Dengue Disease Surveillance: Improving Data For...

Global Financing And Long-term Technical Assist...

Clinical Virology: An Oxymoron Or A Useful Tool?

Antimicrobial Resistance Patterns Among Acineto...

An Economic Model To Compare Linezolid And Vanc...

0 votes
Effectiveness Of Insecticide Spraying And Culling Of Dogs On The Incidence Of Leishmania Infantum Infection In Humans: A Cluster Randomized Trial In Teresina, Brazil
Author: Guilherme L. Werneck, Carlos H. N. Costa, Fernando Aécio Amorim De Carvalho, Maria Do Socorro Pires E Cruz, James H. Maguire, Marcia C. Castro
Publisher: Derivative Works
10 pages
One time payment: €0.00
Required subscription: Free
Type of publication: Article
ISBN/ISSN: 1935-2727
DOI: 10.1371/0003172
Follow this publisher

Share this publication:


Background:To evaluate the effect of insecticide spraying for vector control and elimination of infected dogs on the incidence of human infection with L. infantum, a randomized community intervention trial was carried out in the city of Teresina, Brazil.


Methods/Principal Findings: Within each of ten localities in the city, four blocks were selected and randomized to 4 interventions: 1) spraying houses and animal pens with insecticide; 2) eliminating infected dogs; 3) combination of spraying and eliminating dogs, and 4) nothing. The main outcome is the incidence of infection assessed by the conversion of the Montenegro skin test (MST) after 18 months of follow-up in residents aged ≥1 year with no previous history of visceral leishmaniasis (VL). Reactions were measured at 48–72 h, induration of ≥5 mm considered positive. Interventions were executed after the baseline interview and repeated 6 and 12 months later. The effects of each type of intervention scheme on the incidence of infection were assessed by calculating relative risks and 95% confidence intervals using Poisson population-averaged regression models with robust variance. Among the 1105 participants, 408 (37%) were MST positive at baseline. Of the 697 negatives, only 423 (61%) were reexamined at the end of the follow-up; 151 (36%) of them converted to a positive MST. Only dog culling had some statistically significant effect on reducing the incidence of infection, with estimates of effectiveness varying between 27% and 52%, depending on the type of analysis performed.

Conclusions/Significance:In light of the continuous spread of VL in Brazil despite the large scale deployment of insecticide spraying and dog culling, the relatively low to moderate effectiveness of dog culling and the non-significant effect of insecticide spraying on the incidence of human infection, we conclude that there is an urgent need for revision of the Brazilian VL control program.

About the publisher:

We are a publishing house devoted to reuse CC-BY licensed published materials.


Using CC-BY licenses:


  • Adapt — remix, transform, and build upon the material
  • for any purpose, even commercially.
  • The licensor cannot revoke these freedoms as long as you follow the license terms.


  • No additional restrictions — You may not apply legal terms or technological measures that legally restrict others
    from doing anything the license permits.


  • You do not have to comply with the license for elements of the material in the public domain or where your use is permitted by an applicable exception or limitation.
  • No warranties are given. The license may not give you all of the permissions necessary for your intended use. For example, other rights such as publicity, privacy, or moral rights may limit how you use the material.

Select a payment method