Abstract
Canine visceral leishmaniasis (CVL) diagnosis is still a challenge in endemic areas with limited diagnostic resources. This study proposes a score with the potential to distinguish positive CVL cases from negative ones. We studied 265 dogs that tested positive for CVL on ELISA and parasitological tests. A score ranging between 0 and 19 was recorded on the basis of clinical signs. Dogs with CVL had an overall higher positivity of the majority of clinical signs than did dogs without CVL or with ehrlichiosis. Clinical signs such as enlarged lymph nodes (83.93%), muzzle/ear lesions (55.36%), nutritional status (51.79%), bristle condition (57.14%), pale mucosal colour (48.21%), onychogryphosis (58.93%), skin lesion (39.28%), bleeding (12.50%), muzzle depigmentation (41.07%), alopecia (39.29%), blepharitis (21.43%), and keratoconjunctivitis (42.86%) were more frequent in dogs with CVL than in dogs with ehrlichiosis or without CVL. Moreover, the clinical score increased according to the positivity of all diagnostic tests (ELISA, p < 0.001; parasite culture, p = 0.0021; and smear, p = 0.0003). Onychogryphosis (long nails) [odds ratio (OR): 3.529; 95% confidence interval (CI): 1.832-6.796; p < 0.001], muzzle depigmentation (OR: 4.651; 95% CI: 2.218-9.750; p < 0.001), and keratoconjunctivitis (OR: 5.400; 95% CI: 2.549-11.441; p < 0.001) were highly associated with CVL. Interestingly, a score cut-off value ≥ 6 had an area under the curve of 0.717 (p < 0.0001), sensitivity of 60.71%, and specificity of 73.64% for CVL diagnosis. The clinical sign-based score for CVL diagnosis suggested herein can help veterinarians reliably identify dogs with CVL in endemic areas with limited diagnostic resources.
Highlights
Kleverton Ribeiro da Silva1, Vitor Rosa Ramos de Mendonça1, Kellen Matuzzy Silva2, Leopoldo Fabrício Marçal do Nascimento2, Antonio Ferreira Mendes-Sousa3, Flaviane Alves de Pinho2, Manoel Barral-Netto1,4,5, Aldina Maria Prado Barral1,4,5, Maria do Socorro Pires e Cruz2/+
In order to verify the efficacy of this clinical score, we applied it in a large sample of sick dogs that were brought to a reference veterinary hospital in a highly endemic, lowresource area in Brazil
The results showed that the overall positivity for the clinical signs was slightly more expressed in canine visceral leishmaniasis (CVL)-positive dogs than in all the sick dogs, and that the relative distributions of some signs differed between the two groups, as illustrated by serous or mucopurulent keratoconjunctivitis (42.86% and 20.65%, p = 0.001, Fig. 3D, B, respectively)
Summary
Kleverton Ribeiro da Silva, Vitor Rosa Ramos de Mendonça, Kellen Matuzzy Silva, Leopoldo Fabrício Marçal do Nascimento, Antonio Ferreira Mendes-Sousa, Flaviane Alves de Pinho, Manoel Barral-Netto, Aldina Maria Prado Barral, Maria do Socorro Pires e Cruz2/+. American visceral leishmaniasis is a chronic parasitic zoonosis widespread in Latin America, with 90% of the cases occurring in Brazil, where it affects more than 3,300 individuals per year (Alvar et al 2012) It is caused by a protozoan parasite Leishmania infantum (syn L. chagasi) transmitted by the bite of infected female sand flies of the genus Lutzomyia. In endemic regions with limited resources, the diagnostic procedure is even worse because serological or molecular methods are difficult to perform. In this context, a reliable clinical score based on clinical signs is needed to help CVL diagnosis and management in endemic regions. In order to verify the efficacy of this clinical score, we applied it in a large sample of sick dogs (including CVL-positive and CVL-negative animals) that were brought to a reference veterinary hospital in a highly endemic, lowresource area in Brazil
Sign-in/Register to view highlights & summary Sign-in/Register to access full text options 
Free) 
Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a call
