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.
In visceral leishmaniasis, the detection of the agent is of paramount importance to
identify reservoirs of infection. Here, we evaluated the diagnostic attributes of
PCRs based on primers directed to cytochrome-B (cytB),
cytochrome-oxidase-subunit II (coxII), cytochrome-C
(cytC), and the minicircle-kDNA. Although PCRs directed to
cytB, coxII, cytC were able to detect different species of
Leishmania, and the nucleotide sequence of their amplicons
allowed the unequivocal differentiation of species, the analytical and diagnostic
sensitivity of these PCRs were much lower than the analytical and diagnostic
sensitivity of the kDNA-PCR. Among the 73 seropositive animals, the asymptomatic dogs
had spleen and bone marrow samples collected and tested; only two animals were
positive by PCRs based on cytB, coxII, and
cytC, whereas 18 were positive by the kDNA-PCR. Considering the
kDNA-PCR results, six dogs had positive spleen and bone marrow samples, eight dogs
had positive bone marrow results but negative results in spleen samples and, in four
dogs, the reverse situation occurred. We concluded that PCRs based on
cytB, coxII, and cytC can be
useful tools to identify Leishmania species when used in combination
with automated sequencing. The discordance between the results of the kDNA-PCR in
bone marrow and spleen samples may indicate that conventional PCR lacks sensitivity
for the detection of infected dogs. Thus, primers based on the kDNA should be
preferred for the screening of infected dogs.
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