Vector and reservoir control for preventing leishmaniasis

Abstract

Background Leishmaniasis is caused by the Leishmania parasite, and transmitted by infected phlebotomine sandflies. Of the two distinct clinical syndromes, cutaneous leishmaniasis (CL) affects the skin and mucous membranes, and visceral leishmaniasis (VL) affects internal organs. Approaches to prevent transmission include vector control by reducing human contact with infected sandflies, and reservoir control, by reducing the number of infected animals. Objectives To assess the effects of vector and reservoir control interventions for cutaneous and for visceral leishmaniasis. Search methods We searched the following databases to 13 January 2015: Cochrane Infectious Diseases Group Specialized Register, CENTRAL, MEDLINE, EMBASE, LILACS and WHOLIS, Web of Science, and RePORTER. We also searched trials registers for ongoing trials. Selection criteria Randomized controlled trials (RCTs) evaluating the effects of vector and reservoir control interventions in leishmaniasis‐endemic regions. Data collection and analysis Two review authors independently searched for trials and extracted data from included RCTs. We resolved any disagreements by discussion with a third review author. We assessed the quality of the evidence using the GRADE approach. Main results We included 14 RCTs that evaluated a range of interventions across different settings. The study methods were generally poorly described, and consequently all included trials were judged to be at high or unclear risk of selection and reporting bias. Only seven trials reported clinical outcome data which limits our ability to make broad generalizations to different epidemiological settings and cultures. Cutaneous leishmaniasis One four‐arm RCT from Afghanistan compared indoor residual spraying (IRS), insecticide‐treated bednets (ITNs), and insecticide‐treated bedsheets, with no intervention. Over 15 months follow‐up, all three insecticide‐based interventions had a lower incidence of CL than the control area (IRS: risk ratio (RR) 0.61, 95% confidence interval (CI) 0.38 to 0.97, 2892 participants, moderate quality evidence ; ITNs: RR 0.32, 95% CI 0.18 to 0.56, 2954 participants, low quality evidence; ITS: RR 0.34, 95% CI 0.20 to 0.57, 2784 participants, low quality evidence ). No difference was detected between the three interventions ( low quality evidence ). One additional trial of ITNs from Iran was underpowered to show a difference. Insecticide treated curtains were compared with no intervention in one RCT from Venezuela, where there were no CL episodes in the intervention areas over 12 months follow‐up compared to 142 in control areas (RR 0.00, 95% CI 0.00 to 0.49, one trial, 2938 participants, low quality evidence ...

Canine visceral leishmaniasis in the Northeast Region of Brazil

“…In Brazil, visceral leishmaniasis (VL) is caused by Leishmania (Leishmania) chagasi and shows a wide territorial distribution among areas of different geographic, climatic and social aspects [ 2 ]. Dogs are considered important reservoirs in endemic areas [ 3 ]. The prevalence of canine visceral leishmaniasis (CVL) in the Brazilian Northeast region, ranging from in 16 % in Garanhuns to 40.3 % in Paulista, Pernambuco state [ 4 , 5 ].…”

Sand-Fly Phlebotomus Papatasi ( Phlebotominae ) : A General Review with Special Reference to Zoonotic Cutaneous Leishmaniasis in Egypt

“…The same treatment can be applied to screens, curtains, sheets, and clothing (clothing should be retreated after five washings). González et al (2015) concluded that using insecticides to reduce sandfly numbers was effective at reducing CL incidence in some settings. However, there was insufficient evidence to know whether it was better to spray the internal walls of houses or to use insecticide impregnated bed-nets, curtains, bed-sheets or clothing.…”

Mexican Medicinal Plants as an Alternative for the Development of New Compounds Against Protozoan Parasites

“…In the case of Tr yp an os om a, Leishmania,a ndPlasmodium, an alternative approach is the interruption of disease transmission by either preventing contacts between human beings and vectors, killing or altering the vector life cycle. However, the effectiveness of vector control is limited by the development of insecticide resistance [7][8][9]. Therefore, it is necessary to improve the current chemotherapy arsenal against these protozoan parasites and their vectors.…”