RESUMEN
To reduce morbidity and mortality caused by visceral leishmaniasis (VL), the Brazilian Visceral Leishmaniasis Control and Surveillance Program promotes the diagnosis and treatment of cases, vector control, euthanasia of seropositive dogs, and health education. Nevertheless, the effectiveness of these measures is questionable as they lead to little reduction in the transmission of the disease. Thus, the effectiveness of strategies such as insecticide-impregnated collars, spot-on insecticides, and immunization of dogs should be assessed. Herein, we evaluated the effectiveness of deltamethrin-impregnated collars on reducing the incidence of Leishmania infantum infection in dogs living in an endemic area of VL. An intervention study was conducted and a total 5,850 dogs were analyzed in baseline. Of these 3,742 seronegative dogs were divided into two groups: collared and uncollared (control). Dogs were followed for 12 months and three interventions were performed. The Cox regression model was used to evaluate the effectiveness of the collar. All analyzes were performed by Intention-to-treat and per-protocol. By intention-to-treat, the incidence rates of L. infantum infection were 7.5 and 7.9 in the collar group, and 6.5 and 13.2 per 1,000 dogs-months in the control group after 6 and 12 months, respectively. In the per-protocol analysis, the incidence rates in the control group were similar to those observed in the intention-to-treat analysis. In the collar group, the incidence rate was 5.1/1,000 dogs-months after 6 and 12 months. The effectiveness by intention-to-treat after adjustment by the multivariate Cox model was 48%. In the analysis per-protocol, the effectiveness increased to 63%. Although collar use was effective when it was evaluated by intention-to-treat, higher effectiveness was found in the per-protocol analysis after one year of follow-up. The data emphasize the importance of the uninterrupted use of deltamethrin-impregnated collars to increase protection against canine VL.
Asunto(s)
Enfermedades de los Perros/epidemiología , Insecticidas/química , Leishmaniasis Visceral/epidemiología , Nitrilos/química , Piretrinas/química , Animales , Brasil/epidemiología , Enfermedades de los Perros/patología , Perros , Femenino , Incidencia , Insecticidas/toxicidad , Leishmania infantum/efectos de los fármacos , Leishmania infantum/fisiología , Leishmaniasis Visceral/patología , Masculino , Nitrilos/toxicidad , Control de Plagas , Modelos de Riesgos Proporcionales , Piretrinas/toxicidad , Siphonaptera/efectos de los fármacos , Siphonaptera/parasitología , Garrapatas/efectos de los fármacos , Garrapatas/parasitologíaRESUMEN
Until the 1980s, visceral leishmaniasis was concentrated in poor rural areas of Brazil. The Vale do Rio Doce, located in the Southeastern Brazilian state of Minas Gerais, was an endemic area with high numbers of human and canine cases. Prophylactic measures adopted since the 1960s reduced the number of cases and the region became a 'controlled endemic' area. In the early 1990s, however, the program was interrupted, and the human disease reemerged in 2008. This cross-sectional study evaluated the prevalence and the risk profile of infection of dogs with Leishmania spp in this reemergence area of visceral leishmaniasis. Among a population of approximately 280,000 people, a total of 3835 dog owners were interviewed about socioeconomic conditions, housing, peridomicile features, and their dogs' characteristics and behavior. Blood samples were collected from 5822 dogs of an estimated canine population of 20,000 and anti-Leishmaniasis antibodies were identified using Dual-Path Platform and ELISA. We observed that 1282 of the 5822 dogs were seropositive for the protozoan indicating a seroprevalence of 22%. The risk factors associated with Leishmania infection in dogs were: non-paved backyard (OR 1.4; 95%CI 1.2-1.7); the presence of dry leaves and decaying fruit in the backyard (OR 1.3; 95%CI 1.1-1.5); medium-sized (OR 1.3; 95% 1.1-1.5) or big-sized dogs (OR 1.8; 95%CI 1.5-2.3); short-haired dogs (OR 1.8; 95%CI 1.5-2.1); dogs that slept in the backyard (OR 2.6; 95%CI 1.8-3.6) or in the balcony (OR 1.6; 95%CI 1.1-2.3); and history of canine visceral leishmaniasis in the household (OR 1.3; 95%CI 1.1-1.5). Our results suggest a strong reemergence of canine visceral leishmaniasis after the discontinuation of the control programs. Also, the observed risk factors reinforce the role of health education and environmental management measures to the effective control of the disease.
Asunto(s)
Enfermedades de los Perros , Ambiente , Leishmaniasis Visceral , Animales , Perros , Femenino , Masculino , Brasil/epidemiología , Cromatografía de Afinidad/veterinaria , Estudios Transversales , Enfermedades de los Perros/epidemiología , Enfermedades de los Perros/parasitología , Ensayo de Inmunoadsorción Enzimática/veterinaria , Leishmania/fisiología , Leishmaniasis Visceral/epidemiología , Leishmaniasis Visceral/parasitología , Leishmaniasis Visceral/veterinaria , Prevalencia , Factores de RiesgoRESUMEN
This research involves a school-based cross sectional study to evaluate the association between food insecurity (FI) and inadequate food intake (IFI), among 782 children (mean age of 6.9±0.5) of the 1st year of primary school in the municipal schools of São Leopoldo in the state of Rio Grande do Sul. Data were gathered from mothers or guardians. FI was obtained through the Brazilian Food Insecurity Scale, and food consumption using the food frequency questionnaire. Foods were classified as healthy eating markers (HEM) and unhealthy (UEM) and received scores according to intake frequency. HEM: 0 - 1 day - zero; 2 to 3 days - 0.25; 4 to 5 days - 0.75; 6 to 7 days - 1, and the reverse for the UEM. The scores could range from 0 to 25 (HEMS) and 0 to 19 (UEMS). A standardized total score (TS) was obtained [HEMS * (19/44) + UEMS * (25/44)] and could range from 0 to 22. The scores were categorized into terciles and the 1st considered IFI. The FI was 45.1% and the average scores were 5.9 (HEMS), 15.9 (UEMS) and 11.6 (TS). No association was found between IA and IFI. High IA and low food scores require intersectoral approaches to ensure access to food in quantity and quality appropriate for this population.
Asunto(s)
Ingestión de Alimentos , Abastecimiento de Alimentos , Brasil , Niño , Estudios Transversales , Femenino , Humanos , Masculino , Encuestas Nutricionales , Estudios Retrospectivos , Instituciones Académicas , EstudiantesRESUMEN
Resumo Estudo transversal, de base escolar, que avaliou insegurança alimentar (IA) e associação com consumo alimentar inadequado (CAI) em 782 escolares (6,9 ± 0,5 anos) do 1º ano do ensino fundamental das escolas municipais de São Leopoldo, RS. Os dados foram obtidos das mães/responsáveis. Mediu-se IA com a Escala Brasileira de Insegurança Alimentar, e ingestão com questionário de frequência alimentar. Os alimentos foram classificados em marcadores de alimentação saudável (MAS) e não saudável (MANS) e receberam pontuação segundo a frequência de ingestão. MAS: 0 - 1 dia – zero; 2 a 3 dias – 0,25; 4 a 5 dias – 0,75; 6 a 7 dias – 1, sendo o inverso para os MANS. Os escores podiam variar de 0 a 25 (EMAS) e de 0 a 19 (EMANS). Um escore total (ET) padronizado foi obtido [EMAS*(19/44) + EMANS*(25/44)] e a pontuação podia variar de 0 a 22. Os escores foram categorizados em terços e o 1º considerado CAI. A IA foi de 45,1% e as pontuações médias foram 5,9 (EMAS), 15,9 (EMANS) e 11,6 (ET). Não se identificou associação entre IA e CAI. IA elevada e baixos escores alimentares exigem ações intersetoriais para garantir acesso à alimentação em quantidade e qualidade adequadas nesta população.
Abstract This research involves a school-based cross sectional study to evaluate the association between food insecurity (FI) and inadequate food intake (IFI), among 782 children (mean age of 6.9±0.5) of the 1st year of primary school in the municipal schools of São Leopoldo in the state of Rio Grande do Sul. Data were gathered from mothers or guardians. FI was obtained through the Brazilian Food Insecurity Scale, and food consumption using the food frequency questionnaire. Foods were classified as healthy eating markers (HEM) and unhealthy (UEM) and received scores according to intake frequency. HEM: 0 - 1 day - zero; 2 to 3 days - 0.25; 4 to 5 days - 0.75; 6 to 7 days - 1, and the reverse for the UEM. The scores could range from 0 to 25 (HEMS) and 0 to 19 (UEMS). A standardized total score (TS) was obtained [HEMS * (19/44) + UEMS * (25/44)] and could range from 0 to 22. The scores were categorized into terciles and the 1st considered IFI. The FI was 45.1% and the average scores were 5.9 (HEMS), 15.9 (UEMS) and 11.6 (TS). No association was found between IA and IFI. High IA and low food scores require intersectoral approaches to ensure access to food in quantity and quality appropriate for this population.