Abstract
Canines are proven reservoir hosts of Leishmania infantum, the causative agent of human zoonotic visceral leishmaniasis, and therefore domestic dogs play a central role in transmitting the disease to humans. Studies on the effect of insecticide-impregnated dog collars for controlling canine visceral leishmaniasis (CanL) have been increasing; however, meta-analysis has not been conducted. This study assessed the effectiveness of insecticide-impregnated dog collars for preventing CanL. We searched (PubMed, Web of Science, Scopus, Embase, Ovid Medline(R), and Cochrane library), from inception until 2 May 2020. Two authors independently performed articles screening and data extraction. We applied the RoB 2.0 tool to evaluate the risk of bias in randomized trials, while the ROBINS-I tool was used for non-randomized trials. I-squared statistics(I2) and funnel plot and Egger’s test, respectively, were used to assesses heterogeneity between studies and publication bias. Relative Risk (RR) and 95% Confidence Interval (CI) were calculated using the random-effects model in Stata 14 software. Out of 242 citations identified, 14 studies comprising 3786 collared dogs and 3428 uncollared dogs were eligible for meta-analysis. The use of deltamethrin-impregnated dog collars(DMC) showed an overall effectiveness of 54% (95%CI: 35–65%, I2 = 63.2%, P = 0.002) in decreasing incidence of CanL, while 10% imidacloprid and 4.5% flumethrin collars provided an overall effectiveness of 90% (95%CI: 80–96%, I2 = 0.0%, P = 0.376). DMC efficacy stratified by follow-up duration was estimated to be 58% (RR = 0.42, 95%CI: 0.20–0.87), 54% (RR = 0.46, 95%CI: 0.31–0.68), 53% (RR = 0.47, 95%CI: 0.29–0.82) for follow-up periods of 5 to 6 months, 1 year and 2 years, respectively. The current evidence indicates that using insecticide-impregnated dog collars can reduce the risk of CanL caused by L. infantum. Therefore, insecticide-impregnated dog collars could be a viable alternative for inclusion as a public health measure for controlling CanL.
Highlights
Canine leishmaniosis (CanL), arthropod-borne parasitic zoonosis, caused by Leishmania infantum, mostly occur in the Mediterranean region, and South America [1, 2]
We evaluated the following domains using the ROBINS-I tool: (1) bias due to Effect of insecticide-impregnated dog collars on incidence of canine visceral leishmaniasis confounding, (2) bias in the selection of participants into the study, (3) bias in classification of interventions, (4) bias due to deviations from intended interventions, (5) bias due to missing data, (6) bias in the measurement of the outcome and (7) bias in the selection of the reported result [19]
With the reason that their full-texts were not identified, four abstracts were excluded, out of which 2 studies are reviews, 1 study is unrelated to our outcome of interest, and 1 study evaluated the effect of DMC in reducing CanL incidence
Summary
Canine leishmaniosis (CanL), arthropod-borne parasitic zoonosis, caused by Leishmania infantum, mostly occur in the Mediterranean region, and South America [1, 2]. Antileishmanial treatments of dogs’ lead to clinical improvement of treated dogs and decrease dogs’ infectiousness, limiting the transmission of the parasite from canines to phlebotomine sand flies; owing to drugs limitation in the parasitological cure, complete parasite clearance is not frequently achieved and dogs may remain infectious to sand flies. This leads to recurrences of the disease in dogs, and it requires continuous treatment, which is not costeffective and practically unfeasible from a public health perspective [4, 12]. Though there have been substantial efforts in the development of a robust and effective vaccine, insecticides(pyrethroids) in the form of insecticide-impregnated dog collars have been used to prevent sand fly bite, and spread of the disease [6, 8, 9]
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