Effectiveness of the Brazilian Visceral Leishmaniasis Surveillance and Control Programme in reducing the prevalence and incidence of Leishmania infantum infection.

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dc.contributor.authorRocha, Iara Caixeta Marques da
dc.contributor.authorSantos, Letícia Helena Marques dos
dc.contributor.authorVital, Wendel Coura
dc.contributor.authorCunha, Gisele Macedo Rodrigues da
dc.contributor.authorMagalhães, Fernanda do Carmo
dc.contributor.authorSilva, Thais Almeida Marques da
dc.contributor.authorMorais, Maria Helena Franco
dc.contributor.authorOliveira, Edward
dc.contributor.authorReis, Ilka Afonso
dc.contributor.authorCarneiro, Mariângela
dc.date.accessioned2019-03-28T16:39:14Z
dc.date.available2019-03-28T16:39:14Z
dc.date.issued2018
dc.description.abstractBackground 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.pt_BR
dc.identifier.citationROCHA, I. C. M. da et al. Effectiveness of the Brazilian Visceral Leishmaniasis Surveillance and Control Programme in reducing the prevalence and incidence of Leishmania infantum infection. Parasites & Vectors, v. 11, n. 586, p. 1-12, 2018. Disponível em: <https://parasitesandvectors.biomedcentral.com/articles/10.1186/s13071-018-3166-0>. Acesso em: 21 fev. 2019.pt_BR
dc.identifier.issn17563305
dc.identifier.urihttp://www.repositorio.ufop.br/handle/123456789/10856
dc.language.isoen_USpt_BR
dc.rightsabertopt_BR
dc.rights.licenseThis article is distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made.pt_BR
dc.subjectQuasi-experimental studypt_BR
dc.titleEffectiveness of the Brazilian Visceral Leishmaniasis Surveillance and Control Programme in reducing the prevalence and incidence of Leishmania infantum infection.pt_BR
dc.typeArtigo publicado em periodicopt_BR
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