Controle da leishmaniose visceral em meio urbano: estudo de intervenção randomizado fatorial

Abstract

The objective of this study was to evaluate the effect of vector control and elimination of infected dogs on the incidence of infection with Leishmania chagasi. A randomized community intervention trial was carried out in Teresina between 1995 and 1996. The area was divided in 34 blocks randomically allocated to 4 types of intervention: 1) spraying houses and animal pens with insecticide; 2) spraying houses and eliminating infected dogs; 3) combination of spraying houses and animal pens, and eliminating infected dogs, and 4) only spraying houses. In comparison to blocks receiving only household spraying, culling dogs decreased in 80% the incidence of infection. Spraying animal pens, associated or not with culling dogs, showed no significant effect. The protection offered by culling dogs suggests that this strategy might reduce the source of infection for the vector.

Clinical and epidemiological analysis of patients with HIV/AIDS admitted to a reference hospital in the northeast region of Brazil

“…Of the 828 patients investigated, 254 died (30.7%) and of these, 194 (76.4%) died during the initial attendance and 44 (17.3%) within the first 48 h of hospitalization. The average number of admittances per patient was 1.5 ± 1.4 (1)(2)(3)(4)(5)(6)(7)(8)(9)(10)(11)(12)(13)(14)(15). The number of infectious complications at death was of 2.1 ± 1.1 (0-8) and 231 (90.9%) patients presented up to three opportunistic infections at death.…”

“…In the state of Piauí, VL has been recognized since 1934 and in 1980, it spread as an epidemic of enormous extension that was concentrated in Teresina. Today, this city is considered one of the main urban foci of the disease in Brazil 6,7,8 . Among patients with AIDS hospitalized in the IDTNP, 68 cases (8.2%) of VL were registered, all from endemic areas, expressively from Piauí and Maranhão States.…”

How effective is dog culling in controlling zoonotic visceral leishmaniasis? a critical evaluation of the science, politics and ethics behind this public health policy

“…No reduction also occurred when only additional outdoor spraying was conducted. The three main problems in this study were the large proportion of non interventionbuffer areas (which corresponded to 75% of the study area), the loss of up to 46% of the studied population and the allocation of an indoor spraying fund, which hindered the assessment of the effect of elimination of dogs in the absence of insecticide use 75 . An additional study compared the strategies of: a) no intervention, b) spraying with pyrethroid insecticide, and c) area under the combination of insecticide spraying and screening with the elimination of seropositive dogs, in three districts of Feira de Santana in Bahia State.…”

Age structure of owned dogs under compulsory culling in a visceral leishmaniasis endemic area

“…While a large body of literature has addressed the controversy as to whether or not the elimination of positive dogs is associated with a reduction in VL incidence in humans 5,6,7,8,9 , the impact of increased mortality in the structure and composition of canine populations has not been assessed in spite of its potential to influence VL prevalence in dogs and, consequently, in humans 7,10 . Furthermore, the replacement after compulsory culling also affects the structure of the canine population, thus changing the impact of currently used VL control measures.…”