A long-lasting topical deltamethrin treatment to protect dogs against visceral leishmaniasis.

To develop long-lasting, topical pour-on insecticides for dogs to control zoonotic visceral leishmaniasis, two deltamethrin-based formulations (emulsifiable concentrate [EC] and suspension concentrate [SC]) were tested for their efficacy against the phlebotomine sandfly Lutzomyia longipalpis Lutz & Neiva (Diptera: Psychodidae), vector of Leishmania infantum Nicolle (Kinetoplastida: Trypanosomatidae). The entomological outcomes tested were anti-feeding effect (proportion of female sandflies unfed), lethal effect (24-h female sandfly mortality) and these two effects combined, and the insecticide persistence time at 50% (residual activity, RA50) and 80% (RA80) efficacy. On initial application, the proportions of female flies that demonstrated anti-feeding activity or were killed were similar for both formulations, at 0.93 (95% confidence interval [CI] 0.856-0.977) vs. 0.81 (95% CI 0.763-0.858) (anti-feeding) and 0.86 (95% CI 0.787-0.920) vs. 0.76 (95% CI 0.698-0.817) (24-h mortality) for EC and SC, respectively. The RA(50) rates for anti-feeding and mortality caused by the EC formulation were 4.7 months (95% CI 4.18-5.84) and 2.5 months (95% CI 2.25-2.90), respectively, compared with 1.1 months (95% CI 0.96-1.15) and 0.6 months (95% CI 0.50-0.61), respectively, for the SC formulation. The RA(50) for the combined anti-feeding and mortality effects of EC was 5.2 months (95% CI 4.73-5.96), compared with only 0.9 months (95% CI 0.85-1.00) for the SC formulation. The four- to six-fold superior residual activity of the EC formulation was attributed to the addition of a solvent-soluble resin in the formulation which improved fur adhesion and acted as a reservoir for the slow release of the active ingredient. These results identify the potential of such a low-cost formulation to reduce the inter-intervention interval to 5-6 months, similar to that recommended for deltamethrin-impregnated dog collars or for re-impregnation of conventional bednets, both of which are currently used to combat Leishmania transmission. Finally, a novel bioassay was developed in which sandflies were exposed to fur from treated dogs, revealing no detectable tolerance (24-h mortality) in wild-caught sandflies to the insecticide formulations up to 8 months after the initiation of communitywide application of the insecticides to dogs.

Deltamethrin-impregnated bednets reduce human landing rates of sandfly vector Lutzomyia longipalpis in Amazon households.

The entomological efficacy of using 25% deltamethrin EC insecticide-treated bednets (ITNs) was evaluated against the sandfly Lutzomyia longipalpis Lutz and Neiva (Diptera: Psychodidae), the principal vector of zoonotic visceral leishmaniasis (ZVL) in Latin America. A crossover field study in Amazon Brazil (Marajó Island, Pará State) demonstrated that, compared with untreated nets, the insecticide increased the barrier effect of nets by 39% (95% confidence interval [CI] 34-44%), reduced human landing rates by 80% (95% CI 62-90%) and increased the 24-h mortality rate from 0% to 98% (95% CI 93-99%) inside ITNs. The presence of an ITN also reduced the human landing rate on unprotected persons outside the net in the same room by 56% (95% CI 52-59%), and increased 24-h mortality to 68% (95% CI 62-73%) compared to 0.4% (0.1-2.0%) in untreated houses. The reduction in human landing rates in ITN rooms was associated with a doubling in the proportion of sandflies alighting on walls compared with that in untreated rooms, which was attributed to insecticide-induced excito-repellency. There was no evidence that sandflies were diverted onto unprotected hosts. Human landing catches inside houses peaked between 19.00 hours and 23.00 hours and declined steadily to zero at 02.00 hours and thereafter. House-to-house questionnaires established that only 34% of households owned at least one net (median two, range 1-8), only 20% of the population slept under a net (33% of 0-5-year-old children), and the majority (73%) of the population slept in hammocks. Combined data pertaining to sleeping times for children and sandfly activity period indicate that > 50% of sandfly bites inside houses, and substantially more outside houses, were taken before a third of children were potentially protected by a net. This study demonstrates the clear entomological efficacy of ITNs against Lu. longipalpis in this endemic region. The effectiveness of ITNs at preventing ZVL infection and disease has still to be evaluated.

IgG subclass responses in a longitudinal study of canine visceral leishmaniasis.

Visceral leishmaniasis (VL), caused by Leishmania infantum, is an important disease of domestic dogs. Here, we present data on the IgG subclass antibody response to crude L. infantum antigen in a cohort of naturally infected Brazilian dogs. Specific IgG1-IgG4 responses could be detected in 98, 58, 70 and 82%, respectively of 57 dogs that were seropositive for specific IgG. Levels of all IgG subclasses were strongly inter-correlated. Levels of all IgG subclasses increased at the time of seroconversion, before reaching a plateau after several months. Levels of all IgG subclasses were higher in sick dogs than healthy dogs, and levels of all except IgG2 were higher in parasite-positive (by PCR) than parasite-negative dogs. However, levels of IgG2 relative to IgG1 were lower in sick or parasite-positive dogs compared to healthy or parasite-negative infected dogs. In contrast to previous studies, the results suggest that canine VL is associated with upregulation of specific antibody of all IgG subclasses, particularly IgG1, IgG3 and IgG4.

Low infectiousness of a wildlife host of Leishmania infantum: the crab-eating fox is not important for transmission.

The epidemiological role of the crab-eating fox Cerdocyon thous in the transmission of Leishmania infantum is assessed in a longitudinal study in Amazon Brazil. A total of 37 wild-caught foxes were immunologically and clinically monitored, and 26 foxes exposed to laboratory colonies of the sandfly vector Lutzomyia longipalpis, over a 15-month period. In total 78% (29/37) of foxes were seropositive for anti-Leishmania IgG on at least 1 occasion, and 38% (8/37) had infections confirmed by PCR and/or by culture. Point prevalences were 74% (serology), 15% (PCR), and 26% (culture). No signs of progressive disease were observed. None of the foxes were infectious to the 1469 sandflies dissected from 44 feeds. A conservative estimate of the possible contribution of foxes to transmission was 9% compared to 91% by sympatric domestic dogs. These results show that crab-eating fox populations do not maintain a transmission cycle independently of domestic dogs. The implication is that they are unlikely to introduce the parasite into Leishmania-free dog populations.

Tissue cytokine responses in canine visceral leishmaniasis.

To elucidate the local tissue cytokine response of dogs infected with Leishmania chagasi, cytokine mRNA levels were measured in bone marrow aspirates from 27 naturally infected dogs from Brazil and were compared with those from 5 uninfected control animals. Interferon-gamma mRNA accumulation was enhanced in infected dogs and was positively correlated with humoral (IgG1) but not with lymphoproliferative responses to Leishmania antigen in infected dogs. Increased accumulation of mRNA for interleukin (IL)-4, IL-10, and IL-18 was not observed in infected dogs, and mRNA for these cytokines did not correlate with antibody or proliferative responses. However, infected dogs with detectable IL-4 mRNA had significantly more severe symptoms. IL-13 mRNA was not detectable in either control or infected dogs. These data suggest that clinical symptoms are not due to a deficiency in interferon-gamma production. However, in contrast to its role in human visceral leishmaniasis, IL-10 may not play a key immunosuppressive role in dogs.

Competence of the human host as a reservoir for Leishmania chagasi.

The failure of control programs for visceral leishmaniasis (VL) that depend on elimination of infected dogs suggests that other reservoir hosts may participate in the transmission cycle. To determine whether persons infected with Leishmania chagasi can infect the vector sand fly, laboratory-reared Lutzomyia longipalpis were allowed to feed on Brazilian subjects with active, cured, and asymptomatic VL and on asymptomatic residents of houses of persons with active VL. Of 3747 insects that had fed, 26 acquired infection from 11 of the 44 persons with active VL, but none acquired infection from the 137 asymptomatic persons. Among persons <4 years old with active VL, a history of diarrhea and higher peripheral blood neutrophil counts were independent predictors of infectivity. Further experiments using larger numbers of insects are necessary to evaluate the reservoir competence of persons with asymptomatic infections, who represent a large segment of the population of several Brazilian cities.

Experimental cutaneous leishmaniasis. IV. The humoral response of Cebus apella (Primates: Cebidae) to infections of Leishmania (Leishmania) amazonensis, L. (Viannia) lainsoni and L. (V.) braziliensis using the direct agglutination test.

The direct agglutination test (DAT) was used to evaluate the serological response of 150 serum samples taken from 15 captive-bred capuchin monkeys Cebus apella. These animals had been experimentally infected with either L. (Leishmania) amazonensis, L. (Viannia) lainsoni or L. (V.) braziliensis. Monkeys infected with L. (L.) amazonensis or L. (V.) lainsoni were challenged with the homologous parasite one month after their spontaneous cure. DAT antigens were prepared from L. (L.) donovani, L. (L.) amazonensis and L. (V.) braziliensis. Antigens were difficult to standardise and it was impossible to produce an L. (V.) lainsoni antigen as parasites remained aggregated even after trypsinization. The DAT detected significant humoral responses in all the infected monkeys. Titres were higher when homologous antigens were used, especially in secondary responses. This suggests that homologous antigen should be used to detect antibodies in human cutaneous leishmaniasis.

[Direct agglutination tests in the serodiagnosis of visceral leishmaniasis in the state of Pará]. / Teste de aglutinação directa no sorodiagnóstico da leishmaniose visceral no estado do Pará.

The direct agglutination test (DAT) was evaluated for serodiagnosis of visceral leishmaniasis (VL) in human and canids (dogs and foxes Cerdocyon thous). The results were compared with those of the immunofluorescent antibody assay (IFAT) and enzyme-linked immunosorbent assay (ELISA). The sera used were from: humans (303): confirmed VL (16), suspected VL (65), other conditions (102), negative controls (15) and individuals from an endemic area (105); dogs (82): from an endemic area (68), Salvaterra/Marajó/Pará (21 of which were parasitologically positive), and negative controls (14), from Belém; foxes (9): caught on Marajó Island. Antigens for DAT were prepared from promastigots of L. (L.) donovani, L. (L.) chagasi. Antigens used in ELISA and IFAT were prepared from promastigotes (soluble antigen) and amastigotes respectively of L. (L.) chagasi. In humans, the specificity and sensitivity of DAT using L. (L.) donovani were high (98.4% and 100% respectively) and comparable to that of IFAT (97.5% and 100%). ELISA was less specific (84.8%) although similarly sensitive (100%). In dogs, DAT was more specific using L. (L.) donovani as antigen than using L. (L.) chagasi. However, both DAT and ELISA were less sensitive (both 71.4%) than IFAT (100%). This difference was reflected in the results from endemic dogs, 87% of which were positive by IFAT but only 54% by ELISA and 49% by DAT. Similarly, all 9 fox sera were positive by IFAT, 7 of 9 (78%) by ELISA but none by DAT. In conclusion, DAT using L. (L.) donovani antigen can provide a useful test for human VL; utilization on a large scale would be possible with a suitable reference laboratory to monitor antigen quality. However, DAT appears less useful for canine studies, as it was less sensitive than ELISA and especially IFAT in detecting canine infection.

[Experimental skin leishmaniasis: II--course of the infection in the Cebus apella primate (Cebidae) caused by Leishmania (V.) braziliensis and L. (L.) amazonensis]. / Leishmaniose cutânea experimental: II--Aspectos evolutivos da infecção no primata Cebus apella (Cebidae) pela Leishmania (V.) braziliensis e L. (L.) amazonensis.

As a means of assessing the usefulness of the monkey Cebus apella as an experimental model for the study of cutaneous leishmaniasis, 5 of these animals were inoculated intradermally at 8 sites along the tail with 3 X 10(6) promastigotes of L. (V.) braziliensis, while a further 5 monkeys received similar inoculations with 3 X 10(6) promastigotes of L. (L.) amazonensis. Following the inoculations, weekly examinations and monthly biopsies showed evolution of resulting skin lesions to be as follows: a) L. (V.) braziliensis: lesions were first visible 15-20 days post-inoculation (p.i), and at 30 days they were clearly of an erythematous-papular nature, which assumed a nodular form at 60 days; after 3 months a spontaneous ulceration of these lesions was noted and, at 4 months, the initiation of healing. In one animal total healing was apparent 5 months p.i; in two others at 6 months, in another monkey after 7 months, and in the last animal at 10 months p.i. Amastigotes were demonstrated in smears from the lesions of all monkeys up to 90 days p.i; up to 120 days in two animals, and at 180 days p.i. in the monkey which showed resolution of the lesions after 10 months. b) L. (L.) amazonensis lesions were first apparent after 20 days p.i; at 30 days they were of an erythematous-papular nature, developing into nodules at 60 days. From the third month of infection onwards, however, the lesions diminished rapidly and, at 90 days p.i. amastigotes were no longer detectable in the skin.(ABSTRACT TRUNCATED AT 250 WORDS)

[Experimental cutaneous leishmaniasis: I--on the susceptibility of the primate Cebus apella (Cebidae) to the infection caused by Leishmania (Viannia) lainsoni Silveira, Shaw and Ishikawa, 1987]. / Leishmaniose cutanea experimental: I--Sobre a susceptibilidade do primata Cebus apella (Cebidae) à infecaão pela Leishmania (Viannia) lainsoni Silveira, Shaw, Braga e Ishikawa, 1987.

The susceptibility of the monkey Cebus apella (Cebidae) to experimental infection by Leishmania (Viannia) lainsoni has been investigated. For this purpose, five young monkeys, 2 males and 3 females, were intradermally, inoculated, in eight different places along the dorsal surface of the tail with 3 x 10(6) promastigotes of the parasite (MHOM/BR/81/M6426, Benevides, Pará), from stationary phase culture in Difco B45 medium. After inoculations, infection in the monkeys was indicated by the presence of amastigotes in the skin lesions produced in these animals at the points of inoculation, confirming the susceptibility of the monkey Cebus apella to experimental infection by Leishmania lainsoni, with an infection period of four months. This represents a suitable period for testing antileishmanial drugs or studying the pathogenesis of the disease caused by this parasite.