Abstract
BackgroundVisceral 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.MethodsInformation 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.ResultsControl 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.ConclusionsThe 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.
Highlights
Visceral leishmaniasis is an important but neglected disease that is spreading and is highly lethal when left untreated
Program (VLCP), the main strategies of which include the diagnosis and timely treatment of human cases, environmental management and chemical control of the vector with residual insecticide spraying, and the canine serological survey and the canine culling of positive dogs in order to reduce the vectors’ sources of infection, since the domestic dog is considered the main reservoir of the disease in urban areas [3]
With regards to the coverage of the control measures, it was observed that the coverage of canine culling was highest, reaching values up to 70% in years in which canine serological surveys were performed (Fig. 2b)
Summary
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. Visceral leishmaniasis (VL) is considered a neglected tropical disease. It presents a high fatality rate, which can attain 100% if left untreated [1, 2]. Program (VLCP), the main strategies of which include the diagnosis and timely treatment of human cases, environmental management and chemical control of the vector with residual insecticide spraying, and the canine serological survey and the canine culling of positive dogs in order to reduce the vectors’ sources of infection, since the domestic dog is considered the main reservoir of the disease in urban areas [3]. Those few studies have methodological problems that have been recognized in their experimental designs [8]
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