamensis and Leishmania martiniquensis. Moreover, leishmaniasis cases caused by Leishmania donovani complex were also reported. There is still a lack of information concerning risk factors of Leishmania infection in Thailand. This study aimed to identify the risk factors of Leishmania infection caused by these three species among HIV-infected patients. A cross-sectional study was conducted in HIV clinic at Trang Hospital, Thailand. Nested PCR and sequencing were performed to detect Leishmania DNA in blood and saliva samples and identify Leishmania species. A standardized questionnaire was used to interview individuals. A total of 526 patients were recruited in this study. Sixty-three (12.0%) were positive for L. siamensis, 24 (4.6%) were positive for L. martiniquensis, and 23 (4.4%) were positive for L. donovani complex. Risk factors of L. siamensis infection included using intravenous drug (adjusted odds ratio [AOR] 2.01, 95% CI: 1.01-4.02). Risk factors of L. martiniquensis infection included female gender (AOR 4.23, 95% CI: 1.52-11.75), using recreational drug (AOR 3.43, 95% CI: 1.00-11.74), and having comorbidities (AOR 4.94, 95% CI: 2.00-12.21). Risk factors of L. donovani complex infection included having opportunistic infection (AOR 4.22, 95% CI: 1.00-17.79), CD4 count 200-500 cells/mm3 (AOR 3.64, 95% CI: 1.14-6.86), and not using insect repellent (AOR 3.04, 95% CI: 1.08-8.58). This study identified the risk factors of Leishmania infection caused by three Leishmania species in Thailand. The data could be useful for disease prevention and control. Further studies on trends of Leishmania infection and preventive measures are recommended.
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Affiliation(s)
| | | | - Jipada Manomat
- Department of Microbiology, Faculty of Science, Mahidol University, Bangkok, Thailand
| | - Mathirut Mungthin
- Department of Parasitology, Phramongkutklao College of Medicine, Bangkok, Thailand
| | - Saovanee Leelayoova
- Department of Parasitology, Phramongkutklao College of Medicine, Bangkok, Thailand
| | - Peerapan Tan-Ariya
- Department of Microbiology, Faculty of Science, Mahidol University, Bangkok, Thailand
| | | | - Tawee Naaglor
- Department of Parasitology, Phramongkutklao College of Medicine, Bangkok, Thailand
| | - Phunlerd Piyaraj
- Department of Parasitology, Phramongkutklao College of Medicine, Bangkok, Thailand
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Batista LFS, Torrecilha RBP, Silva RB, Utsunomiya YT, Silva TBF, Tomokane TY, Pacheco AD, Bosco AM, Paulan SC, Rossi CN, Costa GNO, Marcondes M, Ciarlini PC, Nunes CM, Matta VLR, Laurenti MD. Chromosomal segments may explain the antibody response cooperation for canine leishmaniasis pathogenesis. Vet Parasitol 2020; 288:109276. [PMID: 33152678 DOI: 10.1016/j.vetpar.2020.109276] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/15/2019] [Revised: 10/14/2020] [Accepted: 10/15/2020] [Indexed: 12/22/2022]
Abstract
Visceral leishmaniasis (VL) is marked by hyperactivation of a humoral response secreting high quantity of immunoglobulins (Igs) that are inaccessible to intracellular parasites. Here we investigated the contributions of the antibody response to the canine leishmaniasis pathogenesis. Using correlation and genome-wide association analysis, we investigated the relationship of anti-Leishmania infantum immunoglobulin classes levels with parasite burden, clinical response, renal/hepatic biochemical, and oxidative stress markers in dogs from endemic areas of VL. Immunoglobulin G (IgG) and IgA were positively correlated with parasite burden on lymph node and blood. Increased IgG, IgA and IgE levels were associated with severe canine leishmaniasis (CanL) whereas IgM was elevated in uninfected exposed dogs. Correlations of IgM, IgG and IgA with creatinine, urea, AST and ALT levels in the serum were suggested an involvement of those Igs with renal and hepatic changes. The correlogram of oxidative radicals and antioxidants revealed a likely relationship of IgM, IgG and IgA with oxidative stress and lipid peroxidation in the blood, suggested as mechanisms mediating tissue damage and CanL worsening. The gene mapping on chromosomal segments associated with the quantitative variation of immunoglobulin classes identified genetic signatures involved with reactive oxygen species generation, phagolysosome maturation and rupture, free iron availability, Th1/Th2 differenciation and, immunoglobulin clearance. The findings demonstrated the roles of the antibody response as resistance or susceptibility markers and mediators of CanL pathogenesis. In addition we pinpointed candidate genes as potential targets for the therapy against the damage caused by exacerbated antibody response and parasitism in VL.
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Affiliation(s)
- Luís F S Batista
- Laboratório De Patologia De Doenças Infecciosas, Faculdade De Medicina, Universidade De São Paulo, São Paulo, CEP: 01246903, Brazil.
| | - Rafaela B P Torrecilha
- Departamento De Medicina Veterinária Preventiva e Reprodução Animal, Faculdade De Ciências Agrárias e Veterinárias, Univ Estadual Paulista, Jaboticabal, São Paulo, CEP: 14884-900, Brazil.
| | - Rafaela B Silva
- Escola de Saúde, Universidade Salvador, Salvador, Bahia, CEP: 41720-200, Brazil.
| | - Yuri T Utsunomiya
- Departamento de Apoio, Produção e Saúde Animal, Faculdade de Medicina Veterinária de Araçatuba, Univ Estadual Paulista, Araçatuba, São Paulo, CEP: 16015-050, Brazil.
| | - Thaís B F Silva
- Laboratório De Patologia De Doenças Infecciosas, Faculdade De Medicina, Universidade De São Paulo, São Paulo, CEP: 01246903, Brazil.
| | - Thaíse Y Tomokane
- Laboratório De Patologia De Doenças Infecciosas, Faculdade De Medicina, Universidade De São Paulo, São Paulo, CEP: 01246903, Brazil.
| | - Acácio D Pacheco
- Departamento de Clínica, Cirurgia e Reprodução Animal, Faculdade de Medicina Veterinária, Univ Estadual Paulista, Araçatuba, São Paulo, CEP: 16015-050, Brazil.
| | - Anelise M Bosco
- Departamento de Clínica, Cirurgia e Reprodução Animal, Faculdade de Medicina Veterinária, Univ Estadual Paulista, Araçatuba, São Paulo, CEP: 16015-050, Brazil.
| | - Silvana C Paulan
- Departamento de Apoio, Produção e Saúde Animal, Faculdade de Medicina Veterinária de Araçatuba, Univ Estadual Paulista, Araçatuba, São Paulo, CEP: 16015-050, Brazil.
| | - Claudio N Rossi
- Departamento de Clínica, Faculdade de Medicina Veterinária e Zootecnia, Universidade de São Paulo, São Paulo, CEP 05508-270, Brazil.
| | - Gustavo N O Costa
- Departamento De Medicina Veterinária Preventiva e Reprodução Animal, Faculdade De Ciências Agrárias e Veterinárias, Univ Estadual Paulista, Jaboticabal, São Paulo, CEP: 14884-900, Brazil.
| | - Mary Marcondes
- Departamento de Clínica, Cirurgia e Reprodução Animal, Faculdade de Medicina Veterinária, Univ Estadual Paulista, Araçatuba, São Paulo, CEP: 16015-050, Brazil.
| | - Paulo C Ciarlini
- Departamento de Clínica, Cirurgia e Reprodução Animal, Faculdade de Medicina Veterinária, Univ Estadual Paulista, Araçatuba, São Paulo, CEP: 16015-050, Brazil.
| | - Cáris M Nunes
- Departamento de Apoio, Produção e Saúde Animal, Faculdade de Medicina Veterinária de Araçatuba, Univ Estadual Paulista, Araçatuba, São Paulo, CEP: 16015-050, Brazil.
| | - Vânia L R Matta
- Laboratório De Patologia De Doenças Infecciosas, Faculdade De Medicina, Universidade De São Paulo, São Paulo, CEP: 01246903, Brazil.
| | - Márcia D Laurenti
- Laboratório De Patologia De Doenças Infecciosas, Faculdade De Medicina, Universidade De São Paulo, São Paulo, CEP: 01246903, Brazil.
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Falcão de Oliveira E, de Oliveira AG, de Arruda CCP, Fernandes WDS, de Medeiros MJ. Spatio-temporal modeling of visceral leishmaniasis in Midwest Brazil: An ecological study of 18-years data (2001-2018). PLoS One 2020; 15:e0240218. [PMID: 33007033 PMCID: PMC7531797 DOI: 10.1371/journal.pone.0240218] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/19/2020] [Accepted: 09/23/2020] [Indexed: 11/18/2022] Open
Abstract
Visceral leishmaniasis (VL) is a neglected vector-borne disease associated with socioeconomic and environmental issues. In Brazil, epidemics of VL have occurred in major cities since 1980. Applied models for medical and epidemiological research have been used to assess the distribution and characteristics of disease endpoints and identify and characterize potential risk factors. This study described the demographic features of VL and modeled the spatio-temporal distribution of human VL cases and their relationship with underlying predicitve factors using generalized additive models. We conducted an ecological study covering an 18-year period from the first report of an autochthonous case of VL in Campo Grande, state of Mato Grosso do Sul, in 2001 to 2018. The urban area of the city has 74 neighborhoods, and they were the units of analysis of our work. Socioeconomic and demographic data available from Brazilian public databases were considered as covariables. A total of 1,855 VL cases were reported during the study period, with an annual mean incidence rate of 13.23 cases per 100,000 population and a cumulative crude incidence of 235.77 per 100,000 population. The results showed the rapid transition from epidemic to endemic and the centrifugal dispersal pattern of the disease. Moreover, the model highlighted that the urban quality of life index, which is calculated based on income, education, housing conditions, and environmental sanitation data, plays a role in VL occurrence. Our findings highlighted the potential for improving spatio-temporal segmentation of control measures and the cost-effectiveness of integrated disease management programs as soon as VL is difficult to control and prevent and has rapid geographical dispersion and increased incidence rates.
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Affiliation(s)
- Everton Falcão de Oliveira
- Instituto Integrado de Saúde, Universidade Federal de Mato Grosso do Sul, Campo Grande, MS, Brasil
- Programa de Pós-Graduação em Doenças Infecciosas e Parasitárias, Universidade Federal de Mato Grosso do Sul, Campo Grande, MS, Brasil
- * E-mail: (EFO); (MJM)
| | - Alessandra Gutierrez de Oliveira
- Programa de Pós-Graduação em Doenças Infecciosas e Parasitárias, Universidade Federal de Mato Grosso do Sul, Campo Grande, MS, Brasil
- Instituto de Biociências, Universidade Federal de Mato Grosso do Sul, Campo Grande, MS, Brasil
| | | | - Wagner de Souza Fernandes
- Programa de Pós-Graduação em Doenças Infecciosas e Parasitárias, Universidade Federal de Mato Grosso do Sul, Campo Grande, MS, Brasil
| | - Márcio José de Medeiros
- Campus Macaé, Universidade Federal do Rio de Janeiro, Rio de Janeiro, RJ, Brasil
- * E-mail: (EFO); (MJM)
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22
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Donato LE, de Freitas LRS, Duarte EC, Romero GAS. Visceral leishmaniasis lethality in Brazil: an exploratory analysis of associated demographic and socioeconomic factors. Rev Soc Bras Med Trop 2020; 53:e20200007. [PMID: 32935778 PMCID: PMC7491564 DOI: 10.1590/0037-8682-0007-2020] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/07/2019] [Accepted: 06/17/2020] [Indexed: 11/22/2022] Open
Abstract
INTRODUCTION It is believed that delays in diagnosis and treatment of Visceral Leishmaniasis (VL) contribute significantly to the burden of VL lethality in Brazil. METHODS This study included several parts: a descriptive cross-sectional study of the individual characteristics of deaths from disease; a descriptive ecological study of the spatial distribution of deaths from disease; and an ecological analytical study to evaluate the association between disease lethality rates and the demographic, socioeconomic, and health indicators. The study population comprised all cases diagnosed throughout the country per the National Disease Notification System (SINAN) and the total number of disease deaths recorded in the Mortality Information System (SIM) from 2007 to 2012. RESULTS Of the 223 deaths from disease captured by pairing the databases, 59.1% were reported as "death from other causes". There were significant associations between VL lethality rate and municipalities with the highest proportion of vulnerable individuals (rate ratio (RR)=1.18, 95% confidence interval (CI): 1.01-1.27), with VL lower incidence rate (RR=0.62, 95% CI: 0.58-0.67) and a higher incidence rate of Acquired Immune Deficiency Syndrome (AIDS) (RR=1.20, 95% CI: 1.17-1.51). CONCLUSIONS Linking the SINAN and SIM databases allowed the inclusion of 14% of otherwise underreported deaths from VL for the study period, showing that this method is useful for the surveillance of VL-related deaths. The size of the municipal population, proportion of the vulnerable population, incidence of disease, and the incidence of AIDS were associated with municipal lethality rates related to VL in Brazil.
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Affiliation(s)
- Lucas Edel Donato
- Ministério da Saúde, Secretaria de Vigilância em Saúde, Brasília,
DF, Brasil
| | | | - Elisabeth Carmen Duarte
- Universidade de Brasília, Faculdade de Medicina, Programa de
Pós-Graduação em Medicina Tropical, Brasília, DF, Brasil
| | - Gustavo Adolfo Sierra Romero
- Universidade de Brasília, Faculdade de Medicina, Programa de
Pós-Graduação em Medicina Tropical, Brasília, DF, Brasil
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23
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Lopes JV, Michalsky ÉM, Pereira NCL, Paula AJVD, Souza AGM, Pinheiro LC, Lima ACVMDR, Avelar DMD, França-Silva JC, Lanzetta VAS, Melo JD, Fortes-Dias CL, Dias ES. Canine visceral leishmaniasis in area with recent Leishmania transmission: prevalence, diagnosis, and molecular identification of the infecting species. Rev Soc Bras Med Trop 2020; 53:e20200141. [PMID: 32935783 PMCID: PMC7491567 DOI: 10.1590/0037-8682-0141-2020] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/23/2020] [Accepted: 05/15/2020] [Indexed: 11/22/2022] Open
Abstract
INTRODUCTION: Canine visceral leishmaniasis (CVL) is an endemic disease in Brazil, and
integrated control actions have been adopted by the Brazilian Ministry of
Health to control its spread. However, the transmission profile is unknown
in areas with recent CVL cases, including Itaúna, located in the Brazilian
state of Minas Gerais, where the present study was carried out. METHODS: A total of 2,302 dogs from 12 neighborhoods were serologically tested for
canine VL using the current diagnostic protocol adopted by the Brazilian
Ministry of Health. Test positivity rate (TPR) and CVL prevalence were
determined for each neighborhood. The presence of
Leishmania was assessed in 60 seropositive dogs which
had been recommended for euthanasia. Twenty-two of them (37%) were
asymptomatic, and 38 (63%) were symptomatic for CVL. Parasitological
(myeloculture and smear/imprint) and molecular (PCR) methods were employed
for Leishmania detection in bone marrow, spleen, mesenteric
lymph nodes, and ear skin. The infecting Leishmania species
was identified by DNA sequencing. RESULTS: CVL prevalence (per 1,000 dogs) varied from 0.0-166.67, depending on the
neighborhood, with a mean of 68.96 (SD 51.38). Leishmania
DNA was detected in at least one tissue from all seropositive dogs, with
comparable TPR among tissues. Leishmania parasites were
identified in most (54/60) seropositive dogs, and the infecting parasite was
identified as Leishmania infantum in all of these. CONCLUSIONS: Prevalence of CVL is a contributor to the spread of visceral leishmaniasis
in Itaúna.
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Affiliation(s)
| | | | | | | | | | | | | | | | | | | | - Jarbas de Melo
- Prefeitura Municipal de Itaúna, Centro de Controle de Zoonoses, Itaúna, MG, Brasil
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24
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Gianchecchi E, Montomoli E. The enemy at home: leishmaniasis in the Mediterranean basin, Italy on the focus. Expert Rev Anti Infect Ther 2020; 18:563-577. [DOI: 10.1080/14787210.2020.1751611] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/23/2023]
Affiliation(s)
| | - Emanuele Montomoli
- VisMederi S.r.l, Siena, Italy
- Department of Molecular and Developmental Medicine, University of Siena, Siena, Italy
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25
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Molecular Characterization of Visceral Leishmaniasis in Asymptomatic Dogs in North Khorasan, Northeastern Iran. Jundishapur J Microbiol 2020. [DOI: 10.5812/jjm.100078] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
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26
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Cloots K, Burza S, Malaviya P, Hasker E, Kansal S, Mollett G, Chakravarty J, Roy N, Lal BK, Rijal S, Sundar S, Boelaert M. Male predominance in reported Visceral Leishmaniasis cases: Nature or nurture? A comparison of population-based with health facility-reported data. PLoS Negl Trop Dis 2020; 14:e0007995. [PMID: 31995564 PMCID: PMC7010295 DOI: 10.1371/journal.pntd.0007995] [Citation(s) in RCA: 26] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/17/2019] [Revised: 02/10/2020] [Accepted: 12/09/2019] [Indexed: 12/20/2022] Open
Abstract
Background Bangladesh, India, and Nepal aim for the elimination of Visceral Leishmaniasis (VL), a systemic parasitic infectious disease, as a public health problem by 2020. For decades, male patients have comprised the majority of reported VL cases in this region. By comparing this reported VL sex ratio to the one observed in population-based studies conducted in the Indian subcontinent, we tested the working hypothesis that mainly socio-cultural gender differences in healthcare-seeking behavior explain this gender imbalance. Methodology/Principal findings We compared the observed sex ratio of male versus female among all VL cases reported by the health system in Nepal and in the two most endemic states in India with that observed in population-based cohort studies in India and Nepal. Also, we assessed male sex as a potential risk factor for seroprevalence at baseline, seroconversion, and VL incidence in the same population-based data. The male/female ratio among VL cases reported by the health systems was 1.40 (95% CI 1.37–1.43). In the population cohort data, the age- and study site-adjusted male to female risk ratio was 1.27 (95% CI 1.08–1.51). Also, males had a 19% higher chance of being seropositive at baseline in the population surveys (RR 1.19; 95% CI 1.11–1.27), while we observed no significant difference in seroconversion rate between both sexes at the DAT cut-off titer defined as the primary endpoint. Conclusions/Significance Our population-based data show that male sex is a risk factor for VL, and not only as a socio-cultural determinant. Biological sex-related differences likely play an important role in the pathogenesis of this disease. Visceral Leishmaniasis (VL) is a parasitic disease that is lethal if not treated timely and mainly affects impoverished populations. Bangladesh, India, and Nepal have targeted the elimination of this disease as a public health problem by 2020. The majority of VL patients attending the health services are male, and this is usually attributed to unequal access to health care for men and women in this sociocultural context. We analyzed two large datasets obtained in population surveillance projects, including regular door-to-door screening for VL, in India and Nepal. Thereby we minimized any potential differences in access to health care between both sexes, as every suspect VL case occurring in the community received a full diagnostic work-up, and the research project facilitated transport to treatment centers if needed. By comparing the observed sex ratio in the health services records with those of the population surveillance records, we aimed to reach meaningful conclusions about the pathway through which male gender exerts its leverage for increasing VL risk: socio-cultural determinants blocking women from accessing care (nurture) or biological factors (nature) making men more vulnerable to VL. Because in the population-based age adjusted-data, male VL cases were significantly more frequent than female, our findings strongly suggest that in the Indian subcontinent, biological differences between men and women play a more critical role in the pathogenesis of VL than previously assumed, and the observed male predominance in VL cases in health services cannot be explained by socio-cultural factors only. Moreover, data show that above the age of 14 years, males are seropositive more often than females and are at higher risk to develop VL disease.
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Affiliation(s)
- Kristien Cloots
- Department of Public Health, Institute of Tropical Medicine, Antwerp, Belgium
- * E-mail:
| | | | | | - Epco Hasker
- Department of Public Health, Institute of Tropical Medicine, Antwerp, Belgium
| | - Sangeeta Kansal
- Department of Medicine, Banaras Hindu University, Varanasi, India
| | - Guy Mollett
- Faculty of Infectious and Tropical Diseases, London School of Hygiene and Tropical Medicine, London, United Kingdom
| | - Jaya Chakravarty
- Department of Medicine, Banaras Hindu University, Varanasi, India
| | - Nurpur Roy
- National Vector Borne Disease Control Program, Ministry of Health & Family Welfare, New Delhi, India
| | - Bibek Kumar Lal
- Epidemiology and Disease Control Division, Ministry of Health, Kathmandu, Nepal
| | - Suman Rijal
- Drugs for Neglected Diseases initiative, New Delhi, India
| | - Shyam Sundar
- Department of Medicine, Banaras Hindu University, Varanasi, India
| | - Marleen Boelaert
- Department of Public Health, Institute of Tropical Medicine, Antwerp, Belgium
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27
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Oliveira-da-Silva JA, Machado AS, Ramos FF, Tavares GSV, Lage DP, Ludolf F, Steiner BT, Reis TAR, Santos TTO, Costa LE, Martins VT, Galvani NC, Chaves AT, Oliveira JS, Chávez-Fumagalli MA, de Magalhães-Soares DF, Duarte MC, Menezes-Souza D, Silveira JAG, Moreira RLF, Machado-de-Ávila RA, Tupinambás U, Gonçalves DU, Coelho EAF. Evaluation of Leishmania infantum pyridoxal kinase protein for the diagnosis of human and canine visceral leishmaniasis. Immunol Lett 2020; 220:11-20. [PMID: 31981576 DOI: 10.1016/j.imlet.2020.01.005] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/27/2019] [Revised: 01/06/2020] [Accepted: 01/21/2020] [Indexed: 12/27/2022]
Abstract
Visceral leishmaniasis (VL) is a highly neglected disease that is present in several countries worldwide. Present-day treatments against this disease are unsuitable, mainly due to the toxicity and/or high cost of drugs. In addition, the development of vaccines is still insufficient. In this scenario, a prompt VL diagnosis was deemed necessary, although sensitivity and/or specificity values of the tests have been. In this context, new antigenic candidates should be identified to be employed in a more precise diagnosis of canine and human VL. In this light, the present study evaluated the diagnostic efficacy of the Leishmania infantum pyridoxal kinase (PK) protein, applied in its recombinant version (rPK). In addition, one specific B-cell epitope derived of the PK sequence was predicted, synthetized, and evaluated as diagnostic marker. Results in ELISA tests showed that the antigens were highly sensitive to VL identification in dogs and human sera, presenting a low reactivity with VL-related disease samples. The recombinant A2 (rA2) protein and L. infantum antigenic preparation (SLA), used as controls, also proved to be highly sensitive in detecting symptomatic cases, although a low sensitivity was found when asymptomatic sera were analyzed. High cross-reactivity was also found when these antigens were evaluated against VL-related disease samples. The post-therapeutic serological follow-up showed that anti-rPK and anti-peptide IgG antibody levels decreased in significant levels after treatment. By contrast, the presence of high levels of the anti-rA2 and anti-SLA antibodies was still detected after therapy. In conclusion, rPK and its specific B-cell epitope should be considered for future studies as a diagnostic marker for canine and human VL.
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Affiliation(s)
- João A Oliveira-da-Silva
- Programa de Pós-Graduação em Ciências da Saúde: Infectologia e Medicina Tropical, Faculdade de Medicina, Universidade Federal de Minas Gerais, Belo Horizonte, 30130-100, Minas Gerais, Brazil
| | - Amanda S Machado
- Programa de Pós-Graduação em Ciências da Saúde: Infectologia e Medicina Tropical, Faculdade de Medicina, Universidade Federal de Minas Gerais, Belo Horizonte, 30130-100, Minas Gerais, Brazil; Instituto de Ensino e Pesquisa, Santa Casa de Belo Horizonte. Rua Domingos Vieira, 590, Santa Efigênia, 30150-240, Belo Horizonte, Minas Gerais, Brazil
| | - Fernanda F Ramos
- Programa de Pós-Graduação em Ciências da Saúde: Infectologia e Medicina Tropical, Faculdade de Medicina, Universidade Federal de Minas Gerais, Belo Horizonte, 30130-100, Minas Gerais, Brazil
| | - Grasiele S V Tavares
- Programa de Pós-Graduação em Ciências da Saúde: Infectologia e Medicina Tropical, Faculdade de Medicina, Universidade Federal de Minas Gerais, Belo Horizonte, 30130-100, Minas Gerais, Brazil
| | - Daniela P Lage
- Programa de Pós-Graduação em Ciências da Saúde: Infectologia e Medicina Tropical, Faculdade de Medicina, Universidade Federal de Minas Gerais, Belo Horizonte, 30130-100, Minas Gerais, Brazil
| | - Fernanda Ludolf
- Programa de Pós-Graduação em Ciências da Saúde: Infectologia e Medicina Tropical, Faculdade de Medicina, Universidade Federal de Minas Gerais, Belo Horizonte, 30130-100, Minas Gerais, Brazil
| | - Bethina T Steiner
- Programa de Pós-Graduação em Ciências da Saúde, Universidade do Extremo Sul Catarinense, Criciúma, 88806-000, Santa Catarina, Brazil
| | - Thiago A R Reis
- Programa de Pós-Graduação em Ciências da Saúde: Infectologia e Medicina Tropical, Faculdade de Medicina, Universidade Federal de Minas Gerais, Belo Horizonte, 30130-100, Minas Gerais, Brazil
| | - Thaís T O Santos
- Programa de Pós-Graduação em Ciências da Saúde: Infectologia e Medicina Tropical, Faculdade de Medicina, Universidade Federal de Minas Gerais, Belo Horizonte, 30130-100, Minas Gerais, Brazil
| | - Lourena E Costa
- Programa de Pós-Graduação em Ciências da Saúde: Infectologia e Medicina Tropical, Faculdade de Medicina, Universidade Federal de Minas Gerais, Belo Horizonte, 30130-100, Minas Gerais, Brazil
| | - Vívian T Martins
- Programa de Pós-Graduação em Ciências da Saúde: Infectologia e Medicina Tropical, Faculdade de Medicina, Universidade Federal de Minas Gerais, Belo Horizonte, 30130-100, Minas Gerais, Brazil
| | - Nathália C Galvani
- Programa de Pós-Graduação em Ciências da Saúde: Infectologia e Medicina Tropical, Faculdade de Medicina, Universidade Federal de Minas Gerais, Belo Horizonte, 30130-100, Minas Gerais, Brazil
| | - Ana T Chaves
- Programa de Pós-Graduação em Ciências da Saúde: Infectologia e Medicina Tropical, Faculdade de Medicina, Universidade Federal de Minas Gerais, Belo Horizonte, 30130-100, Minas Gerais, Brazil
| | - Jamil S Oliveira
- Departamento de Bioquímica e Imunologia, Instituto de Ciências Biológicas, Universidade Federal de Minas Gerais, Belo Horizonte, 31270-901, Minas Gerais, Brazil
| | | | - Danielle F de Magalhães-Soares
- Departamento de Medicina Veterinária Preventiva, Escola de Veterinária, Universidade Federal de Minas Gerais, Belo Horizonte, 31270-901, Minas Gerais, Brazil
| | - Mariana C Duarte
- Programa de Pós-Graduação em Ciências da Saúde: Infectologia e Medicina Tropical, Faculdade de Medicina, Universidade Federal de Minas Gerais, Belo Horizonte, 30130-100, Minas Gerais, Brazil
| | - Daniel Menezes-Souza
- Programa de Pós-Graduação em Ciências da Saúde: Infectologia e Medicina Tropical, Faculdade de Medicina, Universidade Federal de Minas Gerais, Belo Horizonte, 30130-100, Minas Gerais, Brazil
| | - Julia A G Silveira
- Departamento de Parasitologia, Instituto de Ciências Biológicas, Universidade Federal de Minas Gerais, Belo Horizonte, 31270-901, Minas Gerais, Brazil
| | - Ricardo L F Moreira
- Fundação Hospitalar do Estado de Minas Gerais, Hospital Eduardo de Menezes, Belo Horizonte, 30622-020, Minas Gerais, Brazil
| | - Ricardo A Machado-de-Ávila
- Programa de Pós-Graduação em Ciências da Saúde, Universidade do Extremo Sul Catarinense, Criciúma, 88806-000, Santa Catarina, Brazil
| | - Unaí Tupinambás
- Programa de Pós-Graduação em Ciências da Saúde: Infectologia e Medicina Tropical, Faculdade de Medicina, Universidade Federal de Minas Gerais, Belo Horizonte, 30130-100, Minas Gerais, Brazil
| | - Denise U Gonçalves
- Programa de Pós-Graduação em Ciências da Saúde: Infectologia e Medicina Tropical, Faculdade de Medicina, Universidade Federal de Minas Gerais, Belo Horizonte, 30130-100, Minas Gerais, Brazil
| | - Eduardo A F Coelho
- Programa de Pós-Graduação em Ciências da Saúde: Infectologia e Medicina Tropical, Faculdade de Medicina, Universidade Federal de Minas Gerais, Belo Horizonte, 30130-100, Minas Gerais, Brazil.
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Environmental and socioeconomic risk factors associated with visceral and cutaneous leishmaniasis: a systematic review. Parasitol Res 2020; 119:365-384. [PMID: 31897789 DOI: 10.1007/s00436-019-06575-5] [Citation(s) in RCA: 57] [Impact Index Per Article: 14.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/17/2019] [Accepted: 12/10/2019] [Indexed: 12/11/2022]
Abstract
We performed a systematic review of the literature published since 1900 about leishmaniasis a neglected vector-borne disease, focused on environmental and social risk factors for visceral (VL) and cutaneous leishmaniasis (CL) to better understand their impact on the incidence of disease. The search terms were "leishmaniasis" AND "risk factors" using Google Scholar, PudMed, and Scielo. We reviewed 177 articles, 95 studies for VL, 75 for CL, and 7 on both forms. We identified 14 categories of risk factors which were divided into three groups: socioeconomic (7), environmental (5), and climate (2) variables. Socioeconomic factors were also associated with disease incidence in vulnerable human populations of arid and tropical developing regions. Environmental and climate factors showed significant associations with the incidence of VL and CL in all the studies that considered them. Proximity to natural vegetation remnants increased disease risk in both the New and Old World while the climate conditions favorable for disease transmission differed among regions. We propose a common conceptual framework for both clinical forms that highlights networks of interaction among risk factors. In both clinical forms, the interplay of these factors played a major role in disease incidence. Although there are similarities in environmental and socioeconomic conditions that mediate the transmission cycle of tropical, arid, and Mediterranean regions, the behavior of vector and reservoirs in each region is different. Special attention should be given to the possibility of vector adaptation to urban environments in developing countries where populations with low socioeconomic status are particularly vulnerable to the disease.
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29
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Space-time analysis of the incidence of human visceral leishmaniasis (VL) and prevalence of canine VL in a municipality of southeastern Brazil: Identification of priority areas for surveillance and control. Acta Trop 2019; 197:105052. [PMID: 31233726 DOI: 10.1016/j.actatropica.2019.105052] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/01/2019] [Revised: 06/01/2019] [Accepted: 06/01/2019] [Indexed: 12/13/2022]
Abstract
Human and canine visceral leishmaniasis (HVL and CVL, respectively) represent serious public health issues in Brazil. The surveillance and control measures currently employed have had limited effect in impeding the territorial expansion of the disease and in reducing the number of cases. We have investigated the space-time distribution of HVL incidence rates and CVL prevalence in the coverage areas of the 148 primary healthcare units in Belo Horizonte (MG, Brazil) during a 6-year period in order to identify those that should be prioritized for disease control actions. Data were smoothed using the empirical Bayes method and analyzed by space-time scanning and application of univariate global Moran's I index and local indicators of spatial association (LISA) statistics to identify spatial autocorrelations. Point data of CVL were analyzed using the Kernel method. Bivariate global Moran's I and LISA techniques were employed to identify spatial correlations between HVL and CVL. Based on our results, we were able to formulate two proposals for establishing the prioritization of coverage areas, namely: (i) classification of maximum priority areas as identified by bivariate LISA for HVL and CVL, and (ii) combination of maximum priority areas with high priority areas as identified by univariate LISA for HVL. According to our proposals, 27 coverage areas in Belo Horizonte were categorized as maximum priority and a further 13 were classified as high priority. Our proposals, which are based on practical, feasible and inexpensive statistical tools, will contribute to a better understanding of VL distribution in urban settings and improving the efficiency of governmental control programs.
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Moreno J. Assessment of Vaccine-Induced Immunity Against Canine Visceral Leishmaniasis. Front Vet Sci 2019; 6:168. [PMID: 31214607 PMCID: PMC6558161 DOI: 10.3389/fvets.2019.00168] [Citation(s) in RCA: 16] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/11/2019] [Accepted: 05/16/2019] [Indexed: 12/20/2022] Open
Abstract
Canine visceral leishmaniasis is an increasingly important public health problem. Dogs infected by Leishmania infantum are the main domestic reservoir of the parasite and play a key role in its transmission to humans. Recent findings have helped in the development of novel diagnostic methods, and of control measures such as vaccines, some of which are already commercially available. However, quantitative procedures should be followed to confirm whether these vaccines elicit a cell-mediated immune response. The present work describes the need for this evaluation, and the techniques available for confirming this type of immune response.
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Affiliation(s)
- Javier Moreno
- WHO Collaborating Centre for Leishmaniasis, Laboratory for Reference and Research in Parasitology, Centro Nacional de Microbiología, Instituto de Salud Carlos III, Majadahonda, Spain
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González MA, Bell MJ, Bernhardt SA, Brazil RP, Dilger E, Courtenay O, Hamilton JGC. Susceptibility of wild-caught Lutzomyia longipalpis (Diptera: Psychodidae) sand flies to insecticide after an extended period of exposure in western São Paulo, Brazil. Parasit Vectors 2019; 12:110. [PMID: 30871639 PMCID: PMC6419423 DOI: 10.1186/s13071-019-3364-4] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/01/2018] [Accepted: 02/26/2019] [Indexed: 11/30/2022] Open
Abstract
BACKGROUND In Brazil, members of the sand fly species complex Lutzomyia longipalpis transmit Leishmania infantum, a protist parasite that causes visceral leishmaniasis. Male Lu. longipalpis produce a sex pheromone that is attractive to both females and males. During a cluster randomised trial, to determine the combined effect of synthetic sex-aggregation pheromone and insecticide on Le. infantum transmission Lu. longipalpis had been continuously exposed to insecticide for 30 months. The objective of this study was to determine the effect of continuous exposure to the insecticides used in the trial on the susceptibility of Lu. longipalpis population. METHODS During the trial the sand flies had been exposed to either lambda-cyhalothrin [pheromone + residual insecticide spray (PI)], deltamethrin [dog collars (DC)] or no insecticide [control (C)], for 30 months (November 2012 to April 2015). The insecticide treatment regime was kept in place for an additional 12 months (May 2015-April 2016) during this susceptibility study. Sand flies collected from the field were exposed to WHO insecticide-impregnated papers cyhalothrin (0.05%), deltamethrin (0.5%) and control (silicone oil) in a modified WHO insecticide exposure trial to determine their susceptibility. RESULTS We collected 788 Lu. longipalpis using CDC-light traps in 31 municipalities across the three trial arms. Probit analysis showed that the knockdown times (KDTs) of Lu. longipalpis collected from the lambda-cyhalothrin exposed PI-arm [KDT50: 31.1 min, confidence interval (CI): 29.6-32.6 and KDT90: 44.2 min, CI: 42.1-46.7] were longer than the KDTs from the non-insecticide-treated C-arm (KDT50: 26.3 min, CI: 25.1-27.6 and KDT90: 38.2, CI: 36.5-40.2) (no-overlapping 95% CIs). KDTs of Lu. longipalpis collected from the deltamethrin exposed DC-arm had similar values (KDT50: 13.7 min, CI: 10.1-16.2 and KDT90: 26.7 min, CI: 21.8-30.6) to those for the C-arm (KDT50: 13.5 min; CI: 12.2-14.8 and KDT90: 23.2 min, CI: 21.4-25.4) (overlapping CIs). The wild-caught unexposed Lu. longipalpis (C-arm), took approximately twice as long to knock down as laboratory-colonised specimens for both insecticides. CONCLUSIONS Our study reveals slight changes in KDT, in sand flies after prolonged exposure to lambda-cyhalothrin in the presence of pheromone. These changes are not considered to have reached the reference levels indicative of resistance in sand flies suggesting that pheromone and insecticide treatment at the level indicated in this study do not constitute a significant risk of increased insecticide resistance. Prolonged exposure to deltamethrin in dog collars did not result in changes to KDT.
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Affiliation(s)
- Mikel A. González
- Division of Biomedical and Life Sciences, Faculty of Health and Medicine, Lancaster University, Lancashire, LA1 4YG UK
- Present Address: Departamento de Sanidad Animal, Instituto Vasco de Investigación y Desarrollo Agrario (NEIKER-Teknalia), Derio, 48160 Biscay Spain
| | - Melissa J. Bell
- Division of Biomedical and Life Sciences, Faculty of Health and Medicine, Lancaster University, Lancashire, LA1 4YG UK
| | | | - Reginaldo P. Brazil
- Laboratório de Doenças Parasitárias, Instituto Oswaldo Cruz, Fundaçao Oswaldo Cruz, Av. Brasil, Manguinhos, Rio de Janeiro, RJ 4365 Brazil
| | - Erin Dilger
- School of Life Sciences, University of Warwick, Coventry, CV4 7AL UK
| | - Orin Courtenay
- School of Life Sciences, University of Warwick, Coventry, CV4 7AL UK
| | - James G. C. Hamilton
- Division of Biomedical and Life Sciences, Faculty of Health and Medicine, Lancaster University, Lancashire, LA1 4YG UK
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Marcondes M, Day MJ. Current status and management of canine leishmaniasis in Latin America. Res Vet Sci 2019; 123:261-272. [PMID: 30708238 DOI: 10.1016/j.rvsc.2019.01.022] [Citation(s) in RCA: 53] [Impact Index Per Article: 10.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/18/2018] [Revised: 01/18/2019] [Accepted: 01/20/2019] [Indexed: 12/14/2022]
Abstract
Latin America encompasses diverse geographical, cultural and socio-economic conditions, which are reflected in the challenges for infectious disease control in the region. One of the most significant regional infectious diseases for humans and domestic dogs is leishmaniasis, occurring as visceral leishmaniasis (VL) caused by Leishmania infantum (syn. L. chagasi) transmitted by sand flies (Lutzomyia longipalpis) and with a canine reservoir, and the more common cutaneous leishmaniasis (CL) involving multiple Leishmania spp. (particularly L. braziliensis), sand fly vectors and reservoir hosts. VL is spreading within Latin America for reasons related to mass migration of human and canine populations, with incursion into novel environments (e.g. related to deforestation) coupled with a background of poverty and poor public health infrastructure. The challenges for control of VL also include: (1) the accurate identification of infected dogs (particularly subclinically infected dogs) with the current reliance on serological rather than molecular diagnostic methods, (2) controversy surrounding the ethics and efficacy of culling of seropositive dogs, (3) the limited efficacy of currently available canine vaccines and their potential to interfere with interpretation of serological testing, (4) the expense associated with distribution of insecticidal dog collars, which may prove to be the most valuable control method, and (5) the cost and therefore accessibility of licensed medical treatment for canine leishmaniasis by the general population. Resolution of these isssues will necessitate a 'One Health' approach to co-ordination of resources between human and veterinary healthcare.
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Affiliation(s)
- Mary Marcondes
- São Paulo State University (Unesp), School of Veterinary Medicine, Araçatuba, 16050-680 Araçatuba, São Paulo, Brazil.
| | - Michael J Day
- School of Veterinary and Life Sciences, Murdoch University, Murdoch, Australia
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Sex-Related Differences in Immune Response and Symptomatic Manifestations to Infection with Leishmania Species. J Immunol Res 2019; 2019:4103819. [PMID: 30756088 PMCID: PMC6348913 DOI: 10.1155/2019/4103819] [Citation(s) in RCA: 34] [Impact Index Per Article: 6.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/25/2018] [Revised: 10/22/2018] [Accepted: 12/11/2018] [Indexed: 12/19/2022] Open
Abstract
Worldwide, an estimated 12 million people are infected with Leishmania spp. and an additional 350 million are at risk of infection. Leishmania are intracellular parasites that cause disease by suppressing macrophage microbicidal responses. Infection can remain asymptomatic or lead to a spectrum of diseases including cutaneous, mucocutaneous, and visceral leishmaniasis. Ultimately, the combination of both pathogen and host factors determines the outcome of infection. Leishmaniasis, as well as numerous other infectious diseases, exhibits sex-related differences that cannot be explained solely in terms of environmental exposure or healthcare access. Furthermore, transcriptomic evidence is revealing that biological sex is a variable impacting physiology, immune response, drug metabolism, and consequently, the progression of disease. Herein, we review the distribution, morbidity, and mortality among male and female leishmaniasis patients. Additionally, we discuss experimental findings and new avenues of research concerning sex-specific responses in cutaneous and visceral leishmaniasis. The limitations of current therapies and the emergence of drug-resistant parasites underscore the need for new treatments that could harness the host immune response. As such, understanding the mechanisms driving the differential immune response and disease outcome of males versus females is a necessary step in the development of safer and more effective treatments against leishmaniasis.
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Salles BC, Dias DS, Steiner BT, Lage DP, Ramos FF, Ribeiro PA, Santos TT, Lima MP, Costa LE, Chaves AT, Chávez-Fumagalli MA, Fujiwaraa RT, Buenoa LL, Caligiorne RB, de Magalhães-Soares DF, Silveira JA, Machado-de-Ávila RA, Gonçalves DU, Coelho EA. Potential application of small myristoylated protein-3 evaluated as recombinant antigen and a synthetic peptide containing its linear B-cell epitope for the serodiagnosis of canine visceral and human tegumentary leishmaniasis. Immunobiology 2019; 224:163-171. [DOI: 10.1016/j.imbio.2018.09.003] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/06/2018] [Revised: 09/10/2018] [Accepted: 09/19/2018] [Indexed: 12/31/2022]
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Rodríguez NE, Lima ID, Gaur Dixit U, Turcotte EA, Lockard RD, Batra-Sharma H, Nascimento EL, Jeronimo SMB, Wilson ME. Epidemiological and Experimental Evidence for Sex-Dependent Differences in the Outcome of Leishmania infantum Infection. Am J Trop Med Hyg 2018; 98:142-145. [PMID: 29165220 DOI: 10.4269/ajtmh.17-0563] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022] Open
Abstract
Leishmania infantum causes visceral leishmaniasis (VL) in Brazil. We previously observed that VL is more common in males than females living in endemic neighborhoods, despite similar exposure. Using a larger sample, we document that VL is more common in males than females, but only after puberty. BALB/c and C57BL/6 mouse models confirmed that there is a biological basis for male susceptibility to symptomatic VL, showing higher parasite burdens in males than females. Female C57BL/6 mice generated more antigen-induced cytokines associated with curative responses (interferon-γ, interleukin [IL]-1β). Males expressed higher levels of IL-10 and tumor necrosis factor, which are linked to exacerbated disease. Different parasite lines entered or survived at a higher rate in macrophages of male- than female-origin. These results suggest that males are inherently more susceptible to L. infantum than females and that mice are a valid model to study this sex-dependent difference.
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Affiliation(s)
- Nilda E Rodríguez
- Department of Biology, University of Northern Iowa, Cedar Falls, Iowa
| | - Iraci D Lima
- Health Science Post-Graduate Program, Health Science Center, Federal University of Rio Grande do Norte, Natal, Brazil.,Fundação Nacional de Saúde, Secretaria de Saúde do Estado do Rio Grande do Norte, Natal, Brazil
| | - Upasna Gaur Dixit
- Department of Internal Medicine, University of Iowa, Iowa City, Iowa
| | | | - Ryan D Lockard
- Department of Biology, University of Northern Iowa, Cedar Falls, Iowa
| | | | - Eliana L Nascimento
- Institute of Tropical Medicine of Rio Grande do Norte, Federal University of Rio Grande do Norte, Natal, Brazil.,Department of Biochemistry, Federal University of Rio Grande do Norte, Natal, Brazil.,Health Science Post-Graduate Program, Health Science Center, Federal University of Rio Grande do Norte, Natal, Brazil
| | - Selma M B Jeronimo
- National Institute of Science and Technology of Tropical Diseases, Salvador, Brazil.,Health Science Post-Graduate Program, Health Science Center, Federal University of Rio Grande do Norte, Natal, Brazil.,Institute of Tropical Medicine of Rio Grande do Norte, Federal University of Rio Grande do Norte, Natal, Brazil.,Department of Biochemistry, Federal University of Rio Grande do Norte, Natal, Brazil
| | - Mary E Wilson
- Veterans' Affairs Medical Center, Iowa City, Iowa.,Department of Microbiology, University of Iowa, Iowa City, Iowa.,Department of Internal Medicine, University of Iowa, Iowa City, Iowa
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Gomez SA, Chapman LAC, Dilger E, Courtenay O, Picado A. Estimating the efficacy of community-wide use of systemic insecticides in dogs to control zoonotic visceral leishmaniasis: A modelling study in a Brazilian scenario. PLoS Negl Trop Dis 2018; 12:e0006797. [PMID: 30222756 PMCID: PMC6160230 DOI: 10.1371/journal.pntd.0006797] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/08/2018] [Revised: 09/27/2018] [Accepted: 08/28/2018] [Indexed: 12/31/2022] Open
Abstract
Systemic insecticides in dogs have been suggested as a public health intervention to prevent human cases of Zoonotic Visceral Leishmaniasis (ZVL). But, currently there are no systemic insecticides for dogs registered against zoo-anthropophilic pool blood feeding phlebotomine flies. We predict the impact of community-wide use of systemic insecticide in dog populations as a public health measure to control transmission of Leishmania infantum to humans using a mathematical model. We developed a Susceptible-Exposed-Infected (SEI) compartmental model to describe L. infantum transmission dynamics in dogs, with a vectorial capacity term to represent transmission between L. infantum-hosting dogs via phlebotomine flies. For Infected (I) dogs two levels of infectiousness were modelled, high infectiousness and low infectiousness. Human incidence was estimated through its relationship to infection in the dog population. We evaluated outcomes from a wide range of scenarios comprising different combinations of initial insecticide efficacy, duration of insecticide efficacy over time, and proportion of the dog population treated (60%, 70% & 80%). The same reduction in human infection incidence can be achieved via different combinations of insecticide efficacy, duration and dog coverage. For example, a systemic insecticide with an initial efficacy of 80% and 6 months above 65% efficacy would require treating at least 70% of the dogs to reduce the human infection incidence by 50%. Sensitivity analysis showed that the model outcome was most sensitive to baseline values of phlebotomine fly daily survival rate and insecticide coverage. Community-wide use of systemic insecticides applied to the “L. infantum canine reservoir” can significantly reduce human incidence of L. infantum infection. The results of this mathematical model can help defining the insecticide target product profile and how the insecticide should be applied to maximise effectiveness. Zoonotic visceral leishmaniasis (ZVL) is a potentially deadly disease in humans caused by Leishmania infantum. This leishmania species can be delivered by pool blood feeding zoo-anthropophilic phlebotomine flies to several mammals, the dog population being recognized as the main reservoir. Transmission from infected dogs to humans is through the bite of female phlebotomine sand flies. The disease is endemic in several countries and Brazil has a high prevalence of cases with over 3000 ZVL cases reported per year. The main, inefficient and highly controversial, control measure in Brazil has been culling sero-positive dogs. The community-wide use of systemic insecticides in dogs could be an alternative to control L. infantum transmission from phlebotomine flies to humans. The rationale is that phlebotomine flies which sampled their blood meals from dogs treated with systemic insecticides would die reducing the risk of L. infantum transmission. To reduce the number of ZVL cases, a large proportion of dogs in the community should be treated and the systemic insecticide used should be effective in killing phlebotomine flies acting as vectors of L. infantum parasites for a significant amount of time. We used a mathematical model mimicking L. infantum transmission to show that this novel vector control strategy could be effective. We identified the combination of different key parameters (e.g. insecticide efficacy, duration and proportion of dogs treated) that could lead to a significant reduction of the risk of L. infantum infection in humans.
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Affiliation(s)
- Sonia A. Gomez
- ISGlobal-Hospital Clínic, Universitat de Barcelona, Barcelona, Spain
- * E-mail: (AP); (SAG)
| | - Lloyd A. C. Chapman
- Department of Global Health and Development, London School of Hygiene and Tropical Medicine, London, United Kingdom
- School of Life Sciences, University of Warwick, Gibbet Hill Campus, Coventry, United Kingdom
| | - Erin Dilger
- School of Life Sciences, University of Warwick, Gibbet Hill Campus, Coventry, United Kingdom
| | - Orin Courtenay
- School of Life Sciences, University of Warwick, Gibbet Hill Campus, Coventry, United Kingdom
| | - Albert Picado
- ISGlobal-Hospital Clínic, Universitat de Barcelona, Barcelona, Spain
- * E-mail: (AP); (SAG)
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Bezerra JMT, de Araújo VEM, Barbosa DS, Martins-Melo FR, Werneck GL, Carneiro M. Burden of leishmaniasis in Brazil and federated units, 1990-2016: Findings from Global Burden of Disease Study 2016. PLoS Negl Trop Dis 2018; 12:e0006697. [PMID: 30188898 PMCID: PMC6126835 DOI: 10.1371/journal.pntd.0006697] [Citation(s) in RCA: 42] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/06/2018] [Accepted: 07/17/2018] [Indexed: 12/15/2022] Open
Abstract
BACKGROUND The study presents estimates for the burden of visceral leishmaniasis (VL) and cutaneous and mucocutaneous leishmaniasis (CML) in Brazil and its 27 federated units using data from the Global Burden of Disease Study (GBD) 2016. METHODOLOGY We report the incidence, years of life lost (YLL), years lived with disability (YLD), and disability-adjusted life years (DALY) for leishmaniasis in Brazil from 1990 to 2016. The metrics are presented as age-standardized rates per 100,000 inhabitants with their respective uncertainty intervals (95%UI) and relative percentages of change. PRINCIPAL FINDINGS The age-standardized incidence rate of leishmaniasis decreased 48.5% from 1990 (71.0, 95%UI 24.3-150.7) to 2016 (36.5, 95%UI 24.7-50.9), whereas the age-standardized DALY increased 83.6% over the studied period from 12.2 (95%UI 7.9-18.8) to 22.4 (95%UI 13.3-36.2). The age-standardized incidence rate and YLL for VL increased by 52.9% and 108% from 1990 to 2016, respectively. Considering CML, the age-standardized incidence rate and YLD decreased by 51% and 31.8% respectively for the same period. For VL, similar profiles for male and female were observed, with YLL and DALY increasing over time; with males presenting slightly higher values. The highest YLL rates were among "under 1-year old" children, which increased 131.2% from 1990 to 2016. Regarding CML, the highest values of YLD and DALY were verified among males, and YLD values showed a similar profile, with rates increasing with age. The VL burden increased in some states in the Northeast and Southeast regions and decreased for CML in some Northern states. CONCLUSION The increase of VL burden over the study period might be associated with the difficulties in controlling the disease spread. Information regarding the weight of VL and CML, including the death and disability tolls that they cause, highlights the impact of these neglected diseases on public health and the importance of effective prevention and treatment.
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Affiliation(s)
- Juliana Maria Trindade Bezerra
- Epidemiology of Infectious and Parasitic Diseases Laboratory, Department of Parasitology, Institute of Biological Sciences, Universidade Federal de Minas Gerais, Belo Horizonte, Minas Gerais, Brazil
- * E-mail:
| | | | - David Soeiro Barbosa
- Epidemiology of Infectious and Parasitic Diseases Laboratory, Department of Parasitology, Institute of Biological Sciences, Universidade Federal de Minas Gerais, Belo Horizonte, Minas Gerais, Brazil
| | - Francisco Rogerlândio Martins-Melo
- Federal Institute of Education, Science and Technology of Ceará, Caucaia, Ceará, Brazil
- Institute for Public Health Studies, Universidade Federal do Rio de Janeiro, Rio de Janeiro, Rio de Janeiro, Brazil
| | - Guilherme Loureiro Werneck
- Institute for Public Health Studies, Universidade Federal do Rio de Janeiro, Rio de Janeiro, Rio de Janeiro, Brazil
| | - Mariângela Carneiro
- Epidemiology of Infectious and Parasitic Diseases Laboratory, Department of Parasitology, Institute of Biological Sciences, Universidade Federal de Minas Gerais, Belo Horizonte, Minas Gerais, Brazil
- Post-Graduation Program in Health Sciences, Infectology and Tropical Medicine, Universidade Federal de Minas Gerais, Belo Horizonte, Minas Gerais, Brazil
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Costa DNCC, Blangiardo M, Rodas LAC, Nunes CM, Hiramoto RM, Tolezano JE, Bonfietti LX, Bermudi PMM, Cipriano RS, Cardoso GCD, Codeço CT, Chiaravalloti-Neto F. Canine visceral leishmaniasis in Araçatuba, state of São Paulo, Brazil, and its relationship with characteristics of dogs and their owners: a cross-sectional and spatial analysis using a geostatistical approach. BMC Vet Res 2018; 14:229. [PMID: 30124171 PMCID: PMC6102874 DOI: 10.1186/s12917-018-1550-9] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/14/2018] [Accepted: 07/20/2018] [Indexed: 11/25/2022] Open
Abstract
Background The incidence of visceral leishmaniasis (VL), one of the most important neglected diseases worldwide, is increasing in Brazil. The objectives of this study were to determine the canine VL (CanL) seroprevalence in an urban area of Araçatuba municipality and to evaluate its relationship with the characteristics of dogs and their owners. Results The CanL seroprevalence in the study area was 0.081 (95% credible interval [CI]: 0.068–0.096). The following covariates/categories were positively associated with the occurrence of a seropositive dog: more than 10 dogs that had lived in the house (odds ratio [OR] = 2.36; 95% CI: 1.03–5.43) (baseline: 0–10 dogs); house with dogs that previously died of VL (OR = 4.85; 95% CI: 2.65–8.86) or died of causes other than old age (OR = 2.26; 95% CI: 1.12–4.46) (baseline: natural or no deaths); dogs that spent the day in a sheltered backyard (OR = 2.14; 95% CI: 1.05–4.40); dogs that spent the day in an unsheltered backyard or the street (OR = 2.67; 95% CI: 1.28–5.57) (baseline: inside home). Spatial dependence among observations occurred within about 45.7 m. Conclusions The number of dogs that had lived in the house, previous deaths by VL or other cause, and the place the dog stayed during the day were associated with the occurrence of a VL seropositive dog. The short-distance spatial dependence could be related to the vector characteristics, producing a local neighbourhood VL transmission pattern. The geostatistical approach in a Bayesian context using integrated nested Laplace approximation (INLA) allowed to identify the covariates associated with VL, including its spatially dependent transmission pattern. Electronic supplementary material The online version of this article (10.1186/s12917-018-1550-9) contains supplementary material, which is available to authorized users.
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Affiliation(s)
| | - Marta Blangiardo
- MRC-PHE Centre for Environment and Health, Department of Epidemiology and Biostatistics, Imperial College, St. Mary's Campus, Norfolk Place, London, W2 1PG, UK
| | | | - Caris Maroni Nunes
- Laboratório de Bioquímica e Biologia Molecular, Departamento de Apoio Produção e Saúde Animal, Faculdade de Medicina Veterinária de Araçatuba, Unesp, Rua Clóvis Pestana 793, Araçatuba, SP, 16050-680, Brazil
| | - Roberto Mitsuyoshi Hiramoto
- Núcleo de Parasitoses Sistêmicas, Instituto Adolfo Lutz, Av. Doutor Arnaldo 355, 8o. Andar, São Paulo, SP, 01246-000, Brazil
| | - José Eduardo Tolezano
- Núcleo de Parasitoses Sistêmicas, Instituto Adolfo Lutz, Av. Doutor Arnaldo 355, 8o. Andar, São Paulo, SP, 01246-000, Brazil
| | - Lucas Xavier Bonfietti
- Cento de Laboratório Regional I Araçatuba, Instituto Adolfo Lutz, R. Minas Gerais 135, Araçatuba, SP, 16010-330, Brazil
| | - Patricia Marques Moralejo Bermudi
- Programa de Pós-graduação em Saúde Pública, Faculdade de Saúde Pública, USP, Avenida Doutor Arnaldo 715, São Paulo, SP, 01246-904, Brazil
| | - Rafael Silva Cipriano
- Centro de Controle de Zoonozes, Rua Doutor Luiz de Almeida 145, Araçatuba, SP, 16050-203, Brazil
| | | | - Cláudia Torres Codeço
- Programa de Computação Científica, Fundação Oswaldo Cruz, Avenida Brasil 4365, Antiga Residência Oficial, Rio de Janeiro, RJ, 21045-900, Brazil
| | - Francisco Chiaravalloti-Neto
- Departamento de Epidemiologia, Faculdade de Saúde Pública, Universidade de São Paulo (USP), Avenida Doutor Arnaldo 715, São Paulo, SP, 01246-904, Brazil.
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Dalvi APR, Carvalho TDGD, Werneck GL. Is There an Association Between Exposure to Cats and Occurrence of Visceral Leishmaniasis in Humans and Dogs? Vector Borne Zoonotic Dis 2018; 18:335-342. [DOI: 10.1089/vbz.2017.2162] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Affiliation(s)
- Ana Paula Razal Dalvi
- Department of Epidemiology, State University of Rio de Janeiro, Rio de Janeiro, Brazil
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Bruhn FRP, Morais MHF, Cardoso DL, Bruhn NCP, Ferreira F, Rocha CMBMD. Spatial and temporal relationships between human and canine visceral leishmaniases in Belo Horizonte, Minas Gerais, 2006-2013. Parasit Vectors 2018; 11:372. [PMID: 29954428 PMCID: PMC6022701 DOI: 10.1186/s13071-018-2877-6] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/18/2017] [Accepted: 04/29/2018] [Indexed: 11/25/2022] Open
Abstract
BACKGROUND Visceral leishmaniasis is a serious public health problem in Brazil, and control of this disease constitutes a major challenge. The purpose of this study was to assess the existing spatial and temporal relationships between cases of canine visceral leishmaniasis (CanL) and human visceral leishmaniasis (HVL) recorded in Belo Horizonte, State of Minas Gerais, from 2006 to 2013. METHODS Data provided by the Belo Horizonte Health Services regarding the disease control routine were analyzed in order to perform a retrospective observational and ecological study. Information regarding the incidence rate of HVL and canine seroprevalence was examined in relation to control actions performed atthe 148 coverage areas of healthcare centers for the period between 2006 and 2013. A time series analysis was performed using the Gretl 1.9.12 software followed by the assessment of the existing increasing or declining trend and seasonality in the occurrence of CanL and HVL. Autoregressive integrated moving average (ARIMA) models were adjusted, intervention analysis was performed, vector autoregressive models were developed, and Granger causality was used for testing temporal relationships between variables. The hot spot analysis tool was used for cluster identification through Getis-OrdGi statistics. The ArcGis for desktop 10.2.1 software was used for spatial analysis. RESULTS We identified 866 HVL cases in Belo Horizonte between 2006 and 2013. The mean proportion of canine seroprevalence (PCP) was 7.31% and the mean proportion of monitored hosts (PMH) was 6.73%.HVL and PCP showed a decreasing trend, while PMH increased over time (P<0.05). Vector Autoregressive (VAR) and Granger analysis showed a temporal relation between CanL and HVL cases. Maps illustrating the spatial distribution of cases and obituaries of HVL and CanL cases also showed an apparent association between the occurrence of leishmaniasis in humans, and data about canine cases recorded in the previous years. CONCLUSIONS Cases of HVL were preceded by PMH and PCP cases. Similar results were observed for intraspecific cases (i.e. between PCP and other canine cases and between HVL and other HVL cases), which indicated the existence of favorable environmental conditions for the transmission and spread of L. infantum in Belo Horizonte.
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Affiliation(s)
- Fábio Raphael Pascoti Bruhn
- Federal University of Pelotas (UFPel), Department of Preventive Veterinary, Zoonosis Control Center of UFPel, Capão do Leão, Rio Grande do Sul Brazil
| | | | - Denis Lucio Cardoso
- Department of Preventive Veterinary, Federal University of Lavras (UFLA), Belo Horizonte, Minas Gerais Brazil
| | - Nádia Campos Pereira Bruhn
- Center of Mercosul Integration, Federal University of Pelotas (UFPel), Pelotas, Rio Grande do Sul Brazil
| | - Fernando Ferreira
- Department of Preventive Veterinary Medicine and Animal Health, School of Veterinary Medicine, University of São Paulo, São Paulo, Brazil
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Batista LFS, Utsunomiya YT, Silva TBF, Carneiro MM, Paiva JSF, Silva RB, Tomokane TY, Rossi CN, Pacheco AD, Torrecilha RBP, Silveira FT, Marcondes M, Nunes CM, Laurenti MD. Canine leishmaniasis: Genome-wide analysis and antibody response to Lutzomyia longipalpis saliva. PLoS One 2018; 13:e0197215. [PMID: 29742167 PMCID: PMC5942812 DOI: 10.1371/journal.pone.0197215] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/07/2018] [Accepted: 04/27/2018] [Indexed: 01/22/2023] Open
Abstract
The anti-inflammatory properties of sand fly saliva favor the establishment of the Leishmania infantum infection. In contrast, an antibody response against Lutzomyia longipalpis saliva is often associated with a protective cell-mediated response against canine visceral leishmaniasis. Genetic studies may demonstrate to what extent the ability to secrete anti-saliva antibodies depends on genetic or environmental factors. However, the genetic basis of canine antibody response against sand fly saliva has not been assessed. The aim of this study was to identify chromosomal regions associated with the anti-Lu. longipalpis salivary IgG response in 189 dogs resident in endemic areas in order to provide information for prophylactic strategies. Dogs were classified into five groups based on serological and parasitological diagnosis and clinical evaluation. Anti-salivary gland homogenate (SGH) IgG levels were assessed by Enzyme-Linked Immunosorbent Assay (ELISA). Genomic DNA was isolated from blood samples and genotyped using a SNP chip with 173,662 single nucleotide polymorphism (SNP) markers. The following linear regression model was fitted: IgG level = mean + origin + sex + age + use of a repellent collar, and the residuals were assumed as pseudo-phenotypes for the association test between phenotypes and genotypes (GWA). A component of variance model that takes into account polygenic and sample structure effects (EMMAX) was employed for GWA. Phenotypic findings indicated that anti-SGH IgG levels remained higher in exposed and subclinically infected dogs than in severely diseased dogs even in regression model residuals. Five associated markers were identified on chromosomes 2, 20 and 31. The mapped genes included CD180 (RP105) and MITF related to the rapid activation of B lymphocytes and differentiation into antibody-secreting plasma cells. The findings pointed to chromosomal segments useful for functional confirmation studies and a search for adjuvant molecules of the anti-saliva response.
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Affiliation(s)
- Luís F. S. Batista
- Departamento de Patologia Veterinária, Faculdade de Medicina Veterinária e Zootecnia, Universidade de São Paulo, São Paulo, Brazil
- Escola de Saúde, Universidade Salvador, Salvador, Bahia, Brazil
| | - Yuri T. Utsunomiya
- Departamento de Medicina Veterinária Preventiva e Reprodução Animal, Faculdade de Ciências Agrárias e Veterinárias, Univ Estadual Paulista, Jaboticabal, São Paulo, Brazil
| | - Thaís B. F. Silva
- Laboratório de Patologia de Doenças Infecciosas, Faculdade de Medicina, Universidade de São Paulo, São Paulo, Brazil
| | | | | | | | - Thaíse Y. Tomokane
- Laboratório de Patologia de Doenças Infecciosas, Faculdade de Medicina, Universidade de São Paulo, São Paulo, Brazil
| | - Claudio N. Rossi
- Departmento de Clínica, Faculdade de Medicina Veterinária e Zootecnia, Universidade de São Paulo, São Paulo, Brazil
| | - Acácio D. Pacheco
- Departamento de Clínica, Cirurgia e Reprodução Animal, Faculdade de Medicina Veterinária, Univ Estadual Paulista, Araçatuba, São Paulo, Brazil
| | - Rafaela B. P. Torrecilha
- Departamento de Medicina Veterinária Preventiva e Reprodução Animal, Faculdade de Ciências Agrárias e Veterinárias, Univ Estadual Paulista, Jaboticabal, São Paulo, Brazil
| | - Fernando T. Silveira
- Deparatmento de Parasitologia, Instituto Evandro Chagas, Ananindeua, Pará, Brazil
| | - Mary Marcondes
- Departamento de Clínica, Cirurgia e Reprodução Animal, Faculdade de Medicina Veterinária, Univ Estadual Paulista, Araçatuba, São Paulo, Brazil
| | - Cáris M. Nunes
- Departmento de Saúde Animal e Produção, Faculdade de Medicina Veterinária, Univ Estadual Paulista, Araçatuba, São Paulo, Brazil
| | - Márcia D. Laurenti
- Laboratório de Patologia de Doenças Infecciosas, Faculdade de Medicina, Universidade de São Paulo, São Paulo, Brazil
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da Silva AVA, Figueiredo FB, Menezes RC, Mendes-Junior AA, de Miranda LHM, Cupolillo E, Porrozzi R, Morgado FN. Morphophysiological changes in the splenic extracellular matrix of Leishmania infantum-naturally infected dogs is associated with alterations in lymphoid niches and the CD4+ T cell frequency in spleens. PLoS Negl Trop Dis 2018; 12:e0006445. [PMID: 29677186 PMCID: PMC5931683 DOI: 10.1371/journal.pntd.0006445] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/11/2017] [Revised: 05/02/2018] [Accepted: 04/11/2018] [Indexed: 12/05/2022] Open
Abstract
The spleen is one of the main affected organs in canine visceral leishmaniasis (CVL). Disorganization of the splenic white pulp (SWP) has been associated with immunosuppression and disease progression. This study aims to assess structural and cellular changes in the splenic extracellular matrix of dogs with CVL, correlating these changes with the parasite load and clinical signs. Splenic fragments were collected from 41 naturally infected animals for parasite load quantification by quantitative PCR, histopathological analysis and immunohistochemistry for CD3+, CD4+, and CD8+ T cells; CD21+ B cells; Ki-67+, IFN-γ+, and IL-10+ cells; and the MMP-9 and ADAM-10 enzymes. Laminin, collagen and fibronectin deposition were also evaluated. The animals were grouped according to the level of SWP organization. SWP disorganization was accompanied by a reduction in the quantity of lymphoid follicles/mm2 (p > 0.0001). Animals with moderate to intense SWP disorganization showed more clinical signs (p = 0.021), higher laminin (p = 0.045) and collagen deposition (p = 0.036), higher MMP-9 expression (p = 0.035) and lower numbers of CD4+ T cells (p = 0.027) in the spleen than the animals with organized SWP. These data suggest that splenic structure and function are drastically altered and compromised during CVL. Infected dogs play important roles in the transmission of visceral leishmaniasis. These dogs are considered reservoirs of parasites in urban areas and fail to mount an efficient anti-Leishmania immune response. However, the specific immunosuppression profile is not completely understood. In our report, we evaluate and discuss the morphophysiological alterations in the spleens of dogs with visceral leishmaniasis. We found an association between extracellular matrix alterations and a failure to control the parasite load. We suggest a role for these alterations in hindering an immune response that is otherwise able to control the parasite load, thereby leading to disease progression. Our research contributes to the current knowledge of the immunopathology of canine visceral leishmaniasis.
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Affiliation(s)
- Aurea Virginia Andrade da Silva
- Laboratório de Pesquisas em Leishmaniose, Instituto Oswaldo Cruz, Fundação Oswaldo Cruz, Rio de Janeiro, Rio de Janeiro, Brazil
- Graduate student of the Masters Program in Cellular and Molecular Biology, Instituto Oswaldo Cruz, Fundação Oswaldo Cruz, Rio de Janeiro, Rio de Janeiro, Brazil
| | - Fabiano Borges Figueiredo
- Laboratório de Pesquisa Clínica em Dermatozoonoses em Animais Domésticos, Instituto Nacional de Infectologia Evandro Chagas, Fundação Oswaldo Cruz, Rio de Janeiro, Rio de Janeiro, Brazil
| | - Rodrigo Caldas Menezes
- Laboratório de Pesquisa Clínica em Dermatozoonoses em Animais Domésticos, Instituto Nacional de Infectologia Evandro Chagas, Fundação Oswaldo Cruz, Rio de Janeiro, Rio de Janeiro, Brazil
| | - Arthur Augusto Mendes-Junior
- Laboratório de Pesquisa Clínica em Dermatozoonoses em Animais Domésticos, Instituto Nacional de Infectologia Evandro Chagas, Fundação Oswaldo Cruz, Rio de Janeiro, Rio de Janeiro, Brazil
| | - Luisa Helena Monteiro de Miranda
- Laboratório de Pesquisa Clínica em Dermatozoonoses em Animais Domésticos, Instituto Nacional de Infectologia Evandro Chagas, Fundação Oswaldo Cruz, Rio de Janeiro, Rio de Janeiro, Brazil
| | - Elisa Cupolillo
- Laboratório de Pesquisas em Leishmaniose, Instituto Oswaldo Cruz, Fundação Oswaldo Cruz, Rio de Janeiro, Rio de Janeiro, Brazil
| | - Renato Porrozzi
- Laboratório de Pesquisas em Leishmaniose, Instituto Oswaldo Cruz, Fundação Oswaldo Cruz, Rio de Janeiro, Rio de Janeiro, Brazil
| | - Fernanda Nazaré Morgado
- Laboratório de Pesquisas em Leishmaniose, Instituto Oswaldo Cruz, Fundação Oswaldo Cruz, Rio de Janeiro, Rio de Janeiro, Brazil
- * E-mail:
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43
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Dias Tourinho B, Figueiredo Amâncio F, Lencine Ferraz M, Carneiro M. Prognostic factors for death from visceral leishmaniasis in patients treated with liposomal amphotericin B in an endemic state in Brazil. Trans R Soc Trop Med Hyg 2018; 111:163-171. [PMID: 28673017 DOI: 10.1093/trstmh/trx029] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/13/2017] [Accepted: 05/31/2017] [Indexed: 11/14/2022] Open
Abstract
Objective To characterize the clinical and epidemiological profiles of patients with visceral leishmaniasis (VL) treated with liposomal amphotericin B (LAmB) and to identify prognostic factors for death from VL in 2008-2012 in the state of Minas Gerais, Brazil. Methods A historical cohort study was conducted using data obtained from treatment requests forms, Brazilian Notifiable Disease Information System and the Mortality Information System. Case-fatality rates of patients with VL treated with LAmB were compared with patients treated with other therapies. Logistic regression analysis was used to identify prognostic factors for death. Results The overall case-fatality rate of the 577 patients treated with LAmB was 19.4%. Prognostic factors for death from VL were age between 35 and 49 years (OR 2.7; 95% CI 1.3-5.4) and above 50 years (OR 2.6; 95% CI 1.3-4.9), jaundice (OR 2.2; 95% CI 1.2-3.7), kidney disease (OR 2.8; 95% CI 1.6-4.9), presence of other infections (OR 2.4; 95% CI 1.5-4.1), edema (OR 2.0; 95% CI 1.1-3.4), platelet count below 50.000/mm3 (OR 3.6; 95% CI 2.1-6.0), AST higher than 100 U/L (OR 2.2; 95% CI 1.3-3.8), and assistance in non-specialized institutions (OR 1.9; 95% CI 1.0-3.5). Conclusions Case-fatality rates were higher than that observed among patients with VL treated with other therapies. Identification of prognostic factors of death from VL may allow early diagnosis of patients prone to such outcome and prompt an expeditious and appropriate management of VL to reduce fatality rates.
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Affiliation(s)
- Bruna Dias Tourinho
- Programa de Pós Graduação em Ciências da Saúde, Infectologia e Medicina Tropical, Faculdade de Medicina, Universidade Federal de Minas Gerais, 30130 Belo Horizonte, Brazil.,Diretoria de Vigilância Ambiental, Superintendência de Vigilância Epidemiológica, Ambiental e Saúde do Trabalhador, Subsecretaria de Vigilância em Saúde, Secretaria de Estado de Saúde de Minas Gerais, 30130 Belo Horizonte, Minas Gerais, Brazil.,Laboratório de Epidemiologia de Doenças Infecciosas e Parasitárias, Departamento de Parasitologia, Instituto de Ciências Biológicas, Universidade Federal de Minas Gerais, 30130 Belo Horizonte, Minas Gerais, Brazil
| | | | - Marcela Lencine Ferraz
- Diretoria de Vigilância Ambiental, Superintendência de Vigilância Epidemiológica, Ambiental e Saúde do Trabalhador, Subsecretaria de Vigilância em Saúde, Secretaria de Estado de Saúde de Minas Gerais, 30130 Belo Horizonte, Minas Gerais, Brazil
| | - Mariângela Carneiro
- Programa de Pós Graduação em Ciências da Saúde, Infectologia e Medicina Tropical, Faculdade de Medicina, Universidade Federal de Minas Gerais, 30130 Belo Horizonte, Brazil.,Laboratório de Epidemiologia de Doenças Infecciosas e Parasitárias, Departamento de Parasitologia, Instituto de Ciências Biológicas, Universidade Federal de Minas Gerais, 30130 Belo Horizonte, Minas Gerais, Brazil
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44
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Bruhn FRP, Morais MHF, Bruhn NCP, Cardoso DL, Ferreira F, Rocha CMBM. Human visceral leishmaniasis: factors associated with deaths in Belo Horizonte, Minas Gerais state, Brazil from 2006 to 2013. Epidemiol Infect 2018; 146:565-570. [PMID: 29463341 PMCID: PMC9134532 DOI: 10.1017/s0950268818000109] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/10/2017] [Revised: 12/04/2017] [Accepted: 01/05/2018] [Indexed: 11/06/2022] Open
Abstract
The aim of this study was to evaluate the distribution of cases and the social determinants associated with death from human visceral leishmaniasis (HVL) and VL-HIV co-infection in Belo Horizonte, Minas Gerais state, Brazil, between 2006 and 2013. Descriptive statistics and analysis of associations were performed using chi-square of the raised variables, such as sex, age, skin colour and schooling of cases of HVL. During the study period, there were 866 cases of HVL with 111 deaths in Belo Horizonte. Morbidity and lethality rates (LR) of HVL in Belo Horizonte remained high over almost all the years evaluated, with an average incidence rate of 4.18 cases/100 000 inhabitants and a LR of 11.16%. With respect to skin colour, it was found that people characterised as black or mulatto had higher morbidity, followed by white. Regarding schooling, LR was more prevalent among individuals with lower education. One of the social risk factors was co-infection with HIV, which was present in many cases of HVL. Furthermore, it was found that older age and the male sex were also risk factors for death from HVL in Belo Horizonte.
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Affiliation(s)
- F. R. P. Bruhn
- Federal University of Pelotas (UFPel), Department of Preventive Veterinary, Zoonosis Control Center of UFPel, Capão do Leão, Rio Grande do Sul, Brazil
| | - M. H. F. Morais
- Municipal Department of Health of Belo Horizonte, Minas Gerais, Brazil
| | - N. C. P. Bruhn
- Federal University of Pelotas, Center of Mercosul Integration, Pelotas, Rio Grande do Sul, Brazil
| | - D. L. Cardoso
- Department of Veterinary Medicine, Federal University of Lavras, Lavras, Minas Gerais, Brazil
| | - F. Ferreira
- University of São Paulo, Department of Preventive Veterinary Medicine and Animal Health, School of Veterinary Medicine, São Paulo, Brazil
| | - C. M. B. M. Rocha
- Department of Veterinary Medicine, Federal University of Lavras, Lavras, Minas Gerais, Brazil
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45
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Bsrat A, Berhe M, Gadissa E, Taddele H, Tekle Y, Hagos Y, Abera A, G/micael M, Alemayhu T, Gugsa G, Aseffa A. Serological investigation of visceral Leishmania infection in human and its associated risk factors in Welkait District, Western Tigray, Ethiopia. Parasite Epidemiol Control 2018; 3:13-20. [PMID: 29774295 PMCID: PMC5952676 DOI: 10.1016/j.parepi.2017.10.004] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/15/2017] [Revised: 10/31/2017] [Accepted: 10/31/2017] [Indexed: 12/02/2022] Open
Abstract
Visceral leishmaniasis (VL) is major neglected public health problem in terms of geographical spread and incidence in Ethiopia. Magnitude, public health impact and dynamics of VL were not well studied in Welkait District, Western Tigray, though the area is known for VL. Hence, this study aimed to determine sero-prevalence of human VL and associated risk factors in Welkait as new foci. A cross sectional study design was employed in this study. Two stage stratified random sampling method was used to select study participants. Hence, a total of 329 human study participants were included for serological survey using ITleish and leishmanin skin tests. Semi structured questionnaire was also used to identify VL associated risk factors. Univariate and multivariate logistic regression statistical methods were used to determine the degree of association. The overall sero-prevalence of human VL in the study area was found to be 8.81%. Statistical significant difference in the prevalence of the disease was found among Sub-districts, sex, re-settlement, sleeping outdoor and dog ownership (P < 0.05). Participants who resettled from their original place were found 2 times (AOR = 2.143; 95% CI = 1.02, 14.20) more vulnerable to VL infection. Those who had an experience of sleeping outdoor were found almost 4 times (AOR = 4.29; 95% CI = 1.58, 11.69) more likely to be at risk of acquiring VL infection than those sleep indoor. Furthermore, individuals who owned dogs were 3 times more prone to the VL infection than their counterparts (AOR = 3.37; 95% CI = 1.29, 8.76). Alarming sero-positivity of human VL was recorded from new foci. Hence, it is recommended to improve the VL health services in the study area. The investigation also invites further study on VL dynamics in the study area.
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Affiliation(s)
- Abrha Bsrat
- Mekelle University College of Veterinary Medicine, Mekelle, Ethiopia
| | - Mebrahtu Berhe
- Veterinary Drug and Feed Administration and Control Authority, Tigray, Ethiopia
| | | | - Habtamu Taddele
- Mekelle University College of Veterinary Medicine, Mekelle, Ethiopia
| | - Yohannes Tekle
- Mekelle University College of Veterinary Medicine, Mekelle, Ethiopia
| | - Yohannes Hagos
- Mekelle University College of Veterinary Medicine, Mekelle, Ethiopia
| | - Adugna Abera
- Armauer Hansen Research Institute, Addis Ababa, Ethiopia
| | - Messele G/micael
- Mekelle University College of Veterinary Medicine, Mekelle, Ethiopia
| | - Tehetna Alemayhu
- Mekelle University College of Veterinary Medicine, Mekelle, Ethiopia
| | - Getachew Gugsa
- Wollo University College of Veterinary Medicine, Dessie, Ethiopia
| | - Abraham Aseffa
- Armauer Hansen Research Institute, Addis Ababa, Ethiopia
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46
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Travi BL, Cordeiro-da-Silva A, Dantas-Torres F, Miró G. Canine visceral leishmaniasis: Diagnosis and management of the reservoir living among us. PLoS Negl Trop Dis 2018; 12:e0006082. [PMID: 29324838 PMCID: PMC5764232 DOI: 10.1371/journal.pntd.0006082] [Citation(s) in RCA: 78] [Impact Index Per Article: 13.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/22/2023] Open
Abstract
This article reviews essential topics of canine visceral leishmaniasis (CVL) due to Leishmania infantum infection. It focuses on the current serological and molecular diagnostic methods used in epidemiological research and veterinary clinics to diagnose CVL and includes new point-of-care (POC) tests under development. The efficacy of different treatment regimens on the clinical improvement and infectiousness of dogs is also addressed. In the last section, the review provides a critical appraisal of the effectiveness of different control measures that have been implemented to curb disease transmission. Dogs are the principal reservoir hosts of L. infantum and consequently play a critical role in the transmission cycle of urban VL, which also affects humans. This review provides updated information on important topics such as diagnostic tests and dog treatments that improve dog health and decrease their transmission efficacy to insect vectors. A critical review of control measures is also provided.
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Affiliation(s)
- Bruno L. Travi
- Department of Internal Medicine-Division of Infectious Diseases, University of Texas Medical Branch, Galveston, Texas, United States of America
- * E-mail:
| | - Anabela Cordeiro-da-Silva
- Instituto de Investigação e Inovação em Saúde, Universidade do Porto, Porto, Portugal
- Parasite Disease Group, Instituto de Biologia Molecular e Celular, Universidade do Porto, Porto, Portugal
- Departamento de Ciências Biológicas, Faculdade de Farmácia da Universidade do Porto, Porto, Portugal
| | - Filipe Dantas-Torres
- Department of Immunology, Aggeu Magalhães Institute, Oswaldo Cruz Foundation, Recife, Pernambuco, Brazil
| | - Guadalupe Miró
- Veterinary Faculty, Animal Health Department, Universidad Complutense de Madrid, Madrid, Spain
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Otranto D, Dantas-Torres F, Mihalca AD, Traub RJ, Lappin M, Baneth G. Zoonotic Parasites of Sheltered and Stray Dogs in the Era of the Global Economic and Political Crisis. Trends Parasitol 2017. [DOI: 10.1016/j.pt.2017.05.013] [Citation(s) in RCA: 93] [Impact Index Per Article: 13.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
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48
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Belo VS, Gregório EA, Teixeira-Neto RG, da Rocha Lima ACVM, Pereira AAS, Marcelino AP, Paz GF, da Silva ES. Reliability of techniques used in the diagnosis of canine visceral leishmaniasis by the national control program in Brazil: A survey in an area of recent transmission. Prev Vet Med 2017; 146:10-15. [PMID: 28992913 DOI: 10.1016/j.prevetmed.2017.07.011] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/20/2017] [Revised: 07/11/2017] [Accepted: 07/16/2017] [Indexed: 11/16/2022]
Abstract
One of the key components of the Brazilian Program for the Control of Visceral Leishmaniasis (PCLV) is the euthanasia of Leishmania-infected canine reservoirs, the detection of which depends on a screening procedure involving a Dual Path Platform® (DPP) immunoassay and a confirmatory enzyme-linked immunosorbent assay (ELISA). The aims of the present study were to evaluate the reliability of these techniques in a region of recent transmission of canine VL, to follow up the seroconversion 3-4 months after the initial diagnosis of DPP reactive but ELISA indeterminate or non-reactive dogs, and to identify the species of Leishmania in circulation in the area. Each animal was submitted to DPP under field conditions, performed by municipal health workers using peripheral blood (DPP-field), to DPP under laboratory conditions using serum (DPP-lab) and to ELISA using serum. The agreements between the tests were determined using McNemar's χ2 test, Cohen's kappa coefficient (k) at the 95% confidence interval and prevalence-adjusted bias-adjusted kappa (PABAK). Of the 1130 dogs examined, 74.2% were non-reactive in all three tests applied. Based on the PCLV positive-infection criterion, seroprevalence was 8.9% (101/1130) with 83.2% (84/101) of infected animals showing reactivity in all three tests while 7.8% (8/101) were reactive in DPP-field and ELISA and 8.9% (9/101) in DPP-lab and ELISA. The proportions of disagreements were substantial in all comparisons. Inter-rater reliability between DPP-field and ELISA (k=0.55; PABAK=0.78) and DPP-lab and ELISA (k=0.59; PABAK=0.81) were considered moderate, while that between DPP-field and DPP-lab (k=0.61; PABAK=0.79) was classified as marginally good. The proportion of seroconversions in DPP reactive animals that were initially ELISA indeterminate was significantly higher than in those that were DPP reactive but initially ELISA non-reactive. Restriction fragment length polymorphism analysis revealed the presence of Leishmania infantum, the etiologic agent of VL, in bone marrow samples from VL-infected animals. Our data showed that the techniques and protocols currently employed in the PCLV screening approach are not entirely reliable. Further consideration should be given to monitoring dogs with undetermined results in ELISA and a better training should be provided for health workers responsible for performing DPP tests applied under field conditions.
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Affiliation(s)
- Vinícius Silva Belo
- Universidade Federal de São João del Rei, Campus Centro Oeste Dona Lindu, Rua Sebastião Gonçalves Coelho, 400, 35501-296, Divinópolis, MG, Brazil
| | - Eliana Aparecida Gregório
- Universidade Federal de São João del Rei, Campus Centro Oeste Dona Lindu, Rua Sebastião Gonçalves Coelho, 400, 35501-296, Divinópolis, MG, Brazil
| | - Rafael Gonçalves Teixeira-Neto
- Universidade Federal de São João del Rei, Campus Centro Oeste Dona Lindu, Rua Sebastião Gonçalves Coelho, 400, 35501-296, Divinópolis, MG, Brazil
| | | | - Agnes Antônia Sampaio Pereira
- Fundação Oswaldo Cruz, Centro de pesquisas René Rachou, Av. Augusto de Lima, 1715, 30190-002, Belo Horizonte, MG, Brazil
| | - Andreza Pain Marcelino
- Serviço de Doenças Parasitárias, Divisão de Epidemiologia e Controle de Doenças, Fundação Ezequiel Dias, Rua Conde Pereira Carneiro, 80, 30.510-010, Belo Horizonte, MG, Brazil
| | - Gustavo Fontes Paz
- Fundação Oswaldo Cruz, Centro de pesquisas René Rachou, Av. Augusto de Lima, 1715, 30190-002, Belo Horizonte, MG, Brazil
| | - Eduardo Sérgio da Silva
- Universidade Federal de São João del Rei, Campus Centro Oeste Dona Lindu, Rua Sebastião Gonçalves Coelho, 400, 35501-296, Divinópolis, MG, Brazil.
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49
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Pagliano P, Esposito S. Visceral leishmaniosis in immunocompromised host: an update and literature review. J Chemother 2017; 29:261-266. [PMID: 28490252 DOI: 10.1080/1120009x.2017.1323150] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Abstract
Visceral leishmaniasis (VL) is a chronic infectious disease endemic in tropical and sub-tropical areas including the Mediterranean basin, caused by a group of protozoan parasites of the genus Leishmania and transmitted by phlebotomine sandflies. Immunocompromised patients, in particular HIV positive, are considered at risk of VL. They report atypical signs and poor response to treatment due to impairment of T-helper and regulatory cells activity. Laboratory diagnosis is based on microscopy on bone marrow or spleen aspirates. Value of serology remains high in term of sensibility, but a positive test must be confirmed by microscopy or molecular tests. Treatment is based on Liposomal amphotericin B whose administration is associated to lower incidence of side effects, in respect to antimonials and other formulations of AmB. Use of Miltefosine needs further investigation when L. infantum is the causative agent. Frequent relapses are observed in co-infected HIV who can benefit of a second cycle.
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Affiliation(s)
- Pasquale Pagliano
- a Department of Infectious Diseases , D. Cotugno Hospital, AORN Dei Colli , Naples , Italy
| | - Silvano Esposito
- b Department of Infectious Diseases , University of Salerno , Salerno , Italy
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50
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Ursine RL, Dias JVL, Morais HA, Pires HHR. Human and canine visceral leishmaniasis in an emerging focus in Araçuaí, Minas Gerais: spatial distribution and socio-environmental factors. Mem Inst Oswaldo Cruz 2017; 111:505-11. [PMID: 27384080 PMCID: PMC4981116 DOI: 10.1590/0074-02760160133] [Citation(s) in RCA: 26] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/31/2016] [Accepted: 06/07/2016] [Indexed: 12/02/2022] Open
Abstract
This study aimed to analyse the spatial distribution of human (2007-2013) and canine (2013) visceral leishmaniasis (VL) in the city of Araçuaí, Minas Gerais, Brazil, and identify the socio-environmental factors related to their occurrence. The spatial distribution of human and canine cases was analysed by kernel density estimation (KDE) and the K function. The KDE values were analysed for correlation between human and canine LV and for normalised difference vegetation index (NDVI). Socio-environmental aspects of household structures and surroundings were evaluated. The spatial distribution of human and canine VL cases exhibited a significant aggregated pattern in distances greater than 350 and 75 m, respectively. The higher occurrence of human and canine infection occurred in the central area of the city. A positive correlation between the densities of human and canine cases was observed, as well as a negative correlation between NDVI and densities of human and canine cases. Socio-environmental analysis revealed that the large amount of animals, organic material from trees and deficiencies in environmental sanitation are possibly contributing to the continuation of the transmission cycle of Leishmania infantum in Araçuaí. These results can contribute to the planning by competent agencies to reduce the incidence of infection in the city.
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Affiliation(s)
- Renata Luiz Ursine
- Universidade Federal dos Vales do Jequitinhonha e Mucuri, Grupo de Extensão e Pesquisa em Saúde Coletiva, Diamantina, MG, Brasil
| | - João Victor Leite Dias
- Universidade Federal dos Vales do Jequitinhonha e Mucuri, Grupo de Extensão e Pesquisa em Saúde Coletiva, Diamantina, MG, Brasil
| | - Harriman Aley Morais
- Universidade Federal dos Vales do Jequitinhonha e Mucuri, Grupo de Extensão e Pesquisa em Saúde Coletiva, Diamantina, MG, Brasil
| | - Herton Helder Rocha Pires
- Universidade Federal dos Vales do Jequitinhonha e Mucuri, Grupo de Extensão e Pesquisa em Saúde Coletiva, Diamantina, MG, Brasil
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