Vector and reservoir control for preventing leishmaniasis
Urbà González1, Mariona Pinart2, David Sinclair3, Alireza Firooz4, Claes Enk5, Ivan D Vélez6, Tonya M Esterhuizen7, Mario Tristan8, Jorge Alvar9
1. CLĺNICA GO&FER, Unit of Dermatology, Barcelona, Spain
2. Centre for Research in Environmental Epidemiology (CREAL), Barcelona, Catalunya, Spain
3. Liverpool School of Tropical Medicine, Department of Clinical Sciences, Liverpool, UK
4. Center for Research and Training in Skin Diseases and Leprosy, Tehran University of Medical Sciences, Tehran, Iran
5. Hadassah Medical Center, Department of Dermatology, Jerusalem, Israel
6. Universidad de Antioquia, Programa de Estudio y Control de Enfermedades Tropicales PECET, Medellin, Colombia
7. Stellenbosch University, Centre for Evidence-based Health Care, Faculty of Medicine and Health Sciences, Cape Town, South Africa
8. International Health Central American Institute, Board of Directors, San José, San Jose, Costa Rica
9. Drugs for Neglected Diseases initiative (DNDi), Geneva, Switzerland
González U, Pinart M, Sinclair D, Firooz A, Enk C, Vélez ID, Esterhuizen TM, Tristan M, Alvar J. Vector and reservoir control for preventing leishmaniasis. Cochrane Database of Systematic Reviews 2015, Issue 8. Art. No.: CD008736. DOI: 10.1002/14651858.CD008736.pub2
To read the full review please follow this link: DOI: 10.1002/14651858.CD008736.pub2
This review summarises trials evaluating different measures to prevent leishmaniasis. After searching for relevant trials up to January 2015, we included 14 randomized controlled trials.
What is vector and reservoir control and how might they prevent leishmaniasis?
Leishmaniasis is a group of infectious diseases caused by Leishmania parasites, which are transmitted between humans and animals by the bite of infected phlebotomine sandflies. There are two main clinical diseases: cutaneous leishmaniasis (CL), where parasites infect the skin, and visceral leishmaniasis (VL), where they infect the internal organs.
Leishmaniasis could be prevented by reducing human contact with infected phlebotomine sandflies (the vector), or by reducing the number of infected animals (the reservoir).
What the research says?
Using insecticides to reduce the number of sandflies may be effective at reducing the number of new cases of CL (low quality evidence). However, there is not enough evidence to know whether it is better to use insecticides to spray the internal walls of houses, or use insecticide treated bednets, bedsheets, or curtains.
Personal protection using insecticide treated clothing was also evaluated in two small trials in soldiers, but the trials were too small to know whether this was effective (low quality evidence).
Insecticide treated nets may not be effective at preventing VL but this has only been tested in a single trial from India and Nepal (low quality evidence).
Although culling dogs is sometimes discussed as a potential way to reduce VL, this has not been tested in trials measuring clinical disease.