Effectiveness of the Brazilian Visceral Leishmaniasis Surveillance and Control Programme in reducing the prevalence and incidence of Leishmania infantum infection
Abstract Background Control strategies adopted by the Brazilian Visceral Leishmaniasis Surveillance and Control Programme (VLSCP) include identifying and culling seropositive infected dogs, early diagnosis and treatment of human cases, chemical control of the vector and population awareness. This st...
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| Format: | Article |
| Language: | English |
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BMC
2018-11-01
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| Series: | Parasites & Vectors |
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| Online Access: | http://link.springer.com/article/10.1186/s13071-018-3166-0 |
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| author | Iara Caixeta Marques da Rocha Letícia Helena Marques dos Santos Wendel Coura-Vital Gisele Macedo Rodrigues da Cunha Fernanda do Carmo Magalhães Thais Almeida Marques da Silva Maria Helena Franco Morais Edward Oliveira Ilka Afonso Reis Mariângela Carneiro |
| author_facet | Iara Caixeta Marques da Rocha Letícia Helena Marques dos Santos Wendel Coura-Vital Gisele Macedo Rodrigues da Cunha Fernanda do Carmo Magalhães Thais Almeida Marques da Silva Maria Helena Franco Morais Edward Oliveira Ilka Afonso Reis Mariângela Carneiro |
| author_sort | Iara Caixeta Marques da Rocha |
| collection | DOAJ |
| description | Abstract Background Control strategies adopted by the Brazilian Visceral Leishmaniasis Surveillance and Control Programme (VLSCP) include identifying and culling seropositive infected dogs, early diagnosis and treatment of human cases, chemical control of the vector and population awareness. This study evaluated the effectiveness of the VLSCP on the prevalence and incidence rates of Leishmania infantum in children residing in areas under different VLSCP intervention times. Methods A quasi-experimental epidemiological study with a panel (two cross-sectional) and a concurrent cohort was performed in three areas of Belo Horizonte, southeast Brazil. The first cross-sectional study (I) was carried out with 1875 children, 478 of which were enrolled in the cohort study. In the second cross-sectional study (II), 413 additional children were included, totalizing 891 children. Laboratory diagnosis was performed by ELISA-rK39. Analyses included multilevel logistic and Poisson regression models. Results The incidence rates of L. infantum infection were: 14.4% in the area where VLSCP intervention was initiated in 2006 (AI2006); 21.1% in the area where intervention was initiated in 2008 (AI2008); and 11.6% in the area where intervention was initiated in 2010 (AI2010 - control area). A follow-up period of 24 months showed that the persons-time incidence rates in AI2006, AI2008, and AI2010 were: 6.2/100, 10/100, and 5.6/100 persons/24 months, respectively. The final prevalence rates of infection (cross-sectional II - in 2012), compared to the initial rates (cross-sectional I - in 2010), increased 83.7% in AI2006, 74.1% in AI2008, and decreased 5% in AI2010. Analysis of the effectiveness revealed that children residing in AI2008 are more likely to be infected (OR = 1.84; 95% CI: 1.06-3.23) and present a higher risk of infection (IRR = 1.76; 95% CI: 1.05-2.95) compared to those in AI2010. No statistically significant differences were observed in asymptomatic infection (OR and IRR) in AI2006 compared to AI2010. Conclusions The VLSCP was not effective at controlling L. infantum infection in areas where interventions had respectively been carried out for six and four years. However, it is unclear what the consequences in terms of human infection and diseases would be in the absence of the VLSCP. Efforts to improve the effectiveness of control measures remain a necessary priority. |
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| id | doaj.art-8bfd6bd9a8b049cc8e093b481fa50c86 |
| institution | Directory Open Access Journal |
| issn | 1756-3305 |
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| last_indexed | 2024-12-21T09:40:38Z |
| publishDate | 2018-11-01 |
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| series | Parasites & Vectors |
| spelling | doaj.art-8bfd6bd9a8b049cc8e093b481fa50c862022-12-21T19:08:28ZengBMCParasites & Vectors1756-33052018-11-0111111210.1186/s13071-018-3166-0Effectiveness of the Brazilian Visceral Leishmaniasis Surveillance and Control Programme in reducing the prevalence and incidence of Leishmania infantum infectionIara Caixeta Marques da Rocha0Letícia Helena Marques dos Santos1Wendel Coura-Vital2Gisele Macedo Rodrigues da Cunha3Fernanda do Carmo Magalhães4Thais Almeida Marques da Silva5Maria Helena Franco Morais6Edward Oliveira7Ilka Afonso Reis8Mariângela Carneiro9Laboratório de Epidemiologia das Doenças Infecciosas e Parasitárias, Departamento de Parasitologia, Instituto de Ciências Biológicas, Universidade Federal de Minas GeraisLaboratório de Epidemiologia das Doenças Infecciosas e Parasitárias, Departamento de Parasitologia, Instituto de Ciências Biológicas, Universidade Federal de Minas GeraisDepartamento de Análises Clínicas, Pós-graduação em Ciências Farmacêuticas, Escola de Farmácia, Universidade Federal de Ouro PretoLaboratório de Epidemiologia das Doenças Infecciosas e Parasitárias, Departamento de Parasitologia, Instituto de Ciências Biológicas, Universidade Federal de Minas GeraisLaboratório de Epidemiologia das Doenças Infecciosas e Parasitárias, Departamento de Parasitologia, Instituto de Ciências Biológicas, Universidade Federal de Minas GeraisLaboratório de Epidemiologia das Doenças Infecciosas e Parasitárias, Departamento de Parasitologia, Instituto de Ciências Biológicas, Universidade Federal de Minas GeraisSecretaria Municipal de Saúde de Belo HorizonteLaboratório de Pesquisas Clínicas, Instituto René Rachou, Fundação Oswaldo CruzDepartamento de Estatística, Instituto de Ciências Exatas, Universidade Federal de Minas GeraisLaboratório de Epidemiologia das Doenças Infecciosas e Parasitárias, Departamento de Parasitologia, Instituto de Ciências Biológicas, Universidade Federal de Minas GeraisAbstract Background Control strategies adopted by the Brazilian Visceral Leishmaniasis Surveillance and Control Programme (VLSCP) include identifying and culling seropositive infected dogs, early diagnosis and treatment of human cases, chemical control of the vector and population awareness. This study evaluated the effectiveness of the VLSCP on the prevalence and incidence rates of Leishmania infantum in children residing in areas under different VLSCP intervention times. Methods A quasi-experimental epidemiological study with a panel (two cross-sectional) and a concurrent cohort was performed in three areas of Belo Horizonte, southeast Brazil. The first cross-sectional study (I) was carried out with 1875 children, 478 of which were enrolled in the cohort study. In the second cross-sectional study (II), 413 additional children were included, totalizing 891 children. Laboratory diagnosis was performed by ELISA-rK39. Analyses included multilevel logistic and Poisson regression models. Results The incidence rates of L. infantum infection were: 14.4% in the area where VLSCP intervention was initiated in 2006 (AI2006); 21.1% in the area where intervention was initiated in 2008 (AI2008); and 11.6% in the area where intervention was initiated in 2010 (AI2010 - control area). A follow-up period of 24 months showed that the persons-time incidence rates in AI2006, AI2008, and AI2010 were: 6.2/100, 10/100, and 5.6/100 persons/24 months, respectively. The final prevalence rates of infection (cross-sectional II - in 2012), compared to the initial rates (cross-sectional I - in 2010), increased 83.7% in AI2006, 74.1% in AI2008, and decreased 5% in AI2010. Analysis of the effectiveness revealed that children residing in AI2008 are more likely to be infected (OR = 1.84; 95% CI: 1.06-3.23) and present a higher risk of infection (IRR = 1.76; 95% CI: 1.05-2.95) compared to those in AI2010. No statistically significant differences were observed in asymptomatic infection (OR and IRR) in AI2006 compared to AI2010. Conclusions The VLSCP was not effective at controlling L. infantum infection in areas where interventions had respectively been carried out for six and four years. However, it is unclear what the consequences in terms of human infection and diseases would be in the absence of the VLSCP. Efforts to improve the effectiveness of control measures remain a necessary priority.http://link.springer.com/article/10.1186/s13071-018-3166-0Control programmeVisceral leishmaniasisEffectivenessLeishmania infantum infectionQuasi-experimental study |
| spellingShingle | Iara Caixeta Marques da Rocha Letícia Helena Marques dos Santos Wendel Coura-Vital Gisele Macedo Rodrigues da Cunha Fernanda do Carmo Magalhães Thais Almeida Marques da Silva Maria Helena Franco Morais Edward Oliveira Ilka Afonso Reis Mariângela Carneiro Effectiveness of the Brazilian Visceral Leishmaniasis Surveillance and Control Programme in reducing the prevalence and incidence of Leishmania infantum infection Parasites & Vectors Control programme Visceral leishmaniasis Effectiveness Leishmania infantum infection Quasi-experimental study |
| title | Effectiveness of the Brazilian Visceral Leishmaniasis Surveillance and Control Programme in reducing the prevalence and incidence of Leishmania infantum infection |
| title_full | Effectiveness of the Brazilian Visceral Leishmaniasis Surveillance and Control Programme in reducing the prevalence and incidence of Leishmania infantum infection |
| title_fullStr | Effectiveness of the Brazilian Visceral Leishmaniasis Surveillance and Control Programme in reducing the prevalence and incidence of Leishmania infantum infection |
| title_full_unstemmed | Effectiveness of the Brazilian Visceral Leishmaniasis Surveillance and Control Programme in reducing the prevalence and incidence of Leishmania infantum infection |
| title_short | Effectiveness of the Brazilian Visceral Leishmaniasis Surveillance and Control Programme in reducing the prevalence and incidence of Leishmania infantum infection |
| title_sort | effectiveness of the brazilian visceral leishmaniasis surveillance and control programme in reducing the prevalence and incidence of leishmania infantum infection |
| topic | Control programme Visceral leishmaniasis Effectiveness Leishmania infantum infection Quasi-experimental study |
| url | http://link.springer.com/article/10.1186/s13071-018-3166-0 |
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