Impact of canine control on the epidemiology of canine and human visceral leishmaniasis in Brazil

Brazil is the only country endemic for zoonotic visceral leishmaniasis (ZVL ) that regularly conducts epidemiologic and prophylactic control programs t hat involve the treatment of human cases, insect vector control, and the re moval of seropositive infected dogs. This report reviews 60 studies reporti ng data on the efficacy of these recommended control tools and concludes th at in Brazil 1) eradication of the disease in Minas Gerais was achieved by the concomitant use of the three control methods, 2) although seropositivit y by an immunofluorescent assay is not completely related to infectiousness , the removal of seropositive dogs leads to a significant reduction of cani ne and human incidence, 3) improvement of the sensitivity of the diagnostic tool used for canine control should optimize the efficacy of control, and 4) although difficult and expensive, the public health dog control campaign s performed in Brazil reduced the incidence of ZVL and should be maintained since treatment of dogs is an unrealistic intervention, both because of it s prohibitive cost and relatively poor effectiveness.