Vector and reservoir control for preventing leishmaniasis
This review summarises trials evaluating different measures to prevent leishmaniasis
Abstract
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?
Cutaneous leishmaniasis
Using insecticides to reduce the number of sandflies may be effective at reducing the number of new cases of cutaneous leishmaniasis (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).
Visceral leishmaniasis
Insecticide treated nets may not be effective at preventing visceral leishmaniasis 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 visceral leishmaniasis, this has not been tested in trials measuring clinical disease.
This research is supported by the Department for International Development’s Evidence Building and Synthesis Research Programme which is led by Liverpool School of Tropical Medicine
Citation
González, U.; Pinart, M.; Sinclair, D.; Firooz, A.; Enk, C.; Velez, I.D.; Esterhuizen, T.M.; Tristan, M.; Alvar, J. Vector and reservoir control for preventing leishmaniasis. Cochrane Database of Systematic Reviews (2015) : CD008736. [DOI: 10.1002/14651858.CD008736.pub2]