Hindawi Publishing Corporation
he Scientiic World Journal
Volume 2013, Article ID 810380, 6 pages
http://dx.doi.org/10.1155/2013/810380
Research Article
Estimating the Optimal Control of Zoonotic Visceral
Leishmaniasis by the Use of a Mathematical Model
Laila Massad Ribas,
1
Vera Lucia Zaher,
1
Helio Junji Shimozako,
1
and Eduardo Massad
1,2
1
School of Medicine, University of S˜ ao Paulo and LIM 01-HCFMUSP, Avenida Dr. Arnaldo 455, 01246-903 S˜ ao Paulo, SP, Brazil
2
London School of Hygiene and Tropical Medicine, University of London, UK
Correspondence should be addressed to Eduardo Massad; edmassad@usp.br
Received 30 April 2013; Accepted 9 July 2013
Academic Editors: F. Henriquez, J. F. Lindo, and J. Lorenzo-Morales
Copyright © 2013 Laila Massad Ribas et al. his is an open access article distributed under the Creative Commons Attribution
License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly
cited.
We argue that the strategy of culling infected dogs is not the most eicient way to control zoonotic visceral leishmaniasis (ZVL) and
that, in the presence of alternative control strategies with better potential results, oicial programs of compulsory culling adopted
by some countries are ineicient and unethical. We base our arguments on a mathematical model for the study of control strategies
against ZVL, which allows the comparison of the eicacies of 5, alternative strategies. We demonstrate that the culling program,
previously questioned on both theoretical and practical grounds is the less efective control strategy. In addition, we show that
vector control and the use of insecticide-impregnated dog collars are, by far, more eicient at reducing the prevalence of ZVL in
humans.
1. Introduction
Zoonotic visceral leishmaniasis (ZVL) is one of the most
important emerging parasite diseases [1]. It is endemic in
rural areas of South America and is caused by Leishmania
infantum (syn., L. chagasi). he parasite is transmitted by
the phlebotomine sandly, Lutzomyia longipalpis, and the
domestic dog is the main reservoir of the parasite in these
areas [2, 3]. Once introduced into a community, the parasite
is maintained in a dog-insect-dog peridomestic transmis-
sion cycle [1], and occasionally infected lies bite people,
causing ZVL. herefore, the prevalence and the incidence of
canine ZVL are important epidemiological parameters for
controlling transmission [4], and the estimation of which
depends on the reliable identiication of infected dogs [5]. As
a result, control programs for ZVL oten include elimination
of infected dogs [6]. Control programs also include detection
and treatment of human cases and vector control [7]. More
recently, however, two additional control programs have
been suggested as alternative or complementarily related to
the classical approach, namely, insecticide-impregnated dog
collars [8] and a transmission-blocking vaccine [9].
In the Mediterranean, where dogs are considered “valu-
able” [10], ZVL is both a medical and a veterinary problem.
In Brazil, the country were 90% of New World’s ZVL cases
are reported, human cases are numerous and where human
cases are many and dogs are considered “less valuable” [10],
ZVL is chiely considered to be only a medical problem. As
a result, 850,000 dogs are screened annually in Brazil, and
between 20,000 [11] and 25,000 [10] dogs are culled upon
positive diagnosis. his perspective of undervaluing dogs is
the oicial position of some governments like the Brazilian
Health Authorities, which forbid the treatment of infected
dogs with drugs of human use (Interministerial law no. 1,426
of July 11 2008, Editorial of Clinica Veterin´ aria 83: 16-17,
2009) and impose the elimination of seropositive dogs as
compulsory. Health agents threaten dog owners with heavy
ines for refusing the serological analysis of their animals,
and thousands of diagnosed dogs, with a high probability
of being false positives, are eliminated every year without a
counterproof. Hence, instead of submitting their dogs to the
serological screening, owners refuse the entrance of health
agents into their homes or transfer their animals to areas
where there is no serological screening. Some owners even