在巴西流行地区对犬只接种利什曼疫苗(Leishmune)后,人类和犬类内脏利什曼病发病率降低。

Decrease of the incidence of human and canine visceral leishmaniasis after dog vaccination with Leishmune in Brazilian endemic areas.

作者信息

Palatnik-de-Sousa Clarisa B, Silva-Antunes Ilce, Morgado Adilson de Aguiar, Menz Ingrid, Palatnik Marcos, Lavor Carlile

机构信息

Department of General Microbiology, Institute of Microbiology "Prof. Paulo de Góes", Federal University of Rio de Janeiro (UFRJ), Rio de Janeiro, RJ, Brazil.

出版信息

Vaccine. 2009 Jun 2;27(27):3505-12. doi: 10.1016/j.vaccine.2009.03.045. Epub 2009 Apr 8.

Abstract

Leishmune, the first prophylactic vaccine licensed against canine visceral leishmaniasis (CVL), has been used in Brazil since 2004, where seropositive dogs are sacrificed in order to control human visceral leishmaniasis (VL). We demonstrate here that vaccination with Leishmune does not interfere with the serological control campaign (110,000 dogs). Only 1.3% of positivity (76 among 5860) was detected among Leishmune uninfected vaccinees. We also analyzed the possible additive effect of Leishmune vaccination over dog culling, on the decrease of the incidence of CVL and VL in two Brazilian endemic areas, from 2004 to 2006. In Araçatuba, a 25% of decline was seen in CVL with a 61% decline in human cases, indicating the additive effect of Leishmune vaccination of 5.7% of the healthy dogs (1419 dogs), on regular dog culling. In Belo Horizonte (BH), rising curves of canine and human incidence were observed in the districts of Barreiro, Venda Nova and Noroeste, while the canine and human incidence of Centro Sul, Leste, Nordeste, Norte, Pampulha and Oeste, started to decrease or maintained a stabilized plateau after Leishmune vaccination. Among the districts showing a percent decrease of human incidence (-36.5%), Centro Sul and Pampulha showed the highest dog vaccination percents (63.27% and 27.27%, respectively) and the lowest dog incidence (-3.36% and 1.89%, respectively). They were followed by Oeste, that vaccinated 25.30% of the animals and experienced an increase of only 12.86% of dog incidence and by Leste and Nordeste, with lower proportions of vaccinees (11.72% and 10.76%, respectively) and probably because of that, slightly higher canine incidences (42.77% and 35.73%). The only exception was found in Norte district where the reduced human and canine incidence were not correlated to Leishmune vaccination. Much lower proportions of dogs were vaccinated in Venda Nova (4.35%), Noroeste (10.27%) and Barreiro (0.09%) districts, which according to that exhibited very increased canine incidences (24.48%, 21.85% and 328.57%, respectively), and pronounced increases in human incidence (14%, 4% and 17%, respectively). The decrease of canine (p=-0.008) and human incidences (p=-0.048) is directly correlated to the increase of the number of vaccinated dogs, confirming the additive control effect of Leishmune vaccination over dog culling, reducing the parasite reservoir, protecting dogs and, in this way, reducing the risk of transmission of VL to humans and becoming a new effective control tool.

摘要

利什穆恩(Leishmune)是首个获许可用于预防犬内脏利什曼病(CVL)的疫苗,自2004年起在巴西使用,在巴西,为控制人类内脏利什曼病(VL),血清反应呈阳性的犬会被扑杀。我们在此证明,接种利什穆恩疫苗不会干扰血清学监测活动(涉及110,000只犬)。在未感染利什穆恩疫苗的接种犬中,仅检测到1.3%的阳性率(5860只中有76只)。我们还分析了2004年至2006年期间,在巴西两个流行地区,利什穆恩疫苗接种相对于犬扑杀对CVL和VL发病率降低可能产生的叠加效应。在阿拉萨图巴,CVL发病率下降了25%,人类病例下降了61%,这表明对1419只健康犬进行利什穆恩疫苗接种(占健康犬的5.7%),相对于常规犬扑杀具有叠加效应。在贝洛奥里藏特(BH),在巴雷罗、新文达和西北区观察到犬和人类发病率呈上升曲线,而在利什穆恩疫苗接种后,中南、东、东北、北、潘普利亚和西区的犬和人类发病率开始下降或维持在稳定平台期。在人类发病率下降百分比(-36.5%)的地区中,中南和潘普利亚的犬接种百分比最高(分别为63.27%和27.27%),犬发病率最低(分别为-3.36%和1.89%)。其次是西区,接种了25.30%的动物,犬发病率仅增加了12.86%,以及东区和东北区,接种比例较低(分别为...

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