Control of Visceral Leishmaniasis in Latin America—A Systematic Review

Visceral leishmaniasis is a vector-borne disease characterized by fever, spleen and liver enlargement, and low blood cell counts. In the Americas VL is zoonotic, with domestic dogs as main animal reservoirs, and is caused by the intracellular parasite Leishmania infantum (syn. Leishmania chagasi). Humans acquire the infection through the bite of an infected sand fly. The disease is potentially lethal if untreated. VL is reported from Mexico to Argentina, with recent trends showing a rapid spread in Brazil. Control measures directed against the canine reservoir and insect vectors have been unsuccessful, and early detection and treatment of human cases remains as the most important strategy to reduce case fatality. Well-designed studies evaluating diagnosis, treatment, and prevention/control interventions are scarce. The available scientific evidence reasonably supports the use of rapid diagnostic tests for the diagnosis of human disease. Properly designed randomized controlled trials following good clinical practices are needed to inform drug policy. Routine control strategies against the canine reservoirs and insect vectors are based on weak and conflicting evidence, and vector control strategies and vaccine development should constitute research priorities

Leishmaniasis-Vector Surveillance and Control in Brazil: A Challenge to Control Programs

This is the first English-language book dedicated to Brazilian sand flies and their medical importance. No other country has so many species of these haematophagous insects as Brazil and their diversity has reached an astonishing level. The book contains comprehensive chapters, written by Brazilian experts on their regional distribution, their ecology and their importance as vectors of pathogens and parasites. Methods for sampling, processing and preserving phlebotomines are reviewed as are perspectives on surveillance and leishmaniasis vector control. A novel classification is presented whose aim is to help investigators identify the species that they are working with more efficiently.Fil: Maia Elkhoury, Ana Nilce S.. Pan American Health Organization; BrasilFil: Albuquerque, Rafaella. Ministry of Health. Communicable Diseases General Office; BrasilFil: Salomón, Oscar Daniel. Consejo Nacional de Investigaciones Científicas y Técnicas. Centro Científico Tecnológico Conicet - Nordeste; Argentina. Ministerio de Salud. Instituto Nacional de Medicina Tropical; Argentin