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Rocha R, Conceição C, Gonçalves L, Maia C. Knowledge and practices regarding leishmaniasis in Portugal - Comparison between blood donors and health students/professionals. One Health 2024; 18:100697. [PMID: 38463613 PMCID: PMC10924195 DOI: 10.1016/j.onehlt.2024.100697] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/22/2023] [Accepted: 02/27/2024] [Indexed: 03/12/2024] Open
Abstract
Objective To compare the current knowledge and practices regarding leishmaniasis among blood donors and health students and professionals, in Portugal. Material and methods Data were collected through the application of two questionnaires (one online and one in paper) with similar questions in two distinct cross-sectional independent studies, each targeting one of the groups. Descriptive statistics and hypothesis testing were performed using IBM® SPSS® Statistics. Results In total, 3763 blood donors, 254 students and 232 professionals were included in the comparative analysis. Over 95% of students and professionals, but only around 70% of blood donors had previously heard of leishmaniasis. Over 90% of participants in each group admitted leishmaniasis affected animals, but only in the professional group over 90% were aware of human leishmaniasis. Conclusions Even though canine leishmaniasis is recognized by many blood donors and by most students and professionals, awareness of the disease in humans is less common, highlighting the importance of promoting an approach to this infection through a One Health lens.
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Affiliation(s)
- Rafael Rocha
- Instituto de Higiene e Medicina Tropical (IHMT), Universidade Nova de Lisboa (UNL), Rua da Junqueira N°100, 1349-008 Lisboa, Portugal
- Global Health and Tropical Medicine (GHTM), Associate Laboratory in Translation and Innovation Towards Global Health, LA-REAL, IHMT, UNL, Rua da Junqueira N°100, Lisboa 1349-008, Portugal
| | - Cláudia Conceição
- Instituto de Higiene e Medicina Tropical (IHMT), Universidade Nova de Lisboa (UNL), Rua da Junqueira N°100, 1349-008 Lisboa, Portugal
- Global Health and Tropical Medicine (GHTM), Associate Laboratory in Translation and Innovation Towards Global Health, LA-REAL, IHMT, UNL, Rua da Junqueira N°100, Lisboa 1349-008, Portugal
| | - Luzia Gonçalves
- Instituto de Higiene e Medicina Tropical (IHMT), Universidade Nova de Lisboa (UNL), Rua da Junqueira N°100, 1349-008 Lisboa, Portugal
- Global Health and Tropical Medicine (GHTM), Associate Laboratory in Translation and Innovation Towards Global Health, LA-REAL, IHMT, UNL, Rua da Junqueira N°100, Lisboa 1349-008, Portugal
- Centro de Estatística e Aplicações da Universidade de Lisboa, Faculdade de Ciências da Universidade de Lisboa, Campo Grande, Lisboa 1749-016, Portugal
- Z-Stat4life, Espaço Cowork Baldaya, Palácio Baldaya, Estrada de Benfica N° 701ª, Lisboa 1549-011, Portugal
| | - Carla Maia
- Instituto de Higiene e Medicina Tropical (IHMT), Universidade Nova de Lisboa (UNL), Rua da Junqueira N°100, 1349-008 Lisboa, Portugal
- Global Health and Tropical Medicine (GHTM), Associate Laboratory in Translation and Innovation Towards Global Health, LA-REAL, IHMT, UNL, Rua da Junqueira N°100, Lisboa 1349-008, Portugal
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Rocha R, Conceição C, Gonçalves L, Maia C. Knowledge, perceptions and practices of health students and professionals regarding leishmaniasis in Portugal: a cross-sectional study. Parasit Vectors 2023; 16:381. [PMID: 37880779 PMCID: PMC10598964 DOI: 10.1186/s13071-023-05982-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/21/2023] [Accepted: 09/24/2023] [Indexed: 10/27/2023] Open
Abstract
BACKGROUND Control of leishmaniasis in the Mediterranean Basin relies on the active contributions from researchers in the fields of animal, human and environmental health. The application of knowledge, perceptions and practices (KPP) questionnaires to health students and professionals in Europe could be fundamental to identify and explore gaps in KPP, highlighting the diversity of conceptions related to this disease between students and professionals active in (One) Health. The objective of this study was to characterize and compare the current knowledge, perceptions and practices regarding leishmaniasis among subgroups of students and health professionals in Portugal through the application of an online questionnaire. METHODS A cross-sectional study targeted the population of health students and professionals in Portugal, including students in medicine, veterinary medicine and environmental health, physicians, veterinarians and environmental health technicians. Potential participants were approached by email via universities and professional societies and organizations and provided with the link to access the online questionnaire. Answers to the self-administered sociodemographic and KPP questionnaire were collected between July and December 2022. Individual KPP scores were calculated by summing grades defined for each question. Logistic regression models were used to search for potential associations, and the results were expressed at estimated crude and adjusted odds ratios with 95% confidence intervals. RESULTS In total, 486 participants were included in this study: 254 students and 232 professionals. Overall, 75% of the participants reported having heard of both human and animal leishmaniasis, and > 80% reported hearing about the disease during their course work (although this was significantly lower among those in the field of environmental health). Around 90% of participants identified the pathogenic agent as a parasite, and an arthropod bite was identified as the main route of transmission by > 95%. Animal leishmaniasis was considered to be diagnosed in Portugal by 87% of participants and human leishmaniasis by only 69%. The main barriers pointed out by professionals to the control of leishmaniasis were: lack of knowledge in the general population, failures in the early diagnosis and treatment of diseased animals, absence/inefficacy of vector control programs and lack of knowledge in human health professionals. Median knowledge and perception scores were higher among professionals in the animal health field and higher in professionals than in students. Median practice scores were not significantly different between groups and subgroups. The multivariate analysis revealed that a longer period of study (for students) and having seen cases of leishmaniasis (for physicians) were associated with above-mentioned median knowledge score. CONCLUSIONS Most health students and professionals are knowledgeable about the cause and transmission route of leishmaniasis. However, recognition of the disease as autochthonous in humans is less common, highlighting the importance of promoting an approach to this infection through a One-Health lens. A national structured plan to control leishmaniasis could overcome some of the barriers pointed out by professionals, namely by implementing systematic phlebotomine surveillance and integrated reporting of animal and human cases of disease.
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Affiliation(s)
- Rafael Rocha
- Instituto de Higiene e Medicina Tropical (IHMT), Universidade Nova de Lisboa (UNL), Lisbon, Portugal
- Global Health and Tropical Medicine (GHTM), Associate Laboratory in Translation and Innovation Towards Global Health (LA-REAL), Institute of Hygiene and Tropical Medicine (IHMT), NOVA University Lisbon (UNL), Lisbon, Portugal
| | - Cláudia Conceição
- Instituto de Higiene e Medicina Tropical (IHMT), Universidade Nova de Lisboa (UNL), Lisbon, Portugal
- Global Health and Tropical Medicine (GHTM), Associate Laboratory in Translation and Innovation Towards Global Health (LA-REAL), Institute of Hygiene and Tropical Medicine (IHMT), NOVA University Lisbon (UNL), Lisbon, Portugal
| | - Luzia Gonçalves
- Instituto de Higiene e Medicina Tropical (IHMT), Universidade Nova de Lisboa (UNL), Lisbon, Portugal
- Global Health and Tropical Medicine (GHTM), Associate Laboratory in Translation and Innovation Towards Global Health (LA-REAL), Institute of Hygiene and Tropical Medicine (IHMT), NOVA University Lisbon (UNL), Lisbon, Portugal
- Centro de Estatística e Aplicações da Universidade de Lisboa (UL), Lisbon, Portugal
- Z-Stat4life, Lisbon, Portugal
| | - Carla Maia
- Instituto de Higiene e Medicina Tropical (IHMT), Universidade Nova de Lisboa (UNL), Lisbon, Portugal.
- Global Health and Tropical Medicine (GHTM), Associate Laboratory in Translation and Innovation Towards Global Health (LA-REAL), Institute of Hygiene and Tropical Medicine (IHMT), NOVA University Lisbon (UNL), Lisbon, Portugal.
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Baxarias M, Donato G, Mateu C, Salichs M, Homedes J, Miró G, Pennisi MG, Solano-Gallego L. A blinded, randomized and controlled multicenter clinical trial to assess the efficacy and safety of Leisguard ® as an immunotherapeutic treatment for healthy Leishmania infantum-seropositive dogs. Parasit Vectors 2023; 16:344. [PMID: 37794502 PMCID: PMC10552330 DOI: 10.1186/s13071-023-05903-0] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/24/2023] [Accepted: 07/27/2023] [Indexed: 10/06/2023] Open
Abstract
BACKGROUND Domperidone (Leisguard®) is an immunomodulatory drug used as a preventive measure in healthy dogs. However, no studies have been published in healthy Leishmania infantum-seropositive dogs. The aim of this study was to evaluate the clinical efficacy and safety of domperidone as immunotherapy in Leishmania-seropositive healthy dogs. METHODS Sixty-seven dogs were treated with domperidone at 0.5 mg/kg and 44 dogs received placebo, once daily for 4 consecutive weeks. Monthly treatments were repeated every 4 months until the end of the 1-year follow-up period. Veterinary examinations were performed on days 0, 30, 120, 150, 240, 270 and 360. Samples of blood and urine were collected on days 0, 120, 240 and 360 for routine laboratory tests and quantitative in-house ELISA for the detection of L. infantum-specific antibodies. Furthermore, Leishmania real-time PCR and IFN-γ ELISA were performed at day 0 and the end of the study. Dogs that developed disease were withdrawn from the study and classified as sick dogs. Adverse drug reactions were reported. RESULTS Thirty dogs developed disease during the follow-up period: 13/67 (19.4%) in the group treated with domperidone and 17/44 (38.6%) in the placebo-treated group (P = 0.03). Low-seropositive dogs treated with domperidone (4/40, 9.1%) were significantly less likely to develop disease compared to low-seropositive dogs treated with placebo (7/24, 29.2%; P = 0.04), while no differences were found between domperidone (9/23, 39.1%) and placebo (10/20, 50%) in medium- to high-seropositive dogs. At the end of the study, a higher proportion of Leishmania PCR-positive dogs was observed in the placebo-treated group (16/33, 48.5%) compared to the domperidone group (13/51, 25.5%; P = 0.04). Furthermore, low-seropositive dogs treated with domperidone with an increase of IFN-γ concentration presented a higher increase than those treated with placebo at the end of the study. Four dogs treated with domperidone presented self-limiting diarrhea. CONCLUSIONS Healthy dogs with low L. infantum antibody levels treated with domperidone were less likely to develop disease compared to placebo-treated dogs. Furthermore, domperidone presented a good safety profile.
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Affiliation(s)
- Marta Baxarias
- Departament de Medicina i Cirurgia Animals, Facultat de Veterinària, Universitat Autònoma de Barcelona, Bellaterra, Spain
| | - Giulia Donato
- Dipartimento di Scienze Veterinarie, Università di Messina - Polo Universitario Annunziata, Messina, Italy
| | | | | | | | - Guadalupe Miró
- Departamento de Sanidad Animal, Universidad Complutense de Madrid, Madrid, Spain
| | - Maria Grazia Pennisi
- Dipartimento di Scienze Veterinarie, Università di Messina - Polo Universitario Annunziata, Messina, Italy
| | - Laia Solano-Gallego
- Departament de Medicina i Cirurgia Animals, Facultat de Veterinària, Universitat Autònoma de Barcelona, Bellaterra, Spain.
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Baxarias M, Homedes J, Mateu C, Attipa C, Solano-Gallego L. Use of preventive measures and serological screening tools for Leishmania infantum infection in dogs from Europe. Parasit Vectors 2022; 15:134. [PMID: 35534848 PMCID: PMC9088038 DOI: 10.1186/s13071-022-05251-5] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/21/2022] [Accepted: 03/21/2022] [Indexed: 11/15/2022] Open
Abstract
Background There are several screening tools for detecting Leishmania infantum infection in dogs and various preventive measures to protect against it. Some studies have investigated them, but not many have described their current use. The aim of this study was to investigate which preventive measures and serological screening tools for L. infantum infection were employed from 2012 to 2018 in dogs from different endemic European countries. Methods A set of electronic datasheets was completed for each dog from several veterinary centres. Classification of preventive measures included: (1) repellents, (2) vaccines and (3) immunomodulators. Classification of serological tests included the: (1) direct agglutination test (DAT), (2) enzyme-linked immunosorbent assay (ELISA), (3) indirect immunofluorescence (IFI), (4) rapid tests and (5) other assays. Dogs were also classified depending on their risk of exposure and living area. Results Information from 3762 dogs was gathered. Preventive measures were applied in 91.5% of dogs and the most frequently used were repellents (86.2%) followed by vaccines (39.8%) and Leisguard® (15.3%). The different types of repellents (collar and spot-on) were used similarly. A combination of a vaccine and repellents was preferred in the high-risk group while the low-risk preferred a combination of Leisguard® and a repellent (Chi-square test: X2 = 88.41, df = 10, P < 0.001). Furthermore, all preventive measures were similarly used through the years except for repellents, which were predicted to have a small increase of use each year. Regarding serological screening tools, the most used were rapid and ELISA tests. Rapid tests, ELISA tests and DAT were used similarly through the years, but a significant change was found in the use of IFI and other assays whose use decreased a little each year. Conclusions Repellents were the preferred measure, while vaccines and Leisguard® were second-line options. Some dogs were not treated by any measures, which highlights the need for dog owner education. Moreover, there seems to be a preference for rapid tests in the clinical setting to detect specific L. infantum antibodies while ELISA or IFI are less often employed. This underlines an increasing problem, as qualitative rapid tests have a variable diagnostic performance limiting the adequate diagnosis of seropositive dogs in endemic areas. Graphical abstract ![]()
Supplementary Information The online version contains supplementary material available at 10.1186/s13071-022-05251-5.
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Affiliation(s)
- Marta Baxarias
- Departament de Medicina i Cirurgia Animals, Facultat de Veterinària, Universitat Autònoma de Barcelona, Bellaterra, Spain
| | | | | | - Charalampos Attipa
- Department of Tropical Disease Biology, Liverpool School of Tropical Medicine, Liverpool, UK
| | - Laia Solano-Gallego
- Departament de Medicina i Cirurgia Animals, Facultat de Veterinària, Universitat Autònoma de Barcelona, Bellaterra, Spain.
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Müller A, Montoya A, Escacena C, de la Cruz M, Junco A, Iriso A, Marino E, Fúster F, Miró G. Leishmania infantum infection serosurveillance in stray dogs inhabiting the Madrid community: 2007-2018. Parasit Vectors 2022; 15:96. [PMID: 35422058 PMCID: PMC9281004 DOI: 10.1186/s13071-022-05226-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/13/2022] [Accepted: 02/26/2022] [Indexed: 11/21/2022] Open
Abstract
Background Leishmaniosis is an endemic zoonotic disease in the Mediterranean basin caused by Leishmania infantum and transmitted by phlebotomine sandflies. While in dogs disease may be severe, leishmaniosis is also a public health concern as was shown in the largest outbreak of human leishmaniosis (HL) in Europe in 2009 occurring in the Madrid region. The aim of the present study was to assess the applicability of the Leishmaniosis Surveillance Program (LeishSP) established in Madrid in 1996 by examining trends in L. infantum seroprevalence and associated epidemiological risk factors based on data for the 2007–2018 period. Methods The study population consisted of 3225 stray dogs from 17 animal shelters collaborating with the LeishSP. Seroprevalences were recorded twice annually (April and November) from 2007 to 2018. In each yearly period, a minimum of 100 dogs were tested to detect dogs infected before and after the sandfly risk season in Madrid area. Each dog was subjected to the same protocol of blood sample collection and clinical examination to collect epidemiological data and clinical signs. Anti-Leishmania-specific IgG was determined by IFAT cut-off ≥ 1:100. Results Overall seroprevalence was 6.1% (198 positive dogs). Epidemiological data indicate a significantly higher seroprevalence in dogs > 4 years old, purebred dogs (Pit Bull and related breeds), and medium to large size dogs. There were no seroprevalence differences according to sex and/or season (April and November). In addition, no significant differences were observed according to whether dogs lived inside or outside the HL outbreak area. Remarkably, of 198 dogs testing positive for L. infantum, 64.6% had no clinical signs, indicating a high proportion of clinically healthy infected dogs that could be a potential source of infection. Conclusions Results indicate a stable seroprevalence of L. infantum infection after 2006 in stray dogs in Madrid but with a recent slightly increasing trend. These observations support the need to continue with the LeishSP implemented by sanitary authorities of the Madrid Community as an early warning strategy for human and animal leishmaniosis and to enable continued assessment of the epidemiological role of dogs with subclinical infection in this important zoonotic disease. Graphical Abstract ![]()
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Affiliation(s)
- Aurora Müller
- Unidad Técnica 6 del Área de Salud Pública, Consejería de Sanidad, Comunidad de Madrid, Madrid, Spain
| | - Ana Montoya
- Departamento de Sanidad Animal, Facultad de Veterinaria, Universidad Complutense, Madrid, Spain
| | - Cristina Escacena
- Área de Vigilancia de Riesgos Ambientales en Salud, Consejería de Sanidad, Comunidad de Madrid, Madrid, Spain
| | - María de la Cruz
- Área de Vigilancia de Riesgos Ambientales en Salud, Consejería de Sanidad, Comunidad de Madrid, Madrid, Spain
| | - Ana Junco
- Área de Vigilancia de Riesgos Ambientales en Salud, Consejería de Sanidad, Comunidad de Madrid, Madrid, Spain
| | - Andrés Iriso
- Área de Vigilancia de Riesgos Ambientales en Salud, Consejería de Sanidad, Comunidad de Madrid, Madrid, Spain
| | - Eloy Marino
- Unidad Técnica 1-4-7 del Área de Salud Pública, Consejería de Sanidad, Comunidad de Madrid, Madrid, Spain
| | - Fernando Fúster
- Área de Vigilancia de Riesgos Ambientales en Salud, Consejería de Sanidad, Comunidad de Madrid, Madrid, Spain
| | - Guadalupe Miró
- Departamento de Sanidad Animal, Facultad de Veterinaria, Universidad Complutense, Madrid, Spain.
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Pereira MA, Santos R, Nóbrega C, Mega C, Cruz R, Esteves F, Santos C, Coelho C, Mesquita JR, Vala H, Santos-Gomes G. A Questionnaire-Based Survey on the Long-Term Management of Canine Leishmaniosis by Veterinary Practitioners. Animals (Basel) 2022; 12:ani12060731. [PMID: 35327128 PMCID: PMC8944528 DOI: 10.3390/ani12060731] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/07/2022] [Revised: 03/04/2022] [Accepted: 03/11/2022] [Indexed: 11/16/2022] Open
Abstract
Simple Summary Canine Leishmaniosis is a chronic and potentially fatal disease, caused by Leishmania infantum, a zoonotic microorganism. In economically disadvantaged regions, costs associated with long-term patient monitoring may determine that some owners decline veterinary follow-up of their dogs, with potentially severe implications for animal welfare and public health. This online, questionnaire-based survey aimed to assess how Portuguese veterinary practitioners perform long-term patient management and recognize relapses. More than half of the respondents stated that most dog owners declare having financial restraints, which condition the use of diagnostic tests during long-term follow-up. Allopurinol ad aeternum or until disease remission and domperidone were the most prescribed treatment, and relapses were detected by the reappearance or worsening of clinical signs by most veterinary practitioners. The rate of relapse detection was higher in the most economically favored regions, probably because of a lesser constraint on the use of the appropriate diagnostic tests. This study confirms that owner financial restraints negatively influence veterinary follow-up and relapse recognition, potentially compromising clinical decision making and favoring the maintenance of Leishmania infantum infection endemic status in Portugal. Abstract Canine Leishmaniosis (CanL) is a chronic and potentially fatal disease. In economically disadvantaged regions, costs associated with long-term patient monitoring may determine that some owners decline veterinary follow-up of their dogs. This online, questionnaire-based survey aimed to assess how Portuguese veterinary practitioners perform long-term patient monitoring and recognize relapses. More than 50% of respondents reported that 50–100% of dog owners declared financial restraints. Hence, in these circumstances, most veterinary practitioners only performed clinical examination and serology. However, when owners did not declare financial restriction, other tests were additionally performed, such as renal and hepatic profiles, hemogram, serum protein electrophoresis and urine protein creatinine ratio. The mean number of exams performed when owners presented financial restraints was significantly lower than the number of exams performed without economic limitations. Most veterinary practitioners prescribed allopurinol ad aeternum or until disease remission and domperidone. CanL relapses were recognized by more than half of respondents “Always”, through the reappearance or worsening of clinical signs, whereas about a quarter detected an increase in anti-Leishmania antibody levels and identified abnormalities in the serum protein electrophoresis profile. The relapse rate was higher in the Lisbon Metropolitan Area and north, the most economically favored regions of Portugal. This study confirms that owner financial restraints negatively influence veterinary follow-up and relapse recognition, ultimately compromising clinical decision making and favoring the maintenance of Leishmania infantum infection endemicity.
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Affiliation(s)
- Maria A. Pereira
- Instituto Politécnico de Viseu, Escola Superior Agrária de Viseu, Campus Politécnico, 3504-510 Viseu, Portugal; (C.N.); (C.M.); (R.C.); (F.E.); (C.S.); (C.C.); (H.V.)
- Global Health and Tropical Medicine (GHTM), Instituto de Higiene e Medicina Tropical (IHMT), Universidade Nova de Lisboa, UNL, Rua da Junqueira 100, 1349-008 Lisboa, Portugal;
- CERNAS—Research Centre for Natural Resources, Environment and Society, ESAV, Instituto Politécnico de Viseu, 3500-606 Viseu, Portugal
- Correspondence: ; Tel.: +351-232-446-600
| | - Rute Santos
- Polytechnic Institute of Portalegre, 7300-110 Portalegre, Portugal;
- Research Centre for Endogenous Resource Valorization (VALORIZA), 7300-555 Portalegre, Portugal
| | - Carmen Nóbrega
- Instituto Politécnico de Viseu, Escola Superior Agrária de Viseu, Campus Politécnico, 3504-510 Viseu, Portugal; (C.N.); (C.M.); (R.C.); (F.E.); (C.S.); (C.C.); (H.V.)
- Centre for the Research and Technology of Agro-Environmental and Biological Sciences (CITAB), University of Trás-os-Montes e Alto Douro, 5001-801 Vila Real, Portugal
| | - Cristina Mega
- Instituto Politécnico de Viseu, Escola Superior Agrária de Viseu, Campus Politécnico, 3504-510 Viseu, Portugal; (C.N.); (C.M.); (R.C.); (F.E.); (C.S.); (C.C.); (H.V.)
- CERNAS—Research Centre for Natural Resources, Environment and Society, ESAV, Instituto Politécnico de Viseu, 3500-606 Viseu, Portugal
| | - Rita Cruz
- Instituto Politécnico de Viseu, Escola Superior Agrária de Viseu, Campus Politécnico, 3504-510 Viseu, Portugal; (C.N.); (C.M.); (R.C.); (F.E.); (C.S.); (C.C.); (H.V.)
- Epidemiology Research Unit (EPIUnit), Instituto de Saúde Pública da Universidade do Porto, 4050-091 Porto, Portugal;
- Laboratório para a Investigação Integrativa e Translacional em Saúde Populacional (ITR), 4050-600 Porto, Portugal
| | - Fernando Esteves
- Instituto Politécnico de Viseu, Escola Superior Agrária de Viseu, Campus Politécnico, 3504-510 Viseu, Portugal; (C.N.); (C.M.); (R.C.); (F.E.); (C.S.); (C.C.); (H.V.)
- CERNAS—Research Centre for Natural Resources, Environment and Society, ESAV, Instituto Politécnico de Viseu, 3500-606 Viseu, Portugal
| | - Carla Santos
- Instituto Politécnico de Viseu, Escola Superior Agrária de Viseu, Campus Politécnico, 3504-510 Viseu, Portugal; (C.N.); (C.M.); (R.C.); (F.E.); (C.S.); (C.C.); (H.V.)
| | - Catarina Coelho
- Instituto Politécnico de Viseu, Escola Superior Agrária de Viseu, Campus Politécnico, 3504-510 Viseu, Portugal; (C.N.); (C.M.); (R.C.); (F.E.); (C.S.); (C.C.); (H.V.)
- CERNAS—Research Centre for Natural Resources, Environment and Society, ESAV, Instituto Politécnico de Viseu, 3500-606 Viseu, Portugal
| | - João R. Mesquita
- Epidemiology Research Unit (EPIUnit), Instituto de Saúde Pública da Universidade do Porto, 4050-091 Porto, Portugal;
- Laboratório para a Investigação Integrativa e Translacional em Saúde Populacional (ITR), 4050-600 Porto, Portugal
- ICBAS—School of Medicine and Biomedical Sciences, Porto University, 4050-313 Porto, Portugal
| | - Helena Vala
- Instituto Politécnico de Viseu, Escola Superior Agrária de Viseu, Campus Politécnico, 3504-510 Viseu, Portugal; (C.N.); (C.M.); (R.C.); (F.E.); (C.S.); (C.C.); (H.V.)
- CERNAS—Research Centre for Natural Resources, Environment and Society, ESAV, Instituto Politécnico de Viseu, 3500-606 Viseu, Portugal
- Centre for the Research and Technology of Agro-Environmental and Biological Sciences (CITAB), University of Trás-os-Montes e Alto Douro, 5001-801 Vila Real, Portugal
| | - Gabriela Santos-Gomes
- Global Health and Tropical Medicine (GHTM), Instituto de Higiene e Medicina Tropical (IHMT), Universidade Nova de Lisboa, UNL, Rua da Junqueira 100, 1349-008 Lisboa, Portugal;
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Segarra S. Nutritional Modulation of the Immune Response Mediated by Nucleotides in Canine Leishmaniosis. Microorganisms 2021; 9:2601. [PMID: 34946204 PMCID: PMC8703464 DOI: 10.3390/microorganisms9122601] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/08/2021] [Revised: 12/09/2021] [Accepted: 12/14/2021] [Indexed: 12/24/2022] Open
Abstract
Leishmaniasis is an emerging, uncontrolled, and neglected zoonotic disease. Climate change is contributing to its ongoing global expansion. The dog is the main reservoir; hence the importance of implementing effective treatment, prevention, and control measures in this animal species to protect public health. However, although the standard treatment for canine leishmaniosis (CanL) is effective, it does not provide full parasitological clearance, and side effects and drug resistance have been described. The host's immune system plays a key role in the establishment and evolution of leishmaniasis. Dietary nucleotides modulate the immune response and, given their reported efficacy and safety in sick and clinically healthy Leishmania-infected dogs and because they represent a sustainable option with no associated side effects or resistance, they could be included within the prevention, treatment, and control strategies for leishmaniasis. This article briefly summarizes the scientific literature on CanL management, including unresolved issues, and reviews the scientific evidence on immunomodulatory effects of dietary nucleotides in different animal species. It also proposes a CanL management algorithm, including nucleotides. It is concluded that nutritional modulation of the immune response with nucleotides can contribute to better management of leishmaniasis following a One Health approach, especially in the COVID-19 era.
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Affiliation(s)
- Sergi Segarra
- R&D Bioiberica S.A.U., 08950 Esplugues de Llobregat, Spain
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Giner J, Villanueva-Saz S, Fernández A, Gómez MA, Podra M, Lizarraga P, Lacasta D, Ruiz H, Del Carmen Aranda M, de Los Ángeles Jimenez M, Hernández R, Yzuel A, Verde M. Detection of Anti-Leishmania infantum antibodies in Wild European and American Mink (Mustela lutreola and Neovison vison) from Northern Spain, 2014-20. J Wildl Dis 2021. [PMID: 34818406 DOI: 10.7589/JWD-D-21-00027] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/24/2021] [Accepted: 07/29/2021] [Indexed: 11/20/2022]
Abstract
The European mink (Mustela lutreola) is listed as a critically endangered species because of ongoing population reduction from habitat degradation and the effects of introduced species, such as American mink (Neovison vison). This small, fragmented population becomes vulnerable to many other threats, including diseases. Leishmaniosis is a zoonotic disease caused by the protozoan parasite Leishmania infantum found in the Mediterranean area, which affects many mammals, including wild small mammals. Furthermore, clinical disease caused by L. infantum has recently been described in other mustelids. To assess the exposure to Leishmania sp. infection in mink species in northern Spain, blood samples from 139 feral American mink and 42 native European mink from north Spain were evaluated for Leishmania sp. infection using enzyme-linked immunosorbent assays against Leishmania spp. antibodies, with 52.4% of American mink and 45.3% of European mink being found seropositive. This finding raises questions regarding how the disease may affect these species and the potential repercussions for conservation efforts. Despite a high seroprevalence being observed in wild mink of both species in this study, association with clinical or pathologic signs of disease has yet to be elucidated.
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Vismarra A, Kramer LH, Moschi A, Ciuca L, Genchi M. A survey on canine leishmaniosis: Best practice and guideline awareness among Italian veterinary practitioners. Prev Vet Med 2021; 195:105450. [PMID: 34364152 DOI: 10.1016/j.prevetmed.2021.105450] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/19/2021] [Revised: 07/20/2021] [Accepted: 07/26/2021] [Indexed: 11/20/2022]
Abstract
Canine leishmaniosis (CanL) is a severe, potentially life-threatening disease of dogs and is considered one of the most important vector-borne zoonoses in Europe, where there is evidence that it is currently spreading into previously unaffected areas. Veterinary practitioners represent the first-line defence against CanL and in recent years, several guidelines have been developed to assist veterinarians in the correct diagnosis, management and prevention of the disease. The present study was aimed at surveying Italian practitioners on how they manage CanL and compare results to recommendations from guidelines developed by the European Scientific Council for Companion Animal Parasites (ESCCAP®), by the Leishvet® organization and by the Canine Leishmaniasis Working Group (C.L.W.G.). Approximately 14.0 % of veterinarians contacted replied to the survey. Results suggest that Italian practitioners are aware of currently available guidelines for the management of CanL and adherence to recommendations is good. Interestingly, 16.0 % carry out year-long prevention, even though recent data suggest that transmission in Italy continues to be seasonal. In conclusion, the high awareness among practitioners reported here should be considered an excellent opportunity for guideline developers to continue updating their recommendations to include any new information that can support the correct management of CL.
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Monteiro M, Prata S, Cardoso L, Pereira da Fonseca I, Leal RO. Diagnosis and clinical management of canine leishmaniosis by general veterinary practitioners: a questionnaire-based survey in Portugal. Parasit Vectors 2021; 14:306. [PMID: 34099039 PMCID: PMC8182999 DOI: 10.1186/s13071-021-04799-y] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/23/2021] [Accepted: 05/20/2021] [Indexed: 11/15/2022] Open
Abstract
BACKGROUND Canine leishmaniosis (CanL) can be appropriately managed following international recommendations. However, few studies have assessed the preferred protocols in real-life veterinary practice and whether these are in line with the guidelines. This survey aimed to investigate the current trends in the clinical management of CanL among veterinary practitioners in Portugal, taking into consideration different scenarios of infection/disease and the awareness of and application by veterinary practitioners of the current guidelines. METHODS A questionnaire-based survey was conducted online using an electronic platform. The following topics were surveyed: (i) general characteristics of the responding veterinarian; (ii) the preferred protocols used for the diagnosis, treatment and prevention of CanL, considering different theoretical scenarios of infection/disease; and (iii) the responding veterinarian's current knowledge and application of the existing guidelines on CanL. After internal validation, the survey was distributed online, for 2 months, via Portuguese social network veterinary groups. Data were collected for descriptive analysis. RESULTS Eighty-six replies were obtained. Analysis of the results showed that the preferred diagnostic techniques varied widely according to the theoretical scenario of infection/disease. In general daily practice, serology testing (enzyme-linked immunosorbent assay [ELISA]) was the most used tool (67.4%). The preferred matrices used for PCR test were lymph nodes (62.3%) and/or bone marrow (59.0%). Regarding treatment, for subclinical infection/stage I CanL, 51.2% of the respondents did not prescribe any medical treatment, but 98.8% proceeded with both monitoring and preventive measures. Among those who prescribed a treatment (n = 42), most chose domperidone (47.6%). For the treament of stages IIa, IIb and III CanL, allopurinol/meglumine antimoniate (MA) was chosen by 69.8, 73.3 and 51.2% of respondents, respectively, followed by allopurinol/miltefosine (20.9, 19.8 and 38.4%, respectively). In contrast, dogs with stage IV CanL were mostly treated with allopurinol/miltefosine (48.8%) rather than with allopurinol/MA (23.3%). The use of repellents was the preferred preventive strategy (98.8%). About 93.0% of responders were aware of the existence of guidelines, and most of these veterinarians consulted the guidelines of the LeishVet group and the Canine Leishmaniosis Working Group; however, 31.3% reported that they did not follow any specific recommendations. CONCLUSIONS Of the veterinarians responding to the survey, most reported following international guidelines for the clinical management of CanL. While allopurinol/MA was the preferred therapeutic protocol for the treatment of stages II/III CanL, allopurinol/miltefosine was the first choice for the treatment of stage IV CanL, possibly due to the unpredictable effect of MA on renal function. This study contributes to a better understanding of the trends in practical approaches to the treatment of CanL in Portugal.
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Affiliation(s)
- Marta Monteiro
- Hospital Escolar Veterinário, Faculdade de Medicina Veterinária, Universidade de Lisboa, Lisbon, Portugal
| | - Sara Prata
- Hospital Escolar Veterinário, Faculdade de Medicina Veterinária, Universidade de Lisboa, Lisbon, Portugal
| | - Luís Cardoso
- Department of Veterinary Sciences, and Animal and Veterinary Research Centre (CECAV), University of Trás-Os-Montes e Alto Douro (UTAD), Vila Real, Portugal
| | - Isabel Pereira da Fonseca
- Hospital Escolar Veterinário, Faculdade de Medicina Veterinária, Universidade de Lisboa, Lisbon, Portugal
- Centro de Investigação Interdisciplinar em Sanidade Animal (CIISA), Faculdade de Medicina Veterinária, Universidade de Lisboa, Lisbon, Portugal
| | - Rodolfo Oliveira Leal
- Hospital Escolar Veterinário, Faculdade de Medicina Veterinária, Universidade de Lisboa, Lisbon, Portugal.
- Centro de Investigação Interdisciplinar em Sanidade Animal (CIISA), Faculdade de Medicina Veterinária, Universidade de Lisboa, Lisbon, Portugal.
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Montoya A, Checa R, Marino V, Gálvez R, Portero M, De Mari K, Navarro C, Miró G. Antibodies elicited by the CaniLeish® vaccine: long-term clinical follow-up study of dogs in Spain. Parasitol Res 2021; 120:1471-1479. [PMID: 33624147 DOI: 10.1007/s00436-021-07091-1] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/15/2020] [Accepted: 02/16/2021] [Indexed: 11/30/2022]
Abstract
The prevention of canine leishmaniosis in healthy dogs requires a multimodal approach combining repellents with an effective vaccine. A vaccine that modulates the cell-mediated immune response against the protozoan has been available in Europe since 2012 (CaniLeish®, Virbac, France). The aim of the present study was to monitor dogs vaccinated with CaniLeish® to examine the kinetics of the antibody response and the safety and tolerance of CaniLeish®. Dogs vaccinated with CaniLeish® were monitored for 12 months. In follow-up visits at baseline (primovaccination or annual booster) (Visit 1, V1), and 1 (V2), 4 (V3), 8 (V4) and 12 (V5) months later, we examined antibody response kinetics using two serology techniques (IFAT and Speed Leish K™). Tolerance to CaniLeish® and its safety were also monitored. Anti-L. infantum IgG antibodies were determined in 242 dogs (125 dogs after primovaccination (Group P) and 117 dogs after booster vaccination (Group B). In addition, 46, 22 and 19 dogs were followed for 2, 3 and 4 years, respectively. At baseline, 100% of dogs in Group P returned negative IFAT and Speed Leish K™ test results while 9.4% (11/117) in Group B tested IFAT positive though Speed Leish K™ negative. In subsequent visits, seropositivity was detected by IFAT in 31.2% (Group P) and 41% (Group B) of the dogs in V2; 16.8% (Group P) and 10.2% (Group B) in V3; 6.4% (Group P) and 8.5% (Group B) in V4; and 3.2% (Group P) and 5.9% (Group B) in V5. All dogs tested Speed Leish K™ negative except two, in which it was later confirmed by molecular testing that they were not infected. Adverse events that could be associated with the vaccine were detected in 20 out of 314 dogs (6.4%). The good clinical status of all dogs was confirmed in an exhaustive clinical exam and haemato-biochemical profile. The Canileish® vaccine was well-tolerated with exceptions that did not appear to be related to age, sex, race or size of vaccinated dogs. Anti-L. infantum antibodies were detected by IFAT in 31.9-40.3% of the dogs 1 month after vaccination, and these antibodies could still be detected in 3.2% of the dogs 1 year later. This means that veterinarians need to use other tools (eg. PCR) to correctly diagnose seropositive dogs.
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Affiliation(s)
- A Montoya
- Animal Health Department, Veterinary Faculty, UCM, Madrid, Spain.
| | - R Checa
- Animal Health Department, Veterinary Faculty, UCM, Madrid, Spain
| | - V Marino
- Animal Health Department, Veterinary Faculty, UCM, Madrid, Spain
| | - R Gálvez
- Animal Health Department, Veterinary Faculty, UCM, Madrid, Spain.,Department of Specific Didactics, School of Education and Teacher Training, Universidad Autónoma de Madrid, Madrid, Spain
| | - M Portero
- Veterinary Teaching Hospital, Veterinary Faculty, UCM, Madrid, Spain
| | - K De Mari
- Medical Department, Virbac, 06511, Carros, France
| | - C Navarro
- Medical Department, Virbac, 06511, Carros, France
| | - G Miró
- Animal Health Department, Veterinary Faculty, UCM, Madrid, Spain.
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