Travi Bruno L
Departments of Internal Medicine-Infectious Diseases & Microbiology and Immunology, University of Texas Medical Branch, Galveston, Texas, USA.
Biomedica. 2014 Jan-Mar;34(1):7-12. doi: 10.1590/S0120-41572014000100002.
In the Americas there are between 4,500 and 6,800 annual cases of severe visceral leishmaniasis, and mortality is estimated to range between 7 and 10%. However, underreporting and subclinical infections mask the real epidemiological importance of visceral leishmaniasis. Control efforts, which have typically focused on insecticide spraying of sand fly vectors and dog culling, have yielded disparate results. Nevertheless, thousands of dogs are sacrificed each year in countries endemic for visceral leishmaniasis. Additionally, current guidelines of leishmaniasis control programs have banned dog treatment with drugs of human use while therapy with other drugs resulted in high rates of relapses. Society requires that control programs take a more humanitarian approach aimed at limiting dog culling. There is an urgent need to promote responsible dog-ownership and support research on: a) novel veterinary therapies, b) low-cost molecular diagnosis of canine visceral leishmaniasis, and c) determination of dog infectivity threshold for proper reservoir management.
在美洲，每年有4500至6800例严重内脏利什曼病病例，估计死亡率在7%至10%之间。然而，报告不足和亚临床感染掩盖了内脏利什曼病的实际流行病学重要性。通常侧重于对沙蝇媒介进行杀虫剂喷洒和扑杀犬类的控制措施产生了不同的结果。尽管如此，在内脏利什曼病流行国家，每年仍有成千上万只狗被处死。此外，利什曼病控制项目的现行指南禁止使用人用药物治疗犬类，而使用其他药物治疗则导致高复发率。社会要求控制项目采取更具人道主义的方法，旨在限制犬类扑杀。迫切需要促进负责任的养狗方式，并支持以下方面的研究：a）新型兽医疗法；b）犬内脏利什曼病的低成本分子诊断；c）确定适当管理储存宿主所需的犬类感染阈值。
