title: [Difficulties in implementing the guidelines of the Brazilian Visceral Leishmaniasis Control Program in large cities].
abstract: The expansion of visceral leishmaniasis (VL) transmission areas in Brazil raises questions concerning the country's control strategies. The guidelines of the Brazilian Visceral Leishmaniasis Control Program (PVCLC) focus on decreases in morbidity and case-fatality, reservoir and vector control, and health education. This article assesses difficulties in implementing the measures recommended by the PVCLC, according to the program's coordinators in large cities with canine and/or human transmission (Campinas, Bauru, Goiânia, Campo Grande, Fortaleza, and Belo Horizonte). Semi-structured interviews identified the following main problems: discontinuity of control activities, resistance to canine euthanasia by dog owners, and low coverage of chemical vector control.
  
  
  CONCLUSIONS
  the interviews revealed numerous obstacles to implementation of the measures proposed by the PVCLC and a clear need to reassess Brazil's VL policy.
authors.affiliation: Faculdade de Ciências Médicas, Universidade Estadual de Campinas, Campinas, Brasil., Universidade Estadual de Campinas, Faculdade de Ciências Médicas, Universidade Estadual de Campinas, Campinas , Brazil.
authors.forename: Andrea Paula Bruno von
authors.initials: AP
authors.lastname: Zuben
authors.affiliation: Faculdade de Ciências Médicas, Universidade Estadual de Campinas, Campinas, Brasil., Universidade Estadual de Campinas, Faculdade de Ciências Médicas, Universidade Estadual de Campinas, Campinas , Brazil.
authors.forename: Maria Rita
authors.initials: MR
authors.lastname: Donalísio
mesh_terms: D000818:Animals; D000829:Animals, Domestic / Q000469:parasitology; D001938:Brazil / Q000453:epidemiology; D003140:Communicable Disease Control / Q000379:methods*; D004197:Disease Reservoirs / Q000662:veterinary; D004283:Dog Diseases / Q000453:epidemiology / Q000469:parasitology / Q000517:prevention & control; D004285:Dogs; D007722:Health Knowledge, Attitudes, Practice; D006801:Humans; D015994:Incidence; D007898:Leishmaniasis, Visceral / Q000453:epidemiology / Q000517:prevention & control* / Q000662:veterinary; D011795:Surveys and Questionnaires