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 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).
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
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]
Vector and reservoir control for preventing leishmaniasis