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de Oliveira TCB, Sevá ADP, Neto JABC, Lopes UDL, Bresciani KDS. Finding Priority Areas in the Evaluation of Strategies for the Prevention of Leishmaniasis in an Endemic Municipality of Brazil. Trop Med Infect Dis 2024; 9:115. [PMID: 38787048 PMCID: PMC11125642 DOI: 10.3390/tropicalmed9050115] [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: 02/19/2024] [Revised: 05/01/2024] [Accepted: 05/09/2024] [Indexed: 05/25/2024] Open
Abstract
Visceral leishmaniasis is a zoonotic disease that affects humans and dogs. The infection is endemic in the municipality of Araçatuba, São Paulo, Brazil. Given the role of dogs in the epidemiology of leishmaniasis, strategies to enhance surveillance and reduce transmission are focused on dogs. In this study, we retrospectively analyzed records of canine visceral leishmaniasis from 2013 to 2022. According to this database, the prevalence of dogs testing positive for leishmaniasis fluctuated, with an average of 65.04% (6590/10,133). Cases were clustered in 10 statistically significant areas. Environmental analyses identified a significant geographical association between animals testing positive and higher vegetation density rates compared with animals testing negative. The period from sample collection to diagnosis and euthanasia, as recommended by the Brazilian Ministry, correlated with disease prevalence and decreased over time. These findings serve to implement different action plans against leishmaniasis for each geographic region and to understand the impact and efforts of strategies in an endemic area.
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Affiliation(s)
| | - Anaiá da Paixão Sevá
- Department of Environmental and Agrarian Science, State University of Santa Cruz, Ilhéus 45662-900, Brazil;
| | - João Alfredo Biagi Camargo Neto
- Animal Health and Production Department, Paulista State University (UNESP), Araçatuba 16018-805, Brazil; (J.A.B.C.N.); (K.D.S.B.)
| | - Uelio de Lima Lopes
- Department of Environmental and Agrarian Science, State University of Santa Cruz, Ilhéus 45662-900, Brazil;
| | - Katia Denise Saraiva Bresciani
- Animal Health and Production Department, Paulista State University (UNESP), Araçatuba 16018-805, Brazil; (J.A.B.C.N.); (K.D.S.B.)
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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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Cutaneous Leishmaniasis: A 2022 Updated Narrative Review into Diagnosis and Management Developments. Am J Clin Dermatol 2022; 23:823-840. [PMID: 36103050 PMCID: PMC9472198 DOI: 10.1007/s40257-022-00726-8] [Citation(s) in RCA: 53] [Impact Index Per Article: 26.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/16/2022] [Indexed: 01/10/2023]
Abstract
This review is an update of an earlier narrative review published in 2015 on developments in the clinical management of cutaneous leishmaniasis (CL) including diagnosis, treatment, prevention and control measurements. CL is a vector-borne infection caused by the protozoan parasite Leishmania. The vector is the female sandfly. Globally, CL affects 12 million cases and annually 2 million new cases occur. CL is endemic in almost 100 countries and the total risk population is approximately 350 million people. WHO lists CL an emerging and uncontrolled disease and a neglected tropical disease. Local experience-based evidence remains the mainstay for the management of CL. Whereas intralesional therapeutic options are the first treatment option for most CL patients, those with mucocutaneous and disseminated involvement require a systemic therapeutic approach. Moreover, different Leishmania species can vary in their treatment outcomes. Therefore, species determination is critical for optimal CL clinical management. New DNA techniques allow for relatively easy Leishmania species determination, yet they are not easily implemented in resource-limited settings. There is a desperate need for novel, less toxic, and less painful treatment options, especially for children with CL. Yet, the large and well conducted studies required to provide the necessary evidence are lacking. To further control and potentially eliminate CL, we urgently need to improve vector control, and diagnostics, and we require efficient and safe vaccines. Alas, since CL primarily affects poor people, biotechnical companies dedicate little investment into the research programs that could lead to diagnostic, pharmaceutical, and vaccine innovations.
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India's performance in controlling Visceral Leishmaniasis as compared to Brazil over past three decades: findings from global burden of disease study. J Parasit Dis 2021; 45:877-886. [PMID: 34789968 DOI: 10.1007/s12639-021-01375-0] [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: 01/13/2021] [Accepted: 03/01/2021] [Indexed: 10/21/2022] Open
Abstract
Visceral leishmaniasis (VL) is a neglected tropical disease which contributes to the mortality and morbidity significantly in India and Brazil. This study was planned to compare the trends of incidence, prevalence, death and disability-adjusted life years (DALY) of VL burden in India and Brazil from 1990 to 2019 using Global burden of disease study (GBD) data. The metrics are presented as age-standardized rates per 100,000 inhabitants with their respective uncertainty intervals (95% UI) and relative percentages of change. The decline in the Incidence rate is more in case of India (16.82 cases per 100,000 in 1990 to 0.60 cases in 2019) as compared to Brazil (3.12 cases per 100,000 in 1990 to 2.65 cases in 2019). The annualized rate of change in number of prevalent cases for India is - 0.95 (95% UI - 0.98 to - 0.91) whereas for Brazil it is - 0.06 (95% UI - 0.41 to 0.52). The annualized rate of change in number of DALY for India is - 0.94 (95% UI - 0.96 to - 0.92) whereas for Brazil it is - 0.09 (95% UI - 0.25 to 0.28). The annualized rate of change in number of deaths for India is - 0.93 (95% UI - 0.95 to - 0.92) whereas for Brazil it is increasing i.e. 0.04 (95% UI - 0.12 to 0.51). India achieves significant reduction in the age standardized incidence, prevalence, mortality and DALY of VL as compared to Brazil during the period of 1990 to 2019. A multi-centric study is required to assess bottleneck in the existing strategies of VLSCP in Brazil.
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Pessoa-E-Silva R, Trajano-Silva LAM, Vaitkevicius-Antão V, Dos Santos WJT, Magalhães FB, Moura DMN, Nakasone EKN, de Lorena VMB, de Paiva-Cavalcanti M. Immunoprophylactic Potential of a New Recombinant Leishmania infantum Antigen for Canine Visceral Leishmaniasis: An In Vitro Finding. Front Immunol 2021; 11:605044. [PMID: 33488607 PMCID: PMC7819978 DOI: 10.3389/fimmu.2020.605044] [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: 09/11/2020] [Accepted: 11/23/2020] [Indexed: 11/13/2022] Open
Abstract
The development and application of safe and effective immunoprophylactic/immunotherapeutic agents against canine visceral leishmaniasis (CanL) have been pointed out as the only means for the real control of the disease. Thus, this study aimed to evaluate the in vitro cellular immune response of dogs, elicited by the new recombinant proteins of Leishmania infantum, Lci10 and Lci13, in order to investigate their potential for vaccinology. Twenty-four dogs were submitted to clinical, parasitological, serological and molecular tests, and then separated into two study groups: 12 infected (InD) and 12 non-infected dogs (NInD), and six of each group were directed for Lci10 and Lci13 evaluation. Peripheral blood mononuclear cells (PBMC) were cultured and stimulated with Lci10 (10 μg/ml) or Lci13 (5 μg/ml), and with L. infantum soluble antigen (LSA) (25 μg/ml) or no stimulus (NS) as controls. Afterwards, the mRNA levels of different cytokines were quantified through qPCR, and Nitric Oxide (NO) production was assessed in the culture supernatants. Significant differences were considered when p ≤ 0.05. The comparative analysis revealed that, in the NInD group, Lci13 promoted a significant increase in the expression of IFN-γ in relation to LSA (p = 0.0362), and the expression of this cytokine in NInD was significantly higher than that presented in the InD (p = 0.0028). A negative expression for TGF-β was obtained in both groups. Lci13 also induced a greater production of NO in relation to the NS sample in the NInD group. No significant differences were observed after stimulation with Lci10. In conclusion, the results suggest a protective role of Lci13 for uninfected animals, thus with a potential for immunoprophylaxis. The results will help to direct the antigen Lci13 for further studies (pre-clinical trials), in order to determine its immunogenicity and reactogenicity effects, as a way to consolidate its real applicability for vaccinology against CanL.
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Canine serological survey and dog culling ant its relationship with human visceral leishmaniasis in an endemic urban area. BMC Infect Dis 2020; 20:401. [PMID: 32503461 PMCID: PMC7275440 DOI: 10.1186/s12879-020-05125-0] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/18/2019] [Accepted: 05/28/2020] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Visceral leishmaniasis is an important but neglected disease that is spreading and is highly lethal when left untreated. This study sought to measure the Leishmania infantum seroprevalence in dogs, the coverage of its control activities (identification of the canine reservoir by serological survey, dog culling and insecticide spraying) and to evaluate its relationship with the occurrence of the disease in humans in the municipalities of Araçatuba and Birigui, state of São Paulo, Brazil. METHODS Information from 2006 to 2015 was georeferenced for each municipality and modeling was performed for the two municipalities together. To do this, latent Gaussian Bayesian models with the incorporation of a spatio-temporal structure and Poisson distribution were used. The Besag-York-Mollie models were applied for random spatial effects, as also were autoregressive models of order 1 for random temporal effects. The modeling was performed using the INLA (Integrated Nested Laplace Approximations) deterministic approach, considering both the numbers of cases as well as the coverage paired year by year and lagged at one and two years. RESULTS Control activity coverage was observed to be generally low. The behavior of the temporal tendency in the human disease presented distinct patterns in the two municipalities, however, in both the tendency was to decline. The canine serological survey presented as a protective factor only in the two-year lag model. CONCLUSIONS The canine serological coverage, even at low intensity, carried out jointly with the culling of the positive dogs, suggested a decreasing effect on the occurrence of the disease in humans, whose effects would be seen two years after it was carried out.
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Gonçalves AAM, Leite JC, Resende LA, Mariano RMDS, Silveira P, Melo-Júnior OADO, Ribeiro HS, de Oliveira DS, Soares DF, Santos TAP, Marques AF, Galdino AS, Martins-Filho OA, Dutra WO, da Silveira-Lemos D, Giunchetti RC. An Overview of Immunotherapeutic Approaches Against Canine Visceral Leishmaniasis: What Has Been Tested on Dogs and a New Perspective on Improving Treatment Efficacy. Front Cell Infect Microbiol 2019; 9:427. [PMID: 31921703 PMCID: PMC6930146 DOI: 10.3389/fcimb.2019.00427] [Citation(s) in RCA: 22] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/02/2019] [Accepted: 11/29/2019] [Indexed: 12/14/2022] Open
Abstract
Visceral leishmaniasis (VL), caused by digenetic protozoa of the genus Leishmania, is the most severe form of leishmaniasis. Leishmania infantum is one of the species responsible for VL and the disease caused is considered a zoonosis whose main reservoir is the dog. Canine visceral leishmaniasis (CVL) can lead to the death of the animal if left untreated. Furthermore, the available pharmocologial treatment for CVL presents numerous disadvantages, such as relapses, toxicity, drug resistance, and the fact treated animals continue to be reservoirs when treatment fails to achieve parasitological cure. Moreover, the available VL control methods have not been adequate when it comes to controlling parasite transmission. Advances in immune response knowledge in recent years have led to a better understanding of VL pathogenesis, allowing new treatments to be developed based on immune system activation, often referred to as immunotherapy. In fact, well-defined protocols have been described, ranging from the use of immunomodulators to the use of vaccines. This treatment, which can also be associated with chemotherapy, has been shown to be effective in restoring or inducing an adequate immune response to reduce parasitic burden, leading to clinical improvement. This review focuses on immunotherapy directed at dogs infected by L. infantum, including a literature review of what has already been done in dogs. We also introduce a promising strategy to improve the efficacy of immunotherapy.
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Affiliation(s)
- Ana Alice Maia Gonçalves
- Laboratory of Biology of Cell Interactions, Department of Morphology, Institute of Biological Sciences, Federal University of Minas Gerais, Belo Horizonte, Brazil
| | - Jaqueline Costa Leite
- Laboratory of Biology of Cell Interactions, Department of Morphology, Institute of Biological Sciences, Federal University of Minas Gerais, Belo Horizonte, Brazil
| | - Lucilene Aparecida Resende
- Laboratory of Biology of Cell Interactions, Department of Morphology, Institute of Biological Sciences, Federal University of Minas Gerais, Belo Horizonte, Brazil
| | - Reysla Maria da Silveira Mariano
- Laboratory of Biology of Cell Interactions, Department of Morphology, Institute of Biological Sciences, Federal University of Minas Gerais, Belo Horizonte, Brazil
| | - Patricia Silveira
- Laboratory of Biology of Cell Interactions, Department of Morphology, Institute of Biological Sciences, Federal University of Minas Gerais, Belo Horizonte, Brazil
| | - Otoni Alves de Oliveira Melo-Júnior
- Laboratory of Biology of Cell Interactions, Department of Morphology, Institute of Biological Sciences, Federal University of Minas Gerais, Belo Horizonte, Brazil
| | - Helen Silva Ribeiro
- Laboratory of Biology of Cell Interactions, Department of Morphology, Institute of Biological Sciences, Federal University of Minas Gerais, Belo Horizonte, Brazil
| | - Diana Souza de Oliveira
- Laboratory of Biology of Cell Interactions, Department of Morphology, Institute of Biological Sciences, Federal University of Minas Gerais, Belo Horizonte, Brazil
| | - Diogo Fonseca Soares
- Laboratory of Biology of Cell Interactions, Department of Morphology, Institute of Biological Sciences, Federal University of Minas Gerais, Belo Horizonte, Brazil
| | - Thaiza Aline Pereira Santos
- Laboratory of Biology of Cell Interactions, Department of Morphology, Institute of Biological Sciences, Federal University of Minas Gerais, Belo Horizonte, Brazil
| | - Alexandre Ferreira Marques
- Laboratory of Immuno-Proteome and Parasite Biology, Department of Parasitology, Institute of Biological Sciences, Federal University of Minas Gerais, Belo Horizonte, Brazil
| | | | - Olindo Assis Martins-Filho
- Laboratory of Diagnostic and Monitoring Biomarkers, René Rachou Institute, FIOCRUZ-Minas, Belo Horizonte, Brazil
| | - Walderez Ornelas Dutra
- Laboratory of Biology of Cell Interactions, Department of Morphology, Institute of Biological Sciences, Federal University of Minas Gerais, Belo Horizonte, Brazil
| | - Denise da Silveira-Lemos
- Laboratory of Biology of Cell Interactions, Department of Morphology, Institute of Biological Sciences, Federal University of Minas Gerais, Belo Horizonte, Brazil
| | - Rodolfo Cordeiro Giunchetti
- Laboratory of Biology of Cell Interactions, Department of Morphology, Institute of Biological Sciences, Federal University of Minas Gerais, Belo Horizonte, Brazil
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Silva SCPFE, Gomes LB, Carvalho PCFB, Santos AGRC, Borges LFNM, Oliveira CSF, Morais MHF, Pereira PLL, Amaral Haddad JP, Soares DFDM. Effectiveness of the mass use of deltamethrin-impregnated dog collars for preventing transmission of canine leishmaniasis by Lutzomyia spp.: A cluster randomized controlled trial. Prev Vet Med 2019; 171:104770. [PMID: 31536935 DOI: 10.1016/j.prevetmed.2019.104770] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/30/2019] [Revised: 08/21/2019] [Accepted: 09/03/2019] [Indexed: 11/25/2022]
Abstract
Visceral leishmaniasis (VL) is a zoonosis that greatly impacts public health, especially in developing countries. The effectiveness of deltamethrin-impregnated dog collars for preventing transmission of canine leishmaniasis (CanL) by the sand fly Lutzomyia spp. in countries with high incidence of the disease, such as Brazil, remains unknown. A cluster randomized controlled trial was carried out to evaluate the effectiveness of these collars in preventing infection of dogs with Leishmania infantum. Two areas were selected in a municipality endemic for VL in Brazil: an experimental area (EA) and a control area (CA). In both areas, blood samples were collected from dogs for detection of CanL. Seronegative dogs from the EA received collars impregnated with deltamethrin 4%. After six months, the dogs were retested for CanL and the incidence of the disease, the relative risk, and the effectiveness of collaring determined. In the baseline survey, 1020 dogs from the EA and 589 from the CA were examined. The prevalence calculated for EA was 4.41% (CI95% 3.27-5.91), and 7.13% (CI95% 5.25-9.59) for CA. In the second evaluation, 454 dogs from the EA and 292 from the CA were examined. The person-time incidence calculated for EA was 3.51% (CI95% 1.30-7.48), and for CA was 11.81% (CI95% 7.03-18.23). The difference between the calculated incidences was statistically significant (p = 0.009). The relative risk was 0.2972 (CI95% 0.1204-0.7339; p = 0.009), and the efficacy of the proposed measure was estimated in 70.27%. This report evaluated the effectiveness of the mass use of deltamethrin-impregnated dog collars in areas of transmission of VL by Lutzomyia spp. Collaring was able to protect dogs and may represent an effective strategy that could be implemented to control infection in both dogs and humans in Brazil and perhaps other countries where Lutzomyia spp. is the main vector of the disease.
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Affiliation(s)
| | - Laiza Bonela Gomes
- Departamento de Medicina Veterinária Preventiva, Escola de Medicina Veterinária, Universidade Federal de Minas Gerais, Belo Horizonte, MG, Brazil
| | - Paloma Carla Fonte Boa Carvalho
- Departamento de Medicina Veterinária Preventiva, Escola de Medicina Veterinária, Universidade Federal de Minas Gerais, Belo Horizonte, MG, Brazil
| | | | | | - Camila Stefanie Fonseca Oliveira
- Departamento de Medicina Veterinária Preventiva, Escola de Medicina Veterinária, Universidade Federal de Minas Gerais, Belo Horizonte, MG, Brazil
| | | | - Pedro Lúcio Lithg Pereira
- Departamento de Medicina Veterinária Preventiva, Escola de Medicina Veterinária, Universidade Federal de Minas Gerais, Belo Horizonte, MG, Brazil
| | - João Paulo Amaral Haddad
- Departamento de Medicina Veterinária Preventiva, Escola de Medicina Veterinária, Universidade Federal de Minas Gerais, Belo Horizonte, MG, Brazil
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Mota TF, de Sousa OMF, Silva YDJ, Borja LS, Leite BMM, Solcà MDS, de Melo DA, Brodskyn CI, Dias ES, Veras PST, Fraga DBM. Natural infection by Leishmania infantum in the Lutzomyia longipalpis population of an endemic coastal area to visceral leishmaniasis in Brazil is not associated with bioclimatic factors. PLoS Negl Trop Dis 2019; 13:e0007626. [PMID: 31449534 PMCID: PMC6730935 DOI: 10.1371/journal.pntd.0007626] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/14/2018] [Revised: 09/06/2019] [Accepted: 07/11/2019] [Indexed: 01/24/2023] Open
Abstract
Visceral leishmaniasis (VL) is a zoonosis caused by the protozoan Leishmania infantum and in Brazil is transmitted mainly by the bite of Lutzomuyia longipalpis sand flies. Data about the presence, distribution, natural infection rate, seasonal and monthly dynamics of the vector population are important for optimizing the measures to control VL in endemic areas. This study aimed to identify sand fly fauna in an endemic area for VL to detect the prevalence of L. infantum infection in the Lu. longipalpis population and to elucidate the influence of bioclimatic factors on the monthly fluctuations of this vector. HP light traps were monthly set in the intradomicile and peridomicile of residences located in the central and beachfront areas of Camaçari, a VL endemic area. The sand fly collection was conducted in two periods: i) period 1-between December 2011 and November 2012 and ii) period 2-August 2014 and July 2015. Sand fly species were identified and detection of L. infantum infection by qPCR was performed in pools of female Lu. longipalpis. For the first time, the parasite load of positive pools was correlated with the number of Lu. longipalpis captured per month in both periods. Correlation analyses between the monthly fluctuation of the sand fly population and bioclimatic indices of the municipality in both collection periods were also performed. In both evaluated periods, more than 98% of the collected sand flies were Lu. longipalpis, confirming the predominance of this species in the region. It was captured mostly in the beachfront area in all months evaluated (99%). For the period 1, Leishmania DNA was detected in 81% of tested pools representing a minimal infection rate of 9.6%. In the period 2, 40% of the pools were positive with a minimal infection rate of 10.2%. Infected sand flies were only detected in the beachfront area in both periods. The parasite load was low and did not vary in the evaluated months despite the number of collected sand flies. No correlation was observed for climatic factors in both areas of Camaçari. These findings emphasize the high risk of Leishmania transmission in Camaçari regardless of the season and that other factors, aside from bioclimatic elements, are influencing the sand fly population monthly fluctuation.
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Affiliation(s)
| | | | | | | | | | - Manuela da Silva Solcà
- Escola de Medicina Veterinária e Zootecnia—Universidade Federal da Bahia, Salvador, Brazil
| | | | | | | | - Patrícia Sampaio Tavares Veras
- Instituto Gonçalo Moniz—Fundação Oswaldo Cruz, Salvador, Brazil
- Instituto Nacional de Ciência e Tecnologia de Doenças Tropicais—INCT-DT, 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
- Instituto Nacional de Ciência e Tecnologia de Doenças Tropicais—INCT-DT, Salvador, Brazil
- * E-mail:
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10
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Lima ÁLM, de Lima ID, Coutinho JFV, de Sousa ÚPST, Rodrigues MAG, Wilson ME, Pearson RD, Queiroz JW, Jerônimo SMB. Changing epidemiology of visceral leishmaniasis in northeastern Brazil: a 25-year follow-up of an urban outbreak. Trans R Soc Trop Med Hyg 2018; 111:440-447. [PMID: 29394411 DOI: 10.1093/trstmh/trx080] [Citation(s) in RCA: 23] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/27/2017] [Accepted: 12/19/2017] [Indexed: 12/30/2022] Open
Abstract
Background Visceral leishmaniasis (VL) continues to be a deadly parasitic disease in Brazil but the epidemiology has changed. The objective of this study was to assess the evolution of urban VL in the city of Natal, Brazil, over the past 25 y. Methods A retrospective study of human VL was performed, considering reported cases over the past 25 y in Natal. Analyses considered the spatial distribution of VL cases, human immunodeficiency virus (HIV)/acquired immune deficiency syndrome (AIDS) co-infection, Leishmania infantum infection in dogs, density of the insect vector (Lutzomyia longipalpis) and socio-economic factors. Results Paralleling migration of the population, VL cases changed from mostly rural to predominantly urban regions. The incidence of human VL was highest during the initial years (1990-1994) of our study. Human VL was positively associated with a high density of L. longipalpis, a high prevalence of canine L. infantum infection and HIV/AIDS co-infection. The average age at diagnosis increased over prior years and males were more frequently affected. The overall fatality rate was 6%. Socio-economic variables indicative of poverty were associated with a greater incidence of VL and clusters of VL. Conclusion VL has become endemic in Natal. The disease is associated with poverty and male gender. Surprisingly, there has been an increase in the age at diagnosis.
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Affiliation(s)
- Ádila L M Lima
- Health Graduate Program, Health Science Center, Federal University of Rio Grande do Norte, Natal, Rio Grande do Norte, Brazil.,Center for Zoonotic Control, Health Secretariat of Natal, Rio Grande do Norte, Brazil
| | - Iraci D de Lima
- Health Graduate Program, Health Science Center, Federal University of Rio Grande do Norte, Natal, Rio Grande do Norte, Brazil
| | - José F V Coutinho
- Health Graduate Program, Health Science Center, Federal University of Rio Grande do Norte, Natal, Rio Grande do Norte, Brazil.,Center for Zoonotic Control, Health Secretariat of Natal, Rio Grande do Norte, Brazil.,Institute of Tropical Medicine of Rio Grande do Norte, Federal University of Rio Grande do Norte, Natal, Rio Grande do Norte, Brazil
| | - Úrsula P S T de Sousa
- Center for Zoonotic Control, Health Secretariat of Natal, Rio Grande do Norte, Brazil
| | - Marcos A G Rodrigues
- Center for Zoonotic Control, Health Secretariat of Natal, Rio Grande do Norte, Brazil
| | - Mary E Wilson
- Departments of Internal Medicine and Microbiology, University of Iowa and the Iowa City Veterans' Affairs Medical Center, Iowa City, IA, USA
| | - Richard D Pearson
- Division of Infectious Diseases and International Health, Department of Medicine, University of Virginia, Charlottesville, VA, USA
| | - José W Queiroz
- Institute of Tropical Medicine of Rio Grande do Norte, Federal University of Rio Grande do Norte, Natal, Rio Grande do Norte, Brazil
| | - Selma M B Jerônimo
- Health Graduate Program, Health Science Center, Federal University of Rio Grande do Norte, Natal, Rio Grande do Norte, Brazil.,Institute of Tropical Medicine of Rio Grande do Norte, Federal University of Rio Grande do Norte, Natal, Rio Grande do Norte, Brazil.,Department of Biochemistry, Bioscience Center, Federal University of Rio Grande do Norte, Natal, Rio Grande do Norte, Brazil.,National Institute of Science and Technology of Tropical Diseases, Salvador, Brazil
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11
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Dantas-Torres F, Miró G, Bowman DD, Gradoni L, Otranto D. Culling Dogs for Zoonotic Visceral Leishmaniasis Control: The Wind of Change. Trends Parasitol 2018; 35:97-101. [PMID: 30554966 DOI: 10.1016/j.pt.2018.11.005] [Citation(s) in RCA: 32] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/14/2018] [Revised: 11/19/2018] [Accepted: 11/19/2018] [Indexed: 12/31/2022]
Abstract
Visceral leishmaniasis, caused by Leishmania infantum, is a zoonosis, and culling seropositive dogs has been recommended to control the disease in some endemic countries. However, no scientific evidence supports the effectiveness of this strategy to reduce the incidence of visceral leishmaniasis. Economic and ethical issues concerning dog culling are discussed.
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Affiliation(s)
- Filipe Dantas-Torres
- Department of Immunology, Instituto Aggeu Magalhães (Fiocruz-PE), Pernambuco, Brazil; Department of Veterinary Medicine, Università degli Studi di Bari, Bari, Italy
| | - Guadalupe Miró
- Veterinary Faculty, Animal Health Department, Universidad Complutense de Madrid, Madrid, Spain
| | - Dwight D Bowman
- Department of Microbiology and Immunology, Cornell University, Ithaca, New York, USA
| | - Luigi Gradoni
- Unit of Vector-borne Diseases, Department of Infectious Diseases, Istituto Superiore di Sanità, Rome, Italy
| | - Domenico Otranto
- Department of Veterinary Medicine, Università degli Studi di Bari, Bari, Italy.
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12
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Coura-Vital W, Leal GGDA, Marques LA, Pinheiro ADC, Carneiro M, Reis AB. Effectiveness of deltamethrin-impregnated dog collars on the incidence of canine infection by Leishmania infantum: A large scale intervention study in an endemic area in Brazil. PLoS One 2018; 13:e0208613. [PMID: 30532255 PMCID: PMC6287856 DOI: 10.1371/journal.pone.0208613] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/18/2018] [Accepted: 11/20/2018] [Indexed: 11/18/2022] Open
Abstract
To reduce morbidity and mortality caused by visceral leishmaniasis (VL), the Brazilian Visceral Leishmaniasis Control and Surveillance Program promotes the diagnosis and treatment of cases, vector control, euthanasia of seropositive dogs, and health education. Nevertheless, the effectiveness of these measures is questionable as they lead to little reduction in the transmission of the disease. Thus, the effectiveness of strategies such as insecticide-impregnated collars, spot-on insecticides, and immunization of dogs should be assessed. Herein, we evaluated the effectiveness of deltamethrin-impregnated collars on reducing the incidence of Leishmania infantum infection in dogs living in an endemic area of VL. An intervention study was conducted and a total 5,850 dogs were analyzed in baseline. Of these 3,742 seronegative dogs were divided into two groups: collared and uncollared (control). Dogs were followed for 12 months and three interventions were performed. The Cox regression model was used to evaluate the effectiveness of the collar. All analyzes were performed by Intention-to-treat and per-protocol. By intention-to-treat, the incidence rates of L. infantum infection were 7.5 and 7.9 in the collar group, and 6.5 and 13.2 per 1,000 dogs-months in the control group after 6 and 12 months, respectively. In the per-protocol analysis, the incidence rates in the control group were similar to those observed in the intention-to-treat analysis. In the collar group, the incidence rate was 5.1/1,000 dogs-months after 6 and 12 months. The effectiveness by intention-to-treat after adjustment by the multivariate Cox model was 48%. In the analysis per-protocol, the effectiveness increased to 63%. Although collar use was effective when it was evaluated by intention-to-treat, higher effectiveness was found in the per-protocol analysis after one year of follow-up. The data emphasize the importance of the uninterrupted use of deltamethrin-impregnated collars to increase protection against canine VL.
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Affiliation(s)
- Wendel Coura-Vital
- Programa de Pós-Graduação em Ciências Farmacêuticas, Departamento de Análises Clínicas, Escola de Farmácia, Universidade Federal de Ouro Preto, Minas Gerais, Brazil
- Laboratório de Imunopatologia, Programa de Pós-Graduação em Ciências Biológicas, Núcleo de Pesquisa em Ciências Biológicas, Universidade Federal de Ouro Preto, Ouro Preto, Minas Gerais, Brazil
- * E-mail:
| | - Gleisiane Gomes de Almeida Leal
- Laboratório de Imunopatologia, Programa de Pós-Graduação em Ciências Biológicas, Núcleo de Pesquisa em Ciências Biológicas, Universidade Federal de Ouro Preto, Ouro Preto, Minas Gerais, Brazil
| | - Luana Araújo Marques
- Centro de Controle de Zoonoses, Secretaria Municipal de Saúde, Governador Valadares, Minas Gerais, Brazil
| | - Aimara da Costa Pinheiro
- Centro de Controle de Zoonoses, Secretaria Municipal de Saúde, Governador Valadares, Minas Gerais, Brazil
| | - Mariângela Carneiro
- Laboratório de Epidemiologia das Doenças Infecciosas e Parasitárias, Departamento de Parasitologia, Universidade Federal de Minas Gerais, Belo Horizonte, Minas Gerais, Brazil
| | - Alexandre Barbosa Reis
- Laboratório de Imunopatologia, Programa de Pós-Graduação em Ciências Biológicas, Núcleo de Pesquisa em Ciências Biológicas, Universidade Federal de Ouro Preto, Ouro Preto, Minas Gerais, Brazil
- Instituto Nacional de Ciência e Tecnologia em Doenças Tropicais—INCT-DT, Salvador, Bahia, Brazil
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13
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da Rocha ICM, Dos Santos LHM, Coura-Vital W, da Cunha GMR, Magalhães FDC, da Silva TAM, Morais MHF, Oliveira E, Reis IA, Carneiro M. Effectiveness of the Brazilian Visceral Leishmaniasis Surveillance and Control Programme in reducing the prevalence and incidence of Leishmania infantum infection. Parasit Vectors 2018; 11:586. [PMID: 30419944 PMCID: PMC6233359 DOI: 10.1186/s13071-018-3166-0] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/14/2018] [Accepted: 10/24/2018] [Indexed: 12/02/2022] Open
Abstract
Background Control strategies adopted by the Brazilian Visceral Leishmaniasis Surveillance and Control Programme (VLSCP) include identifying and culling seropositive infected dogs, early diagnosis and treatment of human cases, chemical control of the vector and population awareness. This study evaluated the effectiveness of the VLSCP on the prevalence and incidence rates of Leishmania infantum in children residing in areas under different VLSCP intervention times. Methods A quasi-experimental epidemiological study with a panel (two cross-sectional) and a concurrent cohort was performed in three areas of Belo Horizonte, southeast Brazil. The first cross-sectional study (I) was carried out with 1875 children, 478 of which were enrolled in the cohort study. In the second cross-sectional study (II), 413 additional children were included, totalizing 891 children. Laboratory diagnosis was performed by ELISA-rK39. Analyses included multilevel logistic and Poisson regression models. Results The incidence rates of L. infantum infection were: 14.4% in the area where VLSCP intervention was initiated in 2006 (AI2006); 21.1% in the area where intervention was initiated in 2008 (AI2008); and 11.6% in the area where intervention was initiated in 2010 (AI2010 - control area). A follow-up period of 24 months showed that the persons-time incidence rates in AI2006, AI2008, and AI2010 were: 6.2/100, 10/100, and 5.6/100 persons/24 months, respectively. The final prevalence rates of infection (cross-sectional II - in 2012), compared to the initial rates (cross-sectional I - in 2010), increased 83.7% in AI2006, 74.1% in AI2008, and decreased 5% in AI2010. Analysis of the effectiveness revealed that children residing in AI2008 are more likely to be infected (OR = 1.84; 95% CI: 1.06-3.23) and present a higher risk of infection (IRR = 1.76; 95% CI: 1.05-2.95) compared to those in AI2010. No statistically significant differences were observed in asymptomatic infection (OR and IRR) in AI2006 compared to AI2010. Conclusions The VLSCP was not effective at controlling L. infantum infection in areas where interventions had respectively been carried out for six and four years. However, it is unclear what the consequences in terms of human infection and diseases would be in the absence of the VLSCP. Efforts to improve the effectiveness of control measures remain a necessary priority. Electronic supplementary material The online version of this article (10.1186/s13071-018-3166-0) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Iara Caixeta Marques da Rocha
- Laboratório de Epidemiologia das Doenças Infecciosas e Parasitárias, Departamento de Parasitologia, Instituto de Ciências Biológicas, Universidade Federal de Minas Gerais, Belo Horizonte, Minas Gerais, Brazil.,Secretaria Municipal de Saúde de Belo Horizonte, Belo Horizonte, Minas Gerais, Brazil
| | - Letícia Helena Marques Dos Santos
- Laboratório de Epidemiologia das Doenças Infecciosas e Parasitárias, Departamento de Parasitologia, Instituto de Ciências Biológicas, Universidade Federal de Minas Gerais, Belo Horizonte, Minas Gerais, Brazil
| | - Wendel Coura-Vital
- Departamento de Análises Clínicas, Pós-graduação em Ciências Farmacêuticas, Escola de Farmácia, Universidade Federal de Ouro Preto, Ouro Preto, Minas Gerais, Brazil.,Pós-graduação em Ciências Biológicas, Núcleo de Pesquisa em Ciências Biológicas, Universidade Federal de Ouro Preto, Ouro Preto, Minas Gerais, Brazil
| | - Gisele Macedo Rodrigues da Cunha
- Laboratório de Epidemiologia das Doenças Infecciosas e Parasitárias, Departamento de Parasitologia, Instituto de Ciências Biológicas, Universidade Federal de Minas Gerais, Belo Horizonte, Minas Gerais, Brazil
| | - Fernanda do Carmo Magalhães
- Laboratório de Epidemiologia das Doenças Infecciosas e Parasitárias, Departamento de Parasitologia, Instituto de Ciências Biológicas, Universidade Federal de Minas Gerais, Belo Horizonte, Minas Gerais, Brazil
| | - Thais Almeida Marques da Silva
- Laboratório de Epidemiologia das Doenças Infecciosas e Parasitárias, Departamento de Parasitologia, Instituto de Ciências Biológicas, Universidade Federal de Minas Gerais, Belo Horizonte, Minas Gerais, Brazil.,Instituto de Ensino e Pesquisa da Santa Casa Belo Horizonte, Belo Horizonte, Minas Gerais, Brazil
| | | | - Edward Oliveira
- Laboratório de Pesquisas Clínicas, Instituto René Rachou, Fundação Oswaldo Cruz, Belo Horizonte, Minas Gerais, Brazil
| | - Ilka Afonso Reis
- Departamento de Estatística, Instituto de Ciências Exatas, Universidade Federal de Minas Gerais, Belo Horizonte, Minas Gerais, Brazil
| | - Mariângela Carneiro
- Laboratório de Epidemiologia das Doenças Infecciosas e Parasitárias, Departamento de Parasitologia, Instituto de Ciências Biológicas, Universidade Federal de Minas Gerais, Belo Horizonte, Minas Gerais, Brazil. .,Pós-graduação em Ciências da Saúde: Infectologia e Medicina Tropical, Faculdade de Medicina, Universidade Federal de Minas Gerais, Belo Horizonte, Minas Gerais, Brazil.
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14
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Jafari E, Moeeni M, Fadaei R, Rezayatmand R. Economic Evaluation of Using Pesticides to Control Cutaneous Leishmaniasis in Isfahan. J Res Pharm Pract 2018; 7:123-127. [PMID: 30211236 PMCID: PMC6121765 DOI: 10.4103/jrpp.jrpp_17_95] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
OBJECTIVE Pesticides have been used as the main part of the national cutaneous leishmaniasis control program for serveral years in Iran. However, the cost-effectiveness of this strategy has not been yet analyzed. The aim of this study is to to analyze the cost-effectiveness and cost-utility of using pesticides as the main strategy to prevent rural CL in Isfahan. METHODS This is an economic evaluation study performed from a health system perspective to estimate the cost-effectiveness and cost-utility of the control strategy with and without pesticides. The outcome measures are incidence rate of cutaneous leishmaniasis and the disability-adjusted life years (DALYs). The cost-effectiveness and cost-utility have been analyzed by calculating incremental cost-effectiveness ratio (ICER). Data of cost and incidence rate obtained from the health centers of Isfahan University of Medical Sciences and Vice-Chancellery for Health. The disability weight was obtained from the literature. A one-way sensitivity analysis was applied with a 20% increase and decrease in costs. FINDINGS The total cost of control program in 2013 and 2014 were US$578,453 (ppp) and US$14,978.2 (ppp), respectively. The incidence rate of cutaneous leishmaniasis was estimated at 1396 and 1277 (per 100,000 population in hyperendemic areas where pesticides have been used) in 2013 and 2014, respectively. DALY lost due to disease was estimated to be 8.024 and 7.342 in 2013 and 2014, correspondingly. Both the cost-effectiveness and the cost-utility analyses resulted in negative ICERs, lying in the rejection area of the ICER plane. CONCLUSION The use of pesticides to prevent cutaneous leishmaniasis (rural sicker) in Isfahan province has not proved to offer a reduction in the incidence rate of cutaneous leishmaniasis as well as reduction in DALYs lost. However, due to data availability limitation, the time frame for this study was limited. A prospective design with longitudinal data is recommended to be used by future research. Other alternatives to raise population awareness about different aspects of disease should be also considered for evaluation.
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Affiliation(s)
- Ehsanallah Jafari
- Health Management and Economics Research Center, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Maryam Moeeni
- Health Management and Economics Research Center, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Reza Fadaei
- Department of Infectious Diseases, Vice-Chancellery for Health, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Reza Rezayatmand
- Health Management and Economics Research Center, Isfahan University of Medical Sciences, Isfahan, Iran
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15
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Kazimoto TA, Amora SSA, Figueiredo FB, Magalhães JME, Freitas YBN, Sousa MLR, Melo AECDS, Campos MP, Alves ND, Werneck GL. Impact of 4% Deltamethrin-Impregnated Dog Collars on the Prevalence and Incidence of Canine Visceral Leishmaniasis. Vector Borne Zoonotic Dis 2018; 18:356-363. [PMID: 29683394 DOI: 10.1089/vbz.2017.2166] [Citation(s) in RCA: 23] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
In Brazil, visceral leishmaniasis is caused by the protozoan Leishmania infantum, primarily transmitted by Lutzomyia longipalpis and with the dog as its main urban reservoir. This study aims to evaluate the effectiveness of 4% deltamethrin-impregnated dog collars (DMC) DIC, Scalibor® 65 cm model and MSD manufacturer, on the prevalence and incidence of canine visceral leishmaniasis (CVL) and on the rate of infection of sandflies by L. infantum. The research was conducted in two areas of the municipality Mossoró, State of Rio Grande do Norte in Northeast of Brazil. Two semiannual serosurveys, followed by culling seropositive dogs, and searches for phlebotominae were performed in the control area (CA), whereas in the collar intervention area (IA), aside from those procedures, DMC were fitted to dogs every 6 months. CVL was diagnosed by the Dual Path Platform rapid test (TR-DPP®) and the Immunoenzymatic assay (EIE). The sandflies were collected monthly, identified, and the females were submitted to Quantitative Real-Time Polymerase Chain Reaction for detection of L. infantum DNA. The use of collars was associated with a 53-59% reduction in the incidence of CVL. The most abundant phlebotomine species were L. longipalpis (81.8%). Positive pools of L. longipalpis were obtained in the IA only in the first survey, whereas the presence of the DNA of the parasite in the vector was observed in the CA in both surveys. We conclude that the continuous use of these collars may have the potential to reduce both the incidence of CVL and the rate of infected phlebotomine sandflies.
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Affiliation(s)
- Thaís Aparecida Kazimoto
- 1 Programa de Pós-Graduação em Ambiente, Tecnologia e Sociedade, Universidade Federal Rural do Semi-Árido , Mossoró, Brazil
| | - Sthenia Santos Albano Amora
- 1 Programa de Pós-Graduação em Ambiente, Tecnologia e Sociedade, Universidade Federal Rural do Semi-Árido , Mossoró, Brazil
| | | | - Jamille Maia E Magalhães
- 1 Programa de Pós-Graduação em Ambiente, Tecnologia e Sociedade, Universidade Federal Rural do Semi-Árido , Mossoró, Brazil
| | | | - Maressa Laíse Reginaldo Sousa
- 1 Programa de Pós-Graduação em Ambiente, Tecnologia e Sociedade, Universidade Federal Rural do Semi-Árido , Mossoró, Brazil
| | | | - Monique Paiva Campos
- 3 Laboratório de Pesquisa Clínica em Dermatozoonosesde Animais Domésticos, Instituto Nacional de Infectologia Evandro Chagas , Fundação Oswaldo Cruz, Rio de Janeiro, Brazil
| | - Nilza Dutra Alves
- 1 Programa de Pós-Graduação em Ambiente, Tecnologia e Sociedade, Universidade Federal Rural do Semi-Árido , Mossoró, Brazil
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16
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Toepp A, Larson M, Grinnage-Pulley T, Bennett C, Anderson M, Parrish M, Fowler H, Wilson G, Gibson-Corely K, Gharpure R, Cotter C, Petersen C. Safety Analysis of Leishmania Vaccine Used in a Randomized Canine Vaccine/Immunotherapy Trial. Am J Trop Med Hyg 2018; 98:1332-1338. [PMID: 29512486 DOI: 10.4269/ajtmh.17-0888] [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
In Leishmania infantum-endemic countries, controlling infection within dogs, the domestic reservoir, is critical to public health. There is a need for safe vaccines that prevent canine progression with disease and transmission to others. Protective vaccination against Leishmania requires mounting a strong, inflammatory, Type 1 response. Three commercially available canine vaccines on the global veterinary market use saponin or inflammatory antigen components (Letifend) as a strong pro-inflammatory adjuvant. There is very little information detailing safety of saponin as an adjuvant in field trials. Safety analyses for the use of vaccine as an immunotherapeutic in asymptomatically infected animals are completely lacking. Leishmania infantum, the causative agent of canine leishmaniasis, is enzootic within U.S. hunting hounds. We assessed the safety of LeishTec® after use in dogs from two different clinical states: 1) without clinical signs and tested negative on polymerase chain reaction and serology or 2) without clinical signs and positive for at least one Leishmania diagnostic test. Vaccine safety was assessed after all three vaccinations to quantify the number and severity of adverse events. Vaccinated animals had an adverse event rate of 3.09%, whereas placebo animals had 0.68%. Receiving vaccine was correlated with the occurrence of mild, site-specific, reactions. Occurrence of severe adverse events was not associated with having received vaccine. Infected, asymptomatic animals did not have a higher rate of adverse events. Use of vaccination is, therefore, likely to be safe in infected, asymptomatic animals.
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Affiliation(s)
- Angela Toepp
- Center for Emerging Infectious Diseases, University of Iowa Research Park, Coralville, Iowa.,Department of Epidemiology, College of Public Health, University of Iowa, Iowa City, Iowa
| | - Mandy Larson
- Center for Emerging Infectious Diseases, University of Iowa Research Park, Coralville, Iowa.,Department of Epidemiology, College of Public Health, University of Iowa, Iowa City, Iowa
| | - Tara Grinnage-Pulley
- Center for Emerging Infectious Diseases, University of Iowa Research Park, Coralville, Iowa.,Department of Epidemiology, College of Public Health, University of Iowa, Iowa City, Iowa
| | - Carolyne Bennett
- Center for Emerging Infectious Diseases, University of Iowa Research Park, Coralville, Iowa.,Department of Epidemiology, College of Public Health, University of Iowa, Iowa City, Iowa
| | - Michael Anderson
- Department of Epidemiology, College of Public Health, University of Iowa, Iowa City, Iowa
| | - Molly Parrish
- Center for Emerging Infectious Diseases, University of Iowa Research Park, Coralville, Iowa.,Department of Epidemiology, College of Public Health, University of Iowa, Iowa City, Iowa
| | - Hailie Fowler
- Department of Epidemiology, College of Public Health, University of Iowa, Iowa City, Iowa
| | - Geneva Wilson
- Center for Emerging Infectious Diseases, University of Iowa Research Park, Coralville, Iowa.,Department of Epidemiology, College of Public Health, University of Iowa, Iowa City, Iowa
| | | | - Radhika Gharpure
- Bloomberg School of Public Health, Johns Hopkins University, Baltimore, Maryland
| | - Caitlin Cotter
- Bloomberg School of Public Health, Johns Hopkins University, Baltimore, Maryland
| | - Christine Petersen
- Department of Epidemiology, College of Public Health, University of Iowa, Iowa City, Iowa.,Center for Emerging Infectious Diseases, University of Iowa Research Park, Coralville, Iowa
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17
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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: 87] [Impact Index Per Article: 14.5] [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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18
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Figueiredo ABF, Werneck GL, Cruz MDSPE, Silva JPD, Almeida ASD. Uso e cobertura do solo e prevalência de leishmaniose visceral canina em Teresina, Piauí, Brasil: uma abordagem utilizando sensoriamento remoto orbital. CAD SAUDE PUBLICA 2017; 33:e00093516. [DOI: 10.1590/0102-311x00093516] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/31/2016] [Accepted: 01/06/2017] [Indexed: 11/21/2022] Open
Abstract
Resumo: Este estudo examina a associação entre uso e cobertura do solo e a ocorrência de leishmaniose visceral (LV) canina. Estudo caso-controle em que casos foram residências com cães soropositivos para LV canina e controles, as residências com cães soronegativos. Utilizaram-se imagens de sensoriamento remoto (CBERS: 2/CCD e 2B/HRC) para descrever o uso e cobertura do solo em quadrículas de 625m2 na região do estudo. A chance da LV canina foi duas vezes maior em domicílios localizados em quadrículas com área ≤ 25m2 coberta por estruturas residenciais com pouca vegetação em comparação com aquelas em que essa cobertura alcançou ≥ 600m2. Domicílios localizados em quadrículas com até metade da área coberta por estruturas residenciais com muita vegetação tiveram chances 65% menores de LV canina em comparação com aquelas situadas em áreas quase totalmente cobertas por essa característica. Como a infecção canina costuma preceder a ocorrência de casos humanos, a identificação de características de uso e cobertura do solo associadas à LV canina pode contribuir para a delimitação de áreas de risco para LV humana.
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19
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Horstick O, Runge-Ranzinger S. Protection of the house against Chagas disease, dengue, leishmaniasis, and lymphatic filariasis: a systematic review. THE LANCET. INFECTIOUS DISEASES 2017; 18:e147-e158. [PMID: 29074038 DOI: 10.1016/s1473-3099(17)30422-x] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/11/2016] [Revised: 05/19/2017] [Accepted: 06/15/2017] [Indexed: 12/22/2022]
Abstract
In light of the recent Zika virus outbreak, vector control has received renewed interest. However, which interventions are efficacious and community effective and how to best deliver them remains unclear. Following PRISMA guidelines, we did a systematic review to assess evidence for applied vector control interventions providing protection against Chagas disease, dengue, leishmaniasis, and lymphatic filariasis at the household level. We searched for published literature and grey literature between Jan 1, 1980, and Nov 30, 2015, and updated our search on April 2, 2017, using databases including the Cochrane, Embase, LILACS, PubMed, Web of Science, and WHOLIS. The Cochrane Collaboration's tool for assessing risk of bias was used. Inclusion criteria included studies reporting vector control interventions in and around a house or dwelling; and use of insecticides as sprays on netting or screens, and any method to control larval breeding in water containers in and around the home. 1416 articles were assessed and 32 articles included. The most effective interventions affecting vector indices for multiple diseases were found to be intradomiciliary residual spraying, insecticide-treated materials (especially insecticide-treated nets or curtains), and treatment of larval habitats with biological and chemical methods. Waste management and clean-up campaigns reduce vector populations, although to a lesser extent than other interventions and not consistently. Modifications to the structure of homes (eg, wall plastering) had no impact on the control of vectors. Protection of the house and its surroundings might affect the transmission of several diseases. The most effective interventions should be prioritised when vector control programmes are designed; however, the quality of delivery (ie, coverage and reapplication) of interventions is a crucial factor to ensure their effectiveness. Additional randomised trials that assess the measures of human disease and eventually target several diseases with a combination of interventions that protect the household and its inhabitants against multiple vectors, are needed to inform global policy in this area.
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Affiliation(s)
- Olaf Horstick
- Institute of Public Health, University of Heidelberg, Heidelberg, Germany
| | - Silvia Runge-Ranzinger
- Institute of Public Health, University of Heidelberg, Heidelberg, Germany; Special Programme for Research and Training in Tropical Diseases, World Health Organization, Geneva, Switzerland.
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20
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Mendonça ILD, Batista JF, Schallig H, Cruz MDSPE, Alonso DP, Ribolla PEM, Costa DL, Costa CHN. The performance of serological tests for Leishmania infantum infection screening in dogs depends on the prevalence of the disease. Rev Inst Med Trop Sao Paulo 2017; 59:e39. [PMID: 28591267 PMCID: PMC5459546 DOI: 10.1590/s1678-9946201759039] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/27/2016] [Accepted: 02/22/2017] [Indexed: 11/22/2022] Open
Abstract
Dogs are considered the main reservoir of Leishmania infantum.
This protozoan causes visceral leishmaniasis (VL), an uncontrolled urban
zoonosis in Brazil. Serological tests and polymerase chain reaction (PCR) on
peripheral blood were performed to identify infected dogs in scenarios of higher
and lower prevalence of the disease (Teresina and
Vitória). One-hundred infected and 57
non-infected animals from Teresina and 100 non-infected animals from
Vitória were studied. Animal selection was
not dependent on previous serology. The sensitivity (Teresina) and specificity
(Teresina and Vitória) were as follows:
indirect antibody fluorescence (IFAT) cut-off of 1:40 (IFAT 1:40): 96%, 18%, and
76%; IFAT 1:80: 90%, 33%, and 93%; direct agglutination test (DAT): 96%, 33%,
and 98%; fast agglutination screening test (FAST): 93%, 68%, and 100%;
immunochromatographic assay with a recombinant rK39 antigen (rK39): 88%, 74%,
and 98%; enzyme linked immunosorbent assay (ELISA): 91%, 79%, and 98%; rapid
dual-path platform test (TR DPP®): 98%, 60%, and 98%; and blood PCR:
29%, 93%, and 97%, respectively. In the high transmission area, none of the
tests adequately discriminated L. infantum-infected from
non-infected dogs. However, in the high transmission city, the area under the
receiver operating characteristic (ROC) curve of FAST, DAT, ICrK39, ELISA and TR
DPP® was high.
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Affiliation(s)
- Ivete Lopes de Mendonça
- Universidade Federal do Piauí, Centro de Ciências Agrárias, Programa de Pós-Graduação em Ciência Animal, Teresina, Piauí, Brazil
| | - Joilson Ferreira Batista
- Universidade Federal do Piauí, Centro de Ciências Agrárias, Programa de Pós-Graduação em Ciência Animal, Teresina, Piauí, Brazil
| | - Henk Schallig
- Koninklijk Institut voor de Tropen, Biomedical Research, Amsterdam, Netherlands
| | - Maria do Socorro Pires E Cruz
- Universidade Federal do Piauí, Centro de Ciências Agrárias, Programa de Pós-Graduação em Ciência Animal, Teresina, Piauí, Brazil
| | - Diego Peres Alonso
- Universidade Estadual Paulista, Instituto de Biologia e Biomedicina, Departamento de Parasitologia, Botucatu, São Paulo, Brazil
| | - Paulo Eduardo Martins Ribolla
- Universidade Estadual Paulista, Instituto de Biologia e Biomedicina, Departamento de Parasitologia, Botucatu, São Paulo, Brazil
| | - Dorcas Lamounier Costa
- Universidade Federal do Piauí, Instituto de Doenças Tropicais Natan Portella, Laboratório de Leishmanioses, Teresina, Piauí, Brazil
| | - Carlos Henrique Nery Costa
- Universidade Federal do Piauí, Instituto de Doenças Tropicais Natan Portella, Laboratório de Leishmanioses, Teresina, Piauí, Brazil
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Mendonça SCF. Differences in immune responses against Leishmania induced by infection and by immunization with killed parasite antigen: implications for vaccine discovery. Parasit Vectors 2016; 9:492. [PMID: 27600664 PMCID: PMC5013623 DOI: 10.1186/s13071-016-1777-x] [Citation(s) in RCA: 24] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/31/2015] [Accepted: 08/26/2016] [Indexed: 01/06/2023] Open
Abstract
The leishmaniases are a group of diseases caused by different species of the protozoan genus Leishmania and transmitted by sand fly vectors. They are a major public health problem in almost all continents. There is no effective control of leishmaniasis and its geographical distribution is expanding in many countries. Great effort has been made by many scientists to develop a vaccine against leishmaniasis, but, so far, there is still no effective vaccine against the disease. The only way to generate protective immunity against leishmaniasis in humans is leishmanization, consisting of the inoculation of live virulent Leishmania as a means to acquire long-lasting immunity against subsequent infections. At present, all that we know about human immune responses to Leishmania induced by immunization with killed parasite antigens came from studies with first generation candidate vaccines (killed promastigote extracts). In the few occasions that the T cell-mediated immune responses to Leishmania induced by infection and immunization with killed parasite antigens were compared, important differences were found both in humans and in animals. This review discusses these differences and their relevance to the development of a vaccine against leishmaniasis, the major problems involved in this task, the recent prospects for the selection of candidate antigens and the use of attenuated Leishmania as live vaccines.
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Affiliation(s)
- Sergio C F Mendonça
- Laboratório de Imunoparasitologia, Instituto Oswaldo Cruz, Fundação Oswaldo Cruz, Av. 4365 - Manguinhos, 21040-360, Rio de Janeiro, Brazil.
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22
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Sevá AP, Ovallos FG, Amaku M, Carrillo E, Moreno J, Galati EAB, Lopes EG, Soares RM, Ferreira F. Canine-Based Strategies for Prevention and Control of Visceral Leishmaniasis in Brazil. PLoS One 2016; 11:e0160058. [PMID: 27471852 PMCID: PMC4966914 DOI: 10.1371/journal.pone.0160058] [Citation(s) in RCA: 36] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/25/2016] [Accepted: 07/13/2016] [Indexed: 11/19/2022] Open
Abstract
Visceral leishmaniasis (VL) is a zoonosis found worldwide. Its incidence has increased in Brazil in recent years, representing a serious public and animal health problem. The strategies applied in Brazil are questionable and are not sufficient to control the disease. Thus, we have compared the efficacy of some of the currently available strategies focused on dogs to prevent and control zoonotic VL in endemic areas by optimizing a mathematical model. The simulations showed that the elimination of seropositive dogs, the use of insecticide-impregnated dog collars, and the vaccination of dogs significantly contribute to reducing the prevalence of infection in both canines and humans. The use of insecticide-impregnated collars presented the highest level of efficacy mainly because it directly affected the force of infection and vector-dog contact. In addition, when used at a coverage rate of 90%, insecticide-impregnated collar was able to decrease the prevalence of seropositive dogs and humans to zero; moreover, because of the easy application and acceptance by the targeted population, these collars may be considered the most feasible for inclusion in public policies among the three simulated measures. Vaccination and euthanasia were efficacious, but the latter method is strongly criticized on ethical grounds, and both methods present difficulties for inclusion in public policies. When we compared the use of euthanasia and vaccination at coverages of 70 and 90%, respectively, the proportion of infected populations were similar. However, on evaluating the implications of both of these methods, particularly the negative aspects of culling dogs and the proportion of animals protected by vaccination, the latter measure appears to be the better option if the total cost is not significantly higher. The comparison of complications and advantages of different control strategies allows us to analyze the optimal measure and offer strategies to veterinary and public health authorities for making decisions to prevent and control zoonotic VL. Hence, improvements in both public and animal health can be achieved in regions with scenarios similar to that considered in the present study; such scenarios are characteristically found in some areas of Brazil and other countries.
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Affiliation(s)
- Anaiá P. Sevá
- Department of Preventive Veterinary Medicine and Animal Health, School of Veterinary Medicine and Animal Science, University of São Paulo, São Paulo, Brazil
- * E-mail:
| | - Fredy G. Ovallos
- Department of Epidemiology, School of Public Health, University of São Paulo, São Paulo, Brazil
| | - Marcus Amaku
- Department of Preventive Veterinary Medicine and Animal Health, School of Veterinary Medicine and Animal Science, University of São Paulo, São Paulo, Brazil
- Department of Pathology, School of Medicine, University of São Paulo, São Paulo, Brazil
| | - Eugenia Carrillo
- WHO Collaborating Centre for Leishmaniasis, Centro Nacional de Microbiología, Instituto de Salud Carlos III, Majadahonda, Spain
| | - Javier Moreno
- WHO Collaborating Centre for Leishmaniasis, Centro Nacional de Microbiología, Instituto de Salud Carlos III, Majadahonda, Spain
| | - Eunice A. B. Galati
- Department of Epidemiology, School of Public Health, University of São Paulo, São Paulo, Brazil
| | - Estela G. Lopes
- Department of Preventive Veterinary Medicine and Animal Health, School of Veterinary Medicine and Animal Science, University of São Paulo, São Paulo, Brazil
| | - Rodrigo M. Soares
- Department of Preventive Veterinary Medicine and Animal Health, School of Veterinary Medicine and Animal Science, University of São Paulo, São Paulo, Brazil
| | - Fernando Ferreira
- Department of Preventive Veterinary Medicine and Animal Health, School of Veterinary Medicine and Animal Science, University of São Paulo, São Paulo, Brazil
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23
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Reguera RM, Morán M, Pérez-Pertejo Y, García-Estrada C, Balaña-Fouce R. Current status on prevention and treatment of canine leishmaniasis. Vet Parasitol 2016; 227:98-114. [PMID: 27523945 DOI: 10.1016/j.vetpar.2016.07.011] [Citation(s) in RCA: 72] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/15/2015] [Revised: 07/07/2016] [Accepted: 07/08/2016] [Indexed: 01/17/2023]
Abstract
Canine leishmaniasis (CanL) is a parasite-borne disease mainly induced by Leishmania infantum in the Old World and Leishmania chagasi (infantum) in the New World. CanL is a zoonosis transmitted by the bite of infected Phlebotominae flies that act as vectors. CanL is a very serious disease that usually produces death when remains untreated and can be a focus of transmission to other dogs or humans. Infected dogs and other domestic and wild animals act as reservoirs and are a real threat to uninfected/healthy dogs and humans in endemic areas where the sand flies are present. Prevention of new infections in dogs can help to stop the current increase of the disease in humans, reinforcing the concept of "One Health" approach. The management of CanL is being performed using prophylactic measures in healthy dogs - insecticides impregnated in collars or immunostimulants applied by spot-on devices - and chemotherapy in animals that suffer from the disease. Antimonials as first-line monotherapy have proven efficacy in reducing most of the clinical signs of CanL, but they need to be administered during several days, and no complete parasite clearance is achieved, favouring the presence of relapses among treated dogs. Therefore, new drugs, such as miltefosine, or combinations of this drug or antimonials with allopurinol are in the pipeline of clinical treatment of CanL. Recently, there has been an emergence of protective - prophylactic - and curative - autogenous vaccines - immunotherapy tools to face CanL, whose results are still under study. This review highlights the current use of preventive and eradicative weapons to fight against this disease, which is a scourge for dogs and a continuous threat to human beings.
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Affiliation(s)
- Rosa M Reguera
- Departamento de Ciencias Biomédicas, Facultad de Veterinaria, Universidad de León, Campus de Vegazana s/n, 24071 León, Spain
| | - Miguel Morán
- Departamento de Ciencias Biomédicas, Facultad de Veterinaria, Universidad de León, Campus de Vegazana s/n, 24071 León, Spain
| | - Yolanda Pérez-Pertejo
- Departamento de Ciencias Biomédicas, Facultad de Veterinaria, Universidad de León, Campus de Vegazana s/n, 24071 León, Spain
| | - Carlos García-Estrada
- Departamento de Ciencias Biomédicas, Facultad de Veterinaria, Universidad de León, Campus de Vegazana s/n, 24071 León, Spain; Instituto de Biotecnología de León (INBIOTEC), Parque Científico de León, Avenida Real, n° 1, 24006 León, Spain
| | - Rafael Balaña-Fouce
- Departamento de Ciencias Biomédicas, Facultad de Veterinaria, Universidad de León, Campus de Vegazana s/n, 24071 León, Spain; Instituto de Biotecnología de León (INBIOTEC), Parque Científico de León, Avenida Real, n° 1, 24006 León, Spain.
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24
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Alves EB, Costa CHN, de Carvalho FAA, Pires E Cruz MDS, Werneck GL. Risk Profiles for Leishmania infantum Infection in Brazil. Am J Trop Med Hyg 2016; 94:1276-81. [PMID: 27114290 DOI: 10.4269/ajtmh.15-0513] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/09/2015] [Accepted: 03/07/2016] [Indexed: 11/07/2022] Open
Abstract
The aim of this study was to characterize risk profiles for Leishmania infantum infection in a population living in an area endemic for visceral leishmaniasis. A cohort study was conducted between January 2004 and December 2006 with the participation of 430 individuals living in the city of Teresina, northeast Brazil, who were initially negative for the Montenegro test. Data analysis was performed using the classification and regression tree method. The cumulative incidence (CI) of Montenegro's test conversion was 35% at 18-month follow-up. Eight different risk profiles for L. infantum infection were identified. The profile with the highest risk (CI = 75%) comprised individuals with less than 4 years of education who had never lived outside Teresina. The profile with the lowest risk (CI = 5%) included highly educated subjects who had owned a dog for 5 years or more and lived in areas that received some type of intervention. These results show that there is a high degree of complexity involved in the risk for L. infantum infection and point out the need of developing new studies to perform a comprehensive analysis focused on investigating the interrelation between risk factors rather than their isolated roles on the determination of infection levels in urban areas.
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Affiliation(s)
- Erika Barretto Alves
- Instituto de Estudos em Saúde Coletiva, Universidade Federal do Rio de Janeiro, Rio de Janeiro, Brazil; Instituto de Doenças Tropicais Natan Portela, Teresina, Piauí, Brazil; Universidade Federal do Piauí, Teresina, Piauí, Brazil; Departamento de Bioquímica e Farmacologia, Centro de Ciências da Saúde, Universidade Federal do Piauí, Teresina, Piauí, Brazil; Programa de Pós-graduação em Ciência Animal, Centro de Ciências Agrárias, Universidade Federal do Piauí, Teresina, Piauí, Brazil
| | - Carlos Henrique Nery Costa
- Instituto de Estudos em Saúde Coletiva, Universidade Federal do Rio de Janeiro, Rio de Janeiro, Brazil; Instituto de Doenças Tropicais Natan Portela, Teresina, Piauí, Brazil; Universidade Federal do Piauí, Teresina, Piauí, Brazil; Departamento de Bioquímica e Farmacologia, Centro de Ciências da Saúde, Universidade Federal do Piauí, Teresina, Piauí, Brazil; Programa de Pós-graduação em Ciência Animal, Centro de Ciências Agrárias, Universidade Federal do Piauí, Teresina, Piauí, Brazil
| | - Fernando Aécio Amorim de Carvalho
- Instituto de Estudos em Saúde Coletiva, Universidade Federal do Rio de Janeiro, Rio de Janeiro, Brazil; Instituto de Doenças Tropicais Natan Portela, Teresina, Piauí, Brazil; Universidade Federal do Piauí, Teresina, Piauí, Brazil; Departamento de Bioquímica e Farmacologia, Centro de Ciências da Saúde, Universidade Federal do Piauí, Teresina, Piauí, Brazil; Programa de Pós-graduação em Ciência Animal, Centro de Ciências Agrárias, Universidade Federal do Piauí, Teresina, Piauí, Brazil
| | - Maria do Socorro Pires E Cruz
- Instituto de Estudos em Saúde Coletiva, Universidade Federal do Rio de Janeiro, Rio de Janeiro, Brazil; Instituto de Doenças Tropicais Natan Portela, Teresina, Piauí, Brazil; Universidade Federal do Piauí, Teresina, Piauí, Brazil; Departamento de Bioquímica e Farmacologia, Centro de Ciências da Saúde, Universidade Federal do Piauí, Teresina, Piauí, Brazil; Programa de Pós-graduação em Ciência Animal, Centro de Ciências Agrárias, Universidade Federal do Piauí, Teresina, Piauí, Brazil
| | - Guilherme Loureiro Werneck
- Instituto de Estudos em Saúde Coletiva, Universidade Federal do Rio de Janeiro, Rio de Janeiro, Brazil; Instituto de Doenças Tropicais Natan Portela, Teresina, Piauí, Brazil; Universidade Federal do Piauí, Teresina, Piauí, Brazil; Departamento de Bioquímica e Farmacologia, Centro de Ciências da Saúde, Universidade Federal do Piauí, Teresina, Piauí, Brazil; Programa de Pós-graduação em Ciência Animal, Centro de Ciências Agrárias, Universidade Federal do Piauí, Teresina, Piauí, Brazil
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25
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Menon SS, Rossi R, Nshimyumukiza L, Zinszer K. Decentralized control of human visceral leishmaniasis in endemic urban areas of Brazil: a literature review. Trop Med Health 2016; 44:9. [PMID: 27433128 PMCID: PMC4940922 DOI: 10.1186/s41182-016-0011-z] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/10/2015] [Accepted: 03/17/2016] [Indexed: 11/17/2022] Open
Abstract
OBJECTIVES Human migration and concomitant HIV infections are likely to bring about major changes in the epidemiology of some parasitic infections in Brazil. Human visceral leishmaniasis (HVL) control is particularly fraught with intricacies. It is against a backdrop of decentralized health care that the complex HVL control initiatives are brought to bear. This comprehensive review aims to explore the obstacles facing decentralized HVL control in urban endemic areas in Brazil. METHOD A literature search was carried out in December 2015 by means of three databases: MEDLINE, Google Scholar, and Web of Science. RESULTS Although there have been many strides that have been made in elucidating the eco-epidemiology of Leishmania infantum, which forms the underpinnings of the national control program, transmission risk factors for HVL are still insufficiently elucidated in urban settings. Decentralized HVL epidemiological surveillance and control for animal reservoirs and vectors may compromise sustainability. In addition, it may hamper timely human HVL case management. With the burgeoning of the HIV-HVL co-infection, the potential human transmission may be underestimated. CONCLUSION HVL is a disease with focal transmission at a critical juncture, which warrants that the bottlenecks facing the control program within contexts of decentralized healthcare systems be taken into account. In addition, HIV-driven HVL epidemics may substantially increase the transmission potential of the human reservoir. Calculating the basic reproductive number to fine-tune interventions will have to take into consideration the specific socio-economic development context.
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Affiliation(s)
- Sonia S. Menon
- />International Centre for Reproductive Health (ICRH), Ghent University, De Pintelaan 185 P3, 9000 Ghent, Belgium
- />Department of Epidemiology and Biostatistics, McGill University, Montreal, Canada
| | | | - Leon Nshimyumukiza
- />Department of Social and Preventive Medicine, Laval University, Boston, USA
| | - Kate Zinszer
- />Boston Children’s Hospital, Harvard Medical School, Boston, MA USA
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26
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Dantas-Torres F, Otranto D. Best Practices for Preventing Vector-Borne Diseases in Dogs and Humans. Trends Parasitol 2016; 32:43-55. [DOI: 10.1016/j.pt.2015.09.004] [Citation(s) in RCA: 75] [Impact Index Per Article: 9.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/20/2015] [Revised: 09/03/2015] [Accepted: 09/16/2015] [Indexed: 12/12/2022]
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González U, Pinart M, Sinclair D, Firooz A, Enk C, Vélez ID, Esterhuizen TM, Tristan M, Alvar J. Vector and reservoir control for preventing leishmaniasis. Cochrane Database Syst Rev 2015; 2015:CD008736. [PMID: 26246011 PMCID: PMC4561525 DOI: 10.1002/14651858.cd008736.pub2] [Citation(s) in RCA: 25] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
Abstract
BACKGROUND Leishmaniasis is caused by the Leishmania parasite, and transmitted by infected phlebotomine sandflies. Of the two distinct clinical syndromes, cutaneous leishmaniasis (CL) affects the skin and mucous membranes, and visceral leishmaniasis (VL) affects internal organs. Approaches to prevent transmission include vector control by reducing human contact with infected sandflies, and reservoir control, by reducing the number of infected animals. OBJECTIVES To assess the effects of vector and reservoir control interventions for cutaneous and for visceral leishmaniasis. SEARCH METHODS We searched the following databases to 13 January 2015: Cochrane Infectious Diseases Group Specialized Register, CENTRAL, MEDLINE, EMBASE, LILACS and WHOLIS, Web of Science, and RePORTER. We also searched trials registers for ongoing trials. SELECTION CRITERIA Randomized controlled trials (RCTs) evaluating the effects of vector and reservoir control interventions in leishmaniasis-endemic regions. DATA COLLECTION AND ANALYSIS Two review authors independently searched for trials and extracted data from included RCTs. We resolved any disagreements by discussion with a third review author. We assessed the quality of the evidence using the GRADE approach. MAIN RESULTS We included 14 RCTs that evaluated a range of interventions across different settings. The study methods were generally poorly described, and consequently all included trials were judged to be at high or unclear risk of selection and reporting bias. Only seven trials reported clinical outcome data which limits our ability to make broad generalizations to different epidemiological settings and cultures. Cutaneous leishmaniasisOne four-arm RCT from Afghanistan compared indoor residual spraying (IRS), insecticide-treated bednets (ITNs), and insecticide-treated bedsheets, with no intervention. Over 15 months follow-up, all three insecticide-based interventions had a lower incidence of CL than the control area (IRS: risk ratio (RR) 0.61, 95% confidence interval (CI) 0.38 to 0.97, 2892 participants, moderate quality evidence; ITNs: RR 0.32, 95% CI 0.18 to 0.56, 2954 participants, low quality evidence; ITS: RR 0.34, 95% CI 0.20 to 0.57, 2784 participants, low quality evidence). No difference was detected between the three interventions (low quality evidence). One additional trial of ITNs from Iran was underpowered to show a difference.Insecticide treated curtains were compared with no intervention in one RCT from Venezuela, where there were no CL episodes in the intervention areas over 12 months follow-up compared to 142 in control areas (RR 0.00, 95% CI 0.00 to 0.49, one trial, 2938 participants, low quality evidence).Personal protection using insecticide treated clothing was evaluated by two RCTs in soldiers, but the trials were underpowered to reliably detect effects on the incidence of CL (RR 0.40, 95% CI 0.13 to 1.20, two trials, 558 participants, low quality evidence). Visceral leishmaniasisIn a single RCT of ITNs versus no intervention from India and Nepal, the incidence of VL was low in both groups and no difference was detected (RR 0.99, 95% CI 0.46 to 2.15, one trial, 19,810 participants, moderate quality evidence).Two trials from Brazil evaluated the effects of culling infected dogs compared to no intervention or IRS. Although they report a reduction in seroconversion over 18 months follow-up, they did not measure or report effects on clinical disease. AUTHORS' CONCLUSIONS Using insecticides to reduce phlebotomine sandfly numbers may be effective at reducing the incidence of CL, but there is insufficient evidence from trials to know whether it is better to spray the internal walls of houses or to treat bednets, curtains, bedsheets or clothing.
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Affiliation(s)
- Urbà González
- CLĺNICA GO&FERUnit of DermatologyRiera Blanca 6‐8, L´HospitaletBarcelonaSpain08903
| | - Mariona Pinart
- Centre for Research in Environmental Epidemiology (CREAL)c/ Doctor Aiguader 88BarcelonaCatalunyaSpain08003
| | - David Sinclair
- Liverpool School of Tropical MedicineDepartment of Clinical SciencesPembroke PlaceLiverpoolUKL3 5QA
| | - Alireza Firooz
- Center for Research and Training in Skin Diseases and Leprosy, Tehran University of Medical SciencesNo 79 Taleqani AvenueTehranIran14166‐13675
| | - Claes Enk
- Hadassah Medical CenterDepartment of DermatologyP.O.Box 12000JerusalemIsrael91010
| | - Ivan D Vélez
- Universidad de AntioquiaPrograma de Estudio y Control de Enfermedades Tropicales PECETCalle 62 52 59 SIU Laboratorio 632MedellinColombia
| | - Tonya M Esterhuizen
- Stellenbosch UniversityCentre for Evidence‐based Health Care, Faculty of Medicine and Health SciencesTygerbergCape TownSouth Africa
| | - Mario Tristan
- International Health Central American InstituteBoard of DirectorsAv. 7 Streets 35 and 37 N 3530P.O. Box 1677‐2100‐ IHCAI FOUNDATIONSan JoséSan JoseCosta Rica2100
| | - Jorge Alvar
- Drugs for Neglected Diseases initiative (DNDi)15 Chemin Louis‐DunantGenevaSwitzerland1202
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de Vries HJC, Reedijk SH, Schallig HDFH. Cutaneous leishmaniasis: recent developments in diagnosis and management. Am J Clin Dermatol 2015; 16:99-109. [PMID: 25687688 PMCID: PMC4363483 DOI: 10.1007/s40257-015-0114-z] [Citation(s) in RCA: 241] [Impact Index Per Article: 26.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
This review focuses on recent developments in the diagnosis, treatment, management, and strategies for the prevention and control of cutaneous leishmaniasis (CL) caused by both Old and New World Leishmania species. CL is caused by the vector-borne protozoan parasite Leishmania and is transmitted via infected female sandflies. The disease is endemic in more than 98 countries and an estimated 350 million people are at risk. The overall prevalence is 12 million cases and the annual incidence is 2–2.5 million. The World Health Organization considers CL a severely neglected disease and a category 1 emerging and uncontrolled disease. The management of CL differs from region to region and is primarily based on local experience-based evidence. Most CL patients can be treated with topical treatments, but some Leishmania species can cause mucocutaneous involvement requiring a systemic therapeutic approach. Moreover, Leishmania species can vary in their sensitivity to available therapeutic options. This makes species determination critical for the choice of treatment and the clinical outcome of CL. Identification of the infecting parasite used to be laborious, but now the Leishmania species can be identified relatively easy with new DNA techniques that enable a more rational therapy choice. Current treatment guidelines for CL are based on poorly designed and reported trials. There is a lack of evidence for potentially beneficial treatments, a desperate need for large well-conducted studies, and standardization of future trials. Moreover, intensified research programs to improve vector control, diagnostics, and the therapeutic arsenal to contain further incidence and morbidity are needed.
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Affiliation(s)
- Henry J C de Vries
- Department of Dermatology, Academic Medical Center (AMC), University of Amsterdam, P.O. Box 22700, 1100 DE, Amsterdam, The Netherlands,
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