title: Effect of insecticide-impregnated dog collars on incidence of zoonotic visceral leishmaniasis in Iranian children: a matched-cluster randomised trial.
abstract: BACKGROUND
  Deltamethrin-impregnated dog collars reduce sandfly bite rates on dogs, and are effective in killing sandflies that attempt to feed. Because domestic dogs are the principal reservoir hosts of zoonotic visceral leishmaniasis, we tested whether community-wide application of dog collars could protect children against infection with Leishmania infantum, the parasite that causes the disease.
  
  
  METHODS
  18 villages were paired, matched by preintervention child prevalence of L infantum infection. Within pairs, villages were randomly assigned to either control or intervention. All domestic dogs in intervention villages were provided with collars for the transmission season. The main outcome measure was incidence of L infantum infection after 1 year measured by seroconversion. Secondary outcomes were leishmanin skin test (LST) conversion and seroconversion in dogs.
  
  
  RESULTS
  The seroconversion rate in children was 1.49% (17/1141) in the intervention villages and 2.41% (26/1078) in control villages (odds ratio 0.57, 95% CI 0.36-0.90, p=0.017). LST conversion was also lowered, but not significantly (odds ratio 0.66, 0.41-1.08, p=0.096). The seroconversion rate in dogs in intervention villages was also significantly reduced (0.46, 0.30-0.70, p=0.0003).
  
  
  CONCLUSIONS
  Community-wide application of deltamethrin-impregnated dog collars not only protects domestic dogs from L infantum infections, but might also reduce the risk of L infantum infection in children. These dog collars could have a role in control of visceral leishmaniasis and replace controversial dog culling programmes in some countries. However, the effectiveness of dog collars will depend on the importance of wild versus domestic canids as reservoir hosts of L infantum.
authors.affiliation: Tabriz University of Medical Sciences, Tabriz, Iran.
authors.forename: A S Mazloumi
authors.initials: AS
authors.lastname: Gavgani
authors.forename: M H
authors.initials: MH
authors.lastname: Hodjati
authors.forename: H
authors.initials: H
authors.lastname: Mohite
authors.forename: C R
authors.initials: CR
authors.lastname: Davies
mesh_terms: D000372:Agglutination Tests; D000818:Animals; D016022:Case-Control Studies; D002648:Child; D002675:Child, Preschool; D004285:Dogs; D006801:Humans; D007223:Infant; D007306:Insecticides / Q000627:therapeutic use*; D007492:Iran / Q000453:epidemiology; D018314:Leishmania infantum / Q000187:drug effects*; D007898:Leishmaniasis, Visceral / Q000175:diagnosis / Q000453:epidemiology / Q000517:prevention & control*; D016015:Logistic Models; D009570:Nitriles; D011722:Pyrethrins / Q000627:therapeutic use*
chemical_list: D007306:Insecticides; D009570:Nitriles; D011722:Pyrethrins; C017180:decamethrin