Abstract
BackgroundVisceral leishmaniasis (VL) is an infectious disease with a variety of clinical signs. The main form of parasite transmission to humans and other mammalian hosts is through the bite of infected arthropod females with Lutzomyia longipalpis serving as the main vector in the Americas. Dogs are the main urban domestic reservoirs of the parasite and the main source of vector infection due to their high prevalence in endemic areas and the large number of parasites in the skin of infected animals. Although miltefosine has been used in Europe since 2002 for treatment of VL infected dogs, in the Americas the treatment of dogs has not been recommended. Therefore, this study aimed to evaluate efficacy of miltefosine observing a reduction of clinical signs in infected dogs and the infectiveness to the vector by Leishmania (L.) infantum.MethodsTo our knowledge, this is the first controlled study using qPCR and xenodiagnosis to evaluate the efficacy of miltefosine (Milteforan®, Virbac) as a single treatment in Brazil. Thirty-five adult dogs with canine visceral leishmaniasis (CVL), confirmed by clinical and laboratory tests, were included in this study. They received miltefosine at a dose of 2 mg/kg every 24 h for 28 days. The dogs were observed over a three-month period, during which clinical evaluations based on a scoring system were conducted at pre-established times. Parasite load was assessed by cytology and real-time polymerase chain reaction (qPCR). Transmissibility to the vector was evaluated by xenodiagnosis.ResultsAt the end of the period, the following were observed: (i) the remission of clinical signs with a reduction in clinical scores for 94.2% of the animals; (ii) a statistically significant reduction (98.7%) in parasitic load by qPCR; and (iii) a reduction in infectivity to sand flies. After treatment, 74.2% of the animals remained or had become non-infectious.ConclusionsOur study indicates that the use of miltefosine administered orally for 4 weeks contributes to a clinical improvement and reduction in infectivity of dogs to L. infantum.
Highlights
Visceral leishmaniasis (VL) is an infectious disease with a variety of clinical signs
The results obtained in our study demonstrate that Realtime polymerase chain reaction (qPCR) is an important tool for the detection of Leishmania DNA in tissues, mainly in the skin, given its high diagnostic sensitivity, as previously pointed out by other authors [31, 40,41,42,43]
Our study demonstrated that the use of miltefosine showed potential for reducing the parasitic load of dogs infected with L. infantum; clinical improvement in the dogs was observed
Summary
Visceral leishmaniasis (VL) is an infectious disease with a variety of clinical signs. The main form of parasite transmission to humans and other mammalian hosts is through the bite of infected arthropod females with Lutzomyia longipalpis serving as the main vector in the Americas. This study aimed to evaluate efficacy of miltefosine observing a reduction of clinical signs in infected dogs and the infectiveness to the vector by Leishmania (L.) infantum. Visceral leishmaniasis (VL) is an infectious, non-contagious, chronic disease with significant clinical and epidemiological control priority in the world. The main form of transmission of the parasite to humans and other mammalian hosts is through the bite of infected sand flies (Diptera: Psychodidae). The population density of sand flies increases with high temperature and high relative humidity, resulting in periods of high risk of transmission of the parasite
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