Basic knowledge about visceral leishmaniasis before and after educational intervention among primary health care professionals in Midwestern Brazil

Carvalho, Amanda Gabriela de; Alves, Isaac; Borges, Larissa Marquiori; Spessatto, Laura Bordignon; Castro, Ludiele Souza; Luz, João Gabriel Guimarães

doi:10.1590/s1678-9946202163056

Cited by 6 publications

(3 citation statements)

References 15 publications

(23 reference statements)

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“…The third main challenge for passive case detection is the seemingly low awareness about the link between CVL and VL detected among dog owners. This was previously observed in the area among primary health care professionals [44]. Coura-Vital et al [45] reported elsewhere in Brazil that only one third of dog owners knew the role of dogs in the transmission of VL's agent to humans.…”

Section: Plos Neglected Tropical Diseasesmentioning

confidence: 60%

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

et al. 2021

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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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Section: Plos Neglected Tropical Diseasesmentioning

confidence: 60%

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

et al. 2021

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“…On the other hand, patients diagnosed with ATL should be timely investigated for leprosy to prevent the development of severe conditions due to this disease, which apparently are enhanced in cases of co-diagnosis. For that, it is essential to strengthen diagnostic networks, the role of health services in the active detection of new cases and continued training of health professionals, especially those from primary health care facilities 2,7,22 .…”

Section: Discussionmentioning

confidence: 99%

Are the clinical features of leprosy and American tegumentary leishmaniasis worse in patients with both diseases?

Carvalho

Luz

Steinmann

et al. 2022

Rev. Inst. Med. trop. S. Paulo

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This cross-sectional population-based study compared clinical features of leprosy and American tegumentary leishmaniasis (ATL) in patients diagnosed with both diseases (n=414) and in those diagnosed with only leprosy (n=27,790) or only ATL (n=24,357) in Mato Grosso State, which is a hyperendemic area for both diseases in Midwest Brazil. All new cases of leprosy and ATL reported in the area from 2008 to 2017 were included. Patients diagnosed with both diseases were identified by a probabilistic linkage procedure applied to leprosy and ATL databases of the national reporting system. The distribution of the frequency of clinical features between groups was compared by the chi-square test, followed by a multivariate logistic regression. Patients diagnosed with both leprosy and ATL presented higher odds of having nerve damage (OR: 1.34; 95% CI: 1.09-1.66) and leprosy reactions (OR: 1.35; 95% CI: 1.04-1.76) compared to patients diagnosed only with leprosy. Mucocutaneous leishmaniasis (OR: 2.29; 95% CI: 1.74-3.00) was more frequent among patients with both diagnoses when compared to patients who only had ATL. In conclusion, patients diagnosed with both leprosy and ATL present more severe clinical features of such diseases. Our data can be useful for designing health policies aimed at timely and integrated management of leprosy and ATL in co-endemic areas.

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“…Despite these limitations, our current findings, along with the previous identification of a geographical overlap of both diseases [ 18 ], strongly suggest that primary health care professionals should be aware that leprosy and CL may affect the same patients in hyperendemic areas. This awareness combined with active case detection plays a crucial role in timely diagnosis and treatment [ 55 ], which is the aim state- [ 56 ] and nationwide [ 57 ] for both diseases to decrease stigmatizing and other complications. The integration of control policies for leprosy and CL is a feasible way to achieve that [ 1 ].…”

Section: Discussionmentioning

confidence: 99%

Leprosy and cutaneous leishmaniasis affecting the same individuals: A retrospective cohort analysis in a hyperendemic area in Brazil

et al. 2021

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Background Leprosy and cutaneous leishmaniasis (CL) are neglected tropical diseases (NTDs) affecting the skin. Their control is challenging but the integration of skin NTDs control programs is recommended to improve timely detection and treatment. However, little is known about the occurrence of leprosy and CL in the same individuals, and what are the characteristics of such patients. This study aimed to identify and characterize patients diagnosed with both leprosy and CL (i.e., outcome) in the hyperendemic state of Mato Grosso, Brazil. Also, we investigated the demographic risk factors associated with the period between the diagnosis of both diseases. Methodology/principal findings A retrospective cohort study was conducted with patients diagnosed between 2008 and 2017. From the leprosy (n = 28,204) and CL (n = 24,771) databases of the national reporting system, 414 (0.8%; 414/52,561) patients presenting both diseases were identified through a probabilistic linkage procedure. This observed number was much higher than the number of patients that would be expected by chance alone (n = 22). The spatial distribution of patients presenting the outcome was concentrated in the North and Northeast mesoregions of the state. Through survival analysis, we detected that the probability of a patient developing both diseases increased over time from 0.2% in the first year to 1.0% within seven years. Further, using a Cox model we identified male sex (HR: 2.3; 95% CI: 1.7–2.9) and low schooling level (HR: 1.5; 95% CI: 1.2–1.9) as positively associated with the outcome. Furthermore, the hazard of developing the outcome was higher among individuals aged 40–55 years. Conclusions/significance Leprosy and CL are affecting the same individuals in the area. Integration of control policies for both diseases will help to efficiently cover such patients. Measures should be focused on timely diagnosis by following-up patients diagnosed with CL, active case detection, and training of health professionals.

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Basic knowledge about visceral leishmaniasis before and after educational intervention among primary health care professionals in Midwestern Brazil

Abstract: This is an open-access article distributed under the terms of the Creative Commons Attribution License.

Cited by 6 publications

References 15 publications

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

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

Are the clinical features of leprosy and American tegumentary leishmaniasis worse in patients with both diseases?

Leprosy and cutaneous leishmaniasis affecting the same individuals: A retrospective cohort analysis in a hyperendemic area in Brazil

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