EPIDEMIOLOGY OF CANINE VISCERAL LEISHMANIASIS IN A DOG SHELTER IN ENDEMIC AREA OF RIO GRANDE DO NORTE
Canine visceral leishmaniasis; neglected neotropical disease; public health; collective veterinary medicine; dog shelters.
Visceral leishmaniasis (VL), also known as kala-azar, is a chronic infectious disease with worldwide distribution. If not diagnosed in time and treated properly, it has a high mortality. The disease affects the most vulnerable parts of the population due to migration from the countryside to the city and irregular occupations in peri-urban areas; dwellings close to uncharacterized landscapes; lack of access to water and treated sewage; difficulties in accessing a quality health system, among others. Visceral leishmaniasis (VL) is caused by an obligate intracellular protozoan, Leishmania infantum, and its vector is the nocturnal sand fly, Lutzomyia longipalpis, an insect 2 to 3 mm long, well adapted to the peridomestic environment. VL is a zoonosis and has the domestic dog as the main host - since the animal is present in rural and urban spaces, they occur in public spaces and inside homes, as family members. The human-dog relationship becomes problematic when there is excess population and, as a consequence, excess dogs in public places. This excess can result in the spread of various accidents, suffering and diseases, such as canine visceral leishmaniasis (CVL). In fact, one of the main ways of controlling VL is acting directly on the seropositive reservoirs (dogs). In response and in an attempt to absorb part of the surplus dogs, several countries have shelters for dogs, but, in Brazil, many emerged in a disorganized way, overcrowded and with risks of contamination of infectious diseases among individuals. This study aimed to understand the role of dog shelters in the epidemiology of Canine Visceral Leishmaniasis in endemic areas through correlations of variables at the time of rescue of dogs, variables in the sanitary management of shelters after reception of rescued dogs, different diagnostic responses of dogs tested for CVL residing in the studied shelter and entomological survey of sand flies in the region in order to understand the epidemiology of CVL in a dog shelter in an endemic region of the metropolitan region of Natal, capital of Rio Grande do Norte. In addition, to understand socio-environmental aspects in the context of rescue and reception of dogs, as well as the physical-clinical conditions of sheltered dogs and their management. Different diagnostic methods were used in the study, in addition to the methodology recommended by the Ministry of Health, and correlated with the qualitative information obtained. The results of the clinical, serological and molecular diagnosis of the 98 dogs admitted to the shelter reveal a high rate of infection and disease in the animals examined. The most frequent clinical signs are skin lesions and onychogryphosis. Less frequently, nasal secretion, difficulty in locomotion and neurological alteration. All methods used showed positive results. Parasite culture, bone marrow PCR and blood PCR showed similar detections, approximately 18% of the sample, differing only from the ELISA test which showed the highest level of positivity (42%). Sandflies of the Lutzomyia longipalpis species, a vector of L. infantum and others, were found at the site. The present study can be used to implement a more adequate model for the installation and maintenance of dog shelters, in addition to contributing to the guidelines of public and health policies aimed at neglected diseases, and thus, reducing the incidence of canine visceral leishmaniasis and human.