The shadows of a ghost: a survey of canine leishmaniasis in Presidente Prudente and its spatial dispersion in the western region of São Paulo state, an emerging focus of visceral leishmaniasis in Brazil.
BACKGROUND
Visceral leishmaniasis is an emerging zoonosis and its geographic distribution is restricted to tropical and temperate regions. Most of the individuals infected in Latin America are in Brazil. Despite the control measures that have been adopted, the disease is spreading throughout new regions of the country. Domestic dogs are involved in the transmission cycle and are considered to be the main epidemiologic reservoir of Leishmania infantum (syn. L. chagasi). Our aim was to determine the prevalence of canine leishmaniasis (CL) and Ehrlichiosis infection in Presidente Prudente as well as the spatial dispersion of the disease in the western region of São Paulo state.


METHODS
Dogs underwent clinical examination and symptoms related to CL were recorded. Anti- Leishmania antibodies were detected using ELISA, rK39-immunocromatographic tests (DPP), and an indirect fluorescent antibody test (IFAT). Anti-E. canis antibodies were detected by IFAT. A follow-up was conducted in dogs that were positive in the ELISA at the baseline study. Data on the spatial distribution of L. longipalpis and CL in São Paulo state were obtained from Brazilian public health agencies.


RESULTS
Serum samples from 4547 dogs were analyzed. The seroprevalence of CL was 11.2% by ELISA and 4.5 % by IFAT. In the follow-up, seroprevalence was 32.9% by ELISA, 15.3% by IFAT, 11.8 % by DPP test, and 66.5% for E. canis. There was a significant positive association between Leishmania and E. canis infection (P < 0.0001). In the follow-up, clinical examinations revealed symptoms compatible with CL in 33.5% of the dogs. L. longipalpis was found in 24 and CL in 15 counties of the Presidente Prudente mesoregion. The dispersion route followed the west frontier of São Paulo state toward Paraná state.


CONCLUSIONS
Low CL and high ehrlichiosis prevalence rates were found in Presidente Prudente city. This emerging focus of CL is moving through the western region of São Paulo state toward the border of Paraná state. Integrated actions to fight the vector, parasites, infected dogs, and humans are needed to monitor the disease and implement strategies for epidemiologic control.
Center for Biomedical Sciences and Regional Laboratory, Adolfo Lutz Institute, Avenida Coronel Marcondes, 2357, Presidente Prudente, São Paulo, Brazil. zampieri@ial.sp.gov.br.|Health and Geography Laboratory, Faculty of Science and Technology, Universidade Estadual Paulista, Rua Roberto Simonsen, 305, Presidente Prudente, São Paulo, Brazil. zampieri@ial.sp.gov.br.
Lourdes Aparecida Zampieri
LA
D'Andrea
Health and Geography Laboratory, Faculty of Science and Technology, Universidade Estadual Paulista, Rua Roberto Simonsen, 305, Presidente Prudente, São Paulo, Brazil. elivelton.fonseca@gmail.com.
Elivelton da Silva
Eda S
Fonseca
Immunology and Infectious Diseases Department, Oeste Paulista University, Rua José Bongiovani 700, Presidente Prudente, São Paulo, Brazil. luiz@unoeste.br.
Luiz Euribel
LE
Prestes-Carneiro
Health and Geography Laboratory, Faculty of Science and Technology, Universidade Estadual Paulista, Rua Roberto Simonsen, 305, Presidente Prudente, São Paulo, Brazil. raul@fct.unesp.br.
Raul Borges
RB
Guimarães
Center for Biomedical Sciences and Regional Laboratory, Adolfo Lutz Institute, Avenida Coronel Marcondes, 2357, Presidente Prudente, São Paulo, Brazil. re.yamashita@yahoo.com.br.
Renata Corrêa
RC
Yamashita
Center of Zoonosis Control, Rua Presidente Castelo Branco 93, Presidente Prudente, São Paulo, Brazil. centrozoonoses@presidenteprudente.sp.gov.br.
Célio Nereu
CN
Soares
Center for Parasitology and Mycology, Adolfo Lutz Institute, Av. Dr. Arnaldo, 355, São Paulo, Brazil. robertohiramoto@yahoo.com.br.
Roberto Mitsuyoshi
RM
Hiramoto
Center for Parasitology and Mycology, Adolfo Lutz Institute, Av. Dr. Arnaldo, 355, São Paulo, Brazil. tolezano@hotmail.com.
José Eduardo
JE
Tolezano
D000818:Animals; D001938:Brazil / Q000453:epidemiology; D003430:Cross-Sectional Studies; D004283:Dog Diseases / Q000453:epidemiology / Q000469:parasitology*; D004285:Dogs; D007898:Leishmaniasis, Visceral / Q000453:epidemiology / Q000662:veterinary*; D016036:Seroepidemiologic Studies