Passive case detection for canine visceral leishmaniasis control in urban Brazil: Determinants of population uptake

Background In Brazil, the transmission of Leishmania infantum in urban settings is closely related to infection among dogs, with occasional transmission to humans. Serological screening of dogs for Leishmania spp. infection on requests of their owners (passive case detection) represents a frequent, but little studied, practice within the scope of Brazilian public health. This study identified factors associated with canine visceral leishmaniasis (CVL) diagnosis-seeking behavior of dog owners in Rondonópolis (236,000 inhabitants), a municipality in Central-Western Brazil where VL is endemic. Also, we evaluated the profile of dog owners and their animals screened on free demand. Methodology/Principal findings Using mixed effects negative binomial regression, we modelled the number of dogs screened for Leishmania infection on free demand per neighborhood from 2011 to 2016 as a function of time-dependent predictors (current or recent canine seropositivity and human VL incidence), distance to the screening site, and demographic variables. We assessed potential delays in the effect of time-dependent predictors on the outcome. Among 12,536 dogs screened for Leishmania infection, 64.2% were tested during serosurveys and 35.8% were tested on free demand. Of these, 63.9% were positive. Uptake of screening under free demand was strongly associated with higher levels of canine seropositivity in the neighborhood (current or recent) and decreasing distance to the screening site. A subsample of dog owners (n = 93) who sought CVL screening between 2016 and 2017 were interviewed in more detail. Owners with better socioeconomic status and dogs with apparent CVL clinical manifestations prevailed among them. Conclusions/Significance To support timely CVL management, passive case detection along with awareness activities aimed at dog owners should be encouraged in endemic areas. Screening sites should be prioritized in accessible zones, as well as in socio-economically disadvantage areas. In parallel, CVL active case detection should be continued as a surveillance tool to guide control actions.

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First autochthonous case of canine visceral leishmaniasis in Volta Redonda, Rio de Janeiro, Brazil

Revista Brasileira de Parasitologia Veterinária ◽

10.1590/s1984-29612013000300018 ◽

2013 ◽

Vol 22 (3) ◽

pp. 424-426 ◽

Cited By ~ 8

Author(s):

Monique Paiva de Campos ◽

Denise Amaro da Silva ◽

Maria de Fátima Madeira ◽

Artur Augusto Mendes Velho Júnior ◽

Fabiano Borges Figueiredo

Keyword(s):

Visceral Leishmaniasis ◽

Diagnostic Tests ◽

Rio De Janeiro ◽

Scientific Community ◽

Clinical Manifestations ◽

Canine Visceral Leishmaniasis ◽

Leishmania Chagasi ◽

Laboratory Findings ◽

Autochthonous Case ◽

Canine Diseases

In Brazil, American visceral leishmaniasis (AVL) is caused byLeishmania (Leishmania) chagasi and its main vector isLutzomyia longipalpis. Cases of canine visceral leishmaniasis (CVL) in non-endemic areas have been reported over the last few years throughout the country. The objective of this research note is to describe an autochthonous case of CVL that occurred in the municipality of Volta Redonda, state of Rio de Janeiro, an area where the disease is not endemic, alerting veterinarians and the scientific community to the expansion of this important zoonosis and advising veterinary practitioners on how to deal with a suspicion of CVL. Canine visceral leishmaniasis can be misdiagnosed within a broad spectrum of canine diseases based on clinical and laboratory findings. Therefore, knowledge of its clinical manifestations, specific and sensitive laboratory diagnostic tests and parasitological procedures are of the utmost importance for rapid confirmation and notification of a case, thus contributing directly to the control of a focus.

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Comparison of serological assays for the diagnosis of canine visceral leishmaniasis in animals presenting different clinical manifestations

Veterinary Parasitology ◽

10.1016/j.vetpar.2007.02.015 ◽

2007 ◽

Vol 146 (3-4) ◽

pp. 235-241 ◽

Cited By ~ 80

Author(s):

Eduardo de Castro Ferreira ◽

Marta de Lana ◽

Mariângela Carneiro ◽

Alexandre Barbosa Reis ◽

Daniela Vieira Paes ◽

...

Keyword(s):

Visceral Leishmaniasis ◽

Clinical Manifestations ◽

Canine Visceral Leishmaniasis

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Effectiveness and Feasibility of Active and Passive Case Detection in the Visceral Leishmaniasis Elimination Initiative in India, Bangladesh, and Nepal

American Journal of Tropical Medicine and Hygiene ◽

10.4269/ajtmh.2010.09-0685 ◽

2010 ◽

Vol 83 (3) ◽

pp. 507-511 ◽

Cited By ~ 25

Author(s):

Siddhivinayak Hirve ◽

Megha Raj Banjara ◽

Axel Kroeger ◽

Shri Prakash Singh ◽

Suman Rijal ◽

...

Keyword(s):

Visceral Leishmaniasis ◽

Case Detection ◽

Passive Case Detection

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Impact of socioeconomic status on the knowledge, attitudes, and practices about visceral leishmaniasis among dog owners

The Journal of Infection in Developing Countries ◽

10.3855/jidc.14522 ◽

2021 ◽

Vol 15 (10) ◽

pp. 1523-1531

Author(s):

Amanda Gabriela De Carvalho ◽

João Gabriel Guimarães Luz ◽

Luane Dantas Rodrigues ◽

João Victor Leite Dias ◽

Cor Jesus Fernandes Fontes

Keyword(s):

Socioeconomic Status ◽

Visceral Leishmaniasis ◽

Clinical Manifestations ◽

Social Classes ◽

Cross Sectional ◽

Attitudes And Practices ◽

Dog Owners ◽

The Impact ◽

Previous Occurrence ◽

Knowledge Attitudes And Practices

Introduction: This cross-sectional study evaluated the impact of socioeconomic status on the knowledge, attitudes, and practices (KAP) concerning zoonotic visceral leishmaniasis (VL) among dog owners from the municipality of Rondonópolis—a highly endemic area for the disease in Central-Western Brazil. Methodology: Data were collected between 2016 and 2017 during a household survey. A probabilistic sample of 404 dog owners were interviewed assessing sociodemographic characteristics, previous occurrence of VL cases, and KAP about human VL, vector, and canine VL. Responses regarding KAP were compared among social classes, which are indicators of socioeconomic status. Correct/appropriate answers were scored, and a multivariate Poisson regression analysis evaluated the impact of social class on scoring. Results: The overall KAP regarding VL was limited. Dog owners from higher social classes differed from those of the lower classes regarding the recognition of abdominal distension (p = 0.026) and skin lesions (p < 0.001) as clinical manifestations of human and canine VL, respectively, knowledge of VL transmission (p = 0.020), use of topical repellents (p < 0.001), use of insecticide-impregnated collars (p = 0.003), and previous attempts of treatment for canine VL (p = 0.005). Higher scores were associated with the upper social classes (IRR = 1.18; CI = 1.08-1.29) adjusted by the age (IRR = 1.13; CI = 1.04-1.24) and the previous occurrence of human (IRR = 1.21; CI = 1.07-1.36) and canine (IRR = 1.25; CI = 1.14-1.36) VL in the household/neighbourhood of the respondents. Conclusions: Improved KAP concerning VL was associated with better socioeconomic status of dog owners.

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Visceral leishmaniasis cyclical trends in Bihar, India – implications for the elimination programme.

Gates Open Research ◽

10.12688/gatesopenres.12793.1 ◽

2018 ◽

Vol 2 ◽

pp. 10 ◽

Cited By ~ 1

Author(s):

Rinki M Deb ◽

Michelle C Stanton ◽

Geraldine M Foster ◽

Rudra K Das Gupta ◽

Nupur Roy ◽

...

Keyword(s):

Visceral Leishmaniasis ◽

Negative Binomial ◽

Negative Binomial Regression ◽

Specific Humidity ◽

Sand Fly ◽

Maximum Temperature ◽

Negative Binomial Regression Model ◽

Case Detection ◽

Binomial Regression ◽

Significant Difference

Background:Visceral leishmaniasis (VL) is a vector-borne disease of public health importance in India, with the highest burden of disease in the states of Bihar, Jharkhand, West Bengal and Uttar Pradesh. The disease is currently targeted for elimination (annual incidence to less than one per 10,000 population) using indoor residual spraying, active case detection and treatment. Historically the disease trend in India has been regarded as cyclical with case resurgence characteristically occurring every 15 years. Understanding this pattern is essential if the VL elimination gains are to be sustained. To better understand the cyclical trends, annual climatic indicators including rainfall, temperature and humidity over time were compared with annual VL case incidence data. Methods:Annual climate data (rainfall, average and maximum temperature and specific humidity) from 1956-2004 were used to identify potential factors influencing VL incidence. Months relevant to the VL life-cycle were identified and defined (Monsoon, Sand-fly Peak, Pre-Sand-fly Peak and Annual) for analysis. The Kruskall-Wallis test was used to determine significant difference between categorical rainfall and VL incidence, whilst univariate negative binomial regression models were used to determine predictors of disease incidence.Results:The negative binomial regression model showed statistically significant associations (p <0.05) for VL incidence and maximum temperature, and average temperature, when considering annual and pre-sand fly peak time periods. No other associations between humidity, rainfall or temperature and VL incidence were detected (all values p >0.05). Conclusion:The VL programme in Bihar has made significant progress in adopting best practices for improved treatment and vector control, with the aim to achieve VL elimination. However, open access granular programme data for indoor residual spray activities and case detection is required to fully understand the role of climate in disease transmission and potential resurgence.

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Use of Immunotherapy in the Treatment of Canine Visceral Leishmaniasis

Acta Scientiae Veterinariae ◽

10.22456/1679-9216.105438 ◽

2020 ◽

Vol 48 ◽

Author(s):

Adjanna Karla Leite Araujo ◽

Adriana Leão de Carvalho Lima Gondim

Keyword(s):

Lymph Node ◽

Visceral Leishmaniasis ◽

Serological Test ◽

Clinical Signs ◽

Clinical Manifestations ◽

Confirmatory Test ◽

Canine Visceral Leishmaniasis ◽

Serological Examination ◽

Negative Results ◽

Parasitic Load

Background: Canine visceral leishmaniasis is a worldwide zoonosis, with dogs being the main urban reservoirs. It is caused by a protozoan of the genus Leishmania spp. and is transmitted to mammals through a vector belonging to the phlebotomines family. Its treatment aims to reduce the parasitic load preventing these animals from being transmitters. Immunotherapy has been shown to be efficient in stimulating the patient's immune response, improving the general condition and preventing recurrence. This report describes the case of a dog diagnosed with canine visceral leishmaniasis submitted to immunotherapy and drug protocol, noting significant general improvement.Case: An 8-year-old female dog was treated with ulcerated lesions on the paw pads, nasal plane and lip region, onychogryphosis and ungeitis, in addition, hypertrophied popliteal lymph nodes and erosive lesions in the elbows, without improvement with previous treatments. Serological examination was then performed to diagnose leishmaniasis by the immunosorbent assay (ELISA) technique with negative results. In addition, was performed puncture of the popliteal lymph node, sample in which amastigote forms of Leishmania were observed and blood sample analysis by immunochromatographic rapid test showing reagent result, confirming the diagnosis of canine visceral leishmaniasis. The treatment protocol with marbofloxacin, allopurinol, prednisolone and domperidone was initiated. Thirty days later, there was a total improvement of the lesions and healing of the paw pads. Immunotherapy was then initiated by applying three double doses of recombinant vaccine against canine visceral leishmaniasis. The applications were made subcutaneously, with an interval of 21 days between them, still maintaining allopurinol. After six months a fourth double dose of the vaccine was applied and ten days later a new serological examination was performed using the Indirect Immunofluorescence Reaction (IIFR) technique with total dilution, with the result not reagent. Four months later, the patient was reevaluated and a new serological test was performed through the IIFR technique with total dilution and the result was reagent with high titration (1: 320). Then began the use of milteforan and domperidone. After two months, the patient received a new vaccination booster and the use of domperidone was discontinued. After ten days a new serological examination was performed using the IIIRF technique with total dilution, with reagent result, but with minimal titration (1:40).Discussion: Canine visceral leishmaniasis is a systemic zoonosis of major public health importance. The dog, due to its proximity to humans, is considered the main reservoir of the disease. Although clinical signs are nonspecific, skin lesions such as nasal hyperkeratosis, ulcers and hyperpigmentation, as well as clinical manifestations such as lymphadenopathy, fever, epistaxis and ophthalmic changes are frequently observed. In this case, the patient presented most of the lesions described in the literature. Laboratory abnormalities in blood count and serum biochemistry, commonly observed, were not observed in the animal. The ELISA serological test, despite being used as a screening test, due to its ability to detect low antibody titers, was negative in this case. The diagnosis was confirmed by lymph node cytology, described in the literature as a confirmatory test despite being considered invasive by most authors and positive result in rapid immunochromatography test. With the protocol used, the animal showed improvement, being observed negative results or with low titration of anti-leishmania antibodies in a serological test performed using the IFAT technique, indicating a decrease in parasitic load.

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Public Knowledge about and Detection of Canine Visceral Leishmaniasis in Urban Divinópolis, Brazil

Journal of Tropical Medicine ◽

10.1155/2012/429586 ◽

2012 ◽

Vol 2012 ◽

pp. 1-8 ◽

Cited By ~ 6

Author(s):

Carina Margonari ◽

Júlia Alves Menezes ◽

Marcele Neves Rocha ◽

Kamila Nunes Maia ◽

Michael Éder de Oliveira ◽

...

Keyword(s):

Visceral Leishmaniasis ◽

Wide Spectrum ◽

Clinical Manifestations ◽

Disease Outbreak ◽

Social Conditions ◽

Public Knowledge ◽

Canine Visceral Leishmaniasis ◽

The Past ◽

Pcr Rflp ◽

Minas Gerais State

Background. Leishmaniases are diseases with a wide spectrum of clinical manifestations including cutaneous (CL) and visceral (VL) forms. Many factors may affect their occurrence and expansion including environmental, geographic, and social conditions. In the past two decades, Divinópolis, Minas Gerais State, Brazil, has exhibited the potential for a disease outbreak, with the appearance of CL, and VL cases (human and canine). Hence, this study was initiated to monitor public knowledge of the disease. Questionnaires were administered in four neighborhoods (Jardim Belvedere, Esplanada, Danilo Passos I and II) where most of the human and canine cases have been reported. The analyses demonstrated that public knowledge of the disease is sparse and fragmented. A strong perception of the dog as the main reservoir was observed. Five veterinary clinics were evaluated for the presence of canine VL using serological (RIFI and ELISA) and molecular (PCR-RFLP) techniques. This is the first study demonstrating the occurrence ofLeishmania infantumin Divinópolis, suggesting a possible urbanization of VL.

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Costs and outcomes of active and passive case detection for visceral leishmaniasis (Kala-Azar) to inform elimination strategies in Bihar, India

PLoS Neglected Tropical Diseases ◽

10.1371/journal.pntd.0009129 ◽

2021 ◽

Vol 15 (2) ◽

pp. e0009129

Author(s):

Natalie J. Dial ◽

Graham F. Medley ◽

Simon L. Croft ◽

Tanmay Mahapatra ◽

Khushbu Priyamvada ◽

...

Keyword(s):

Visceral Leishmaniasis ◽

Index Case ◽

Unit Cost ◽

Scale Up ◽

Scaling Up ◽

Case Detection ◽

Health Authorities ◽

Passive Case Detection ◽

The Cost ◽

Case Based

Background Effective case identification strategies are fundamental to capturing the remaining visceral leishmaniasis (VL) cases in India. To inform government strategies to reach and sustain elimination benchmarks, this study presents costs of active- and passive- case detection (ACD and PCD) strategies used in India’s most VL-endemic state, Bihar, with a focus on programme outcomes stratified by district-level incidence. Methods Expenditure analysis was complemented by onsite micro-costing to compare the cost of PCD in hospitals alongside index case-based ACD and a combination of blanket (house-to-house) and camp ACD from January to December 2018. From the provider’s perspective, a cost analysis evaluated the overall programme cost of each activity, the cost per case detected, and the cost of scaling up ACD. Results During 2018, index case-based ACD, blanket and camp ACD, and PCD reported 1,497, 131, and 1,983 VL-positive cases at a unit cost of $522.81, $4,186.81, and $246.79, respectively. In high endemic districts, more VL cases were identified through PCD while in meso- and low-endemic districts more cases were identified through ACD. The cost of scaling up ACD to identify 3,000 additional cases ranged from $1.6–4 million, depending on the extent to which blanket and camp ACD was relied upon. Conclusion Cost per VL test conducted (rather than VL-positive case identified) may be a better metric estimating unit costs to scale up ACD in Bihar. As more VL cases were identified in meso-and low-endemic districts through ACD than PCD, health authorities in India should consider bolstering ACD in these areas. Blanket and camp ACD identified fewer cases at a higher unit cost than index case-based ACD. However, the value of detecting additional VL cases early outweighs long-term costs for reaching and sustaining VL elimination benchmarks in India.

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