Uso da Miltefosina como tratamento em cães sorologicamente positivos para leishmaniose visceral no município de Bauru – São Paulo.
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Data
2023-09-01
Autores
Camprigher, Valéria Medina
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Editor
Universidade Estadual Paulista (Unesp)
Resumo
A Leishmaniose Visceral é uma importante zoonose parasitária e encontra-se em franca expansão geográfica. Um dos pilares das políticas públicas de vigilância é o controle da fonte de infecção canina. A miltefosina é o fármaco autorizado para o tratamento dos cães no Brasil. O objetivo do trabalho foi realizar o diagnóstico, tratamento, avaliar a evolução clínica, carga parasitária e os parâmetros laboratoriais dos cães soropositivos; medidas que podem contribuir para o controle da Leishmaniose Visceral no município de Bauru-SP. Foram avaliados 34 cães durante o período de um ano, trimestralmente, sendo que 19 animais finalizaram o tratamento. Houve quatro óbitos por leishmaniose, três óbitos por outras causas e oito tutores abandonaram o tratamento por motivos diversos. Na primeira avaliação clínica, com 34 animais, os sintomas mais frequentes foram linfadenomegalia, descamação, conjuntivite e onicogrifose. Na última avaliação, os 19 animais encontravam-se assintomáticos. Nos exames de sangue, os padrões mais alterados foram os das hemáceas, hemoglobina, volume globular, plaquetas, proteína total, albumina, globulina e relação albuminaglobulina. De forma geral, houve melhora dos parâmetros hematimétricos e bioquímicos. A qPCR mostrou maior sensibilidade que a cPCR no acompanhamento da carga parasitária; que diminuiu ao longo do período, sugerindo eficácia no tratamento de cães com LVC; mesmo não havendo cura parasitária. Assim, nossos resultados demonstram que o tratamento de cães pode ser incorporado nas estratégias de políticas públicas em saúde com um foco em saúde única
Visceral Leishmaniasis is an important parasitic zoonosis that has been showing significant geographic expansion. One of the pillars of Public Surveillance Policies is the control of the source of canine infection. Miltefosine is the drug approved for the treatment of dogs in Brazil. The aim of this study was to evaluate the treatment, clinical evolution, parasitic load and laboratory parameters of seropositive dogs; that can contribute to the surveillance and control measures for Visceral Leishmaniasis in the municipality of Bauru – São Paulo, Brazil. Thirty-four dogs were evaluated quarterly for one year, and 19 dogs completed the treatment. Of the 15 losses, eight were due to treatment abandonment and seven were death; being four due to leishmaniasis. In the first evaluation, the most frequent symptoms were lymphadenopathy, desquamation, conjunctivitis and onychogryphosis. After one year, 19 animals that remained in the treatment were asymptomatic. The most altered patterns in the blood tests were: erythrocytes, hemoglobin, packed cell volume, platelets, total protein, albumin, globulin and albumin-globulin ratio. At the end of the evaluation, there was an improvement in the hematimetric and biochemical parameters. qPCR showed greater sensitivity than cPCR in monitoring the parasite load; which decreased over the period, suggesting efficacy in the treatment of dogs with CVL; even though there is no parasitic cure. Thus, our results demonstrate that the treatment of dogs can be incorporated into public health policy strategies that focus the one health concept.
Visceral Leishmaniasis is an important parasitic zoonosis that has been showing significant geographic expansion. One of the pillars of Public Surveillance Policies is the control of the source of canine infection. Miltefosine is the drug approved for the treatment of dogs in Brazil. The aim of this study was to evaluate the treatment, clinical evolution, parasitic load and laboratory parameters of seropositive dogs; that can contribute to the surveillance and control measures for Visceral Leishmaniasis in the municipality of Bauru – São Paulo, Brazil. Thirty-four dogs were evaluated quarterly for one year, and 19 dogs completed the treatment. Of the 15 losses, eight were due to treatment abandonment and seven were death; being four due to leishmaniasis. In the first evaluation, the most frequent symptoms were lymphadenopathy, desquamation, conjunctivitis and onychogryphosis. After one year, 19 animals that remained in the treatment were asymptomatic. The most altered patterns in the blood tests were: erythrocytes, hemoglobin, packed cell volume, platelets, total protein, albumin, globulin and albumin-globulin ratio. At the end of the evaluation, there was an improvement in the hematimetric and biochemical parameters. qPCR showed greater sensitivity than cPCR in monitoring the parasite load; which decreased over the period, suggesting efficacy in the treatment of dogs with CVL; even though there is no parasitic cure. Thus, our results demonstrate that the treatment of dogs can be incorporated into public health policy strategies that focus the one health concept.
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Palavras-chave
Leishmaniose, Cães, Reação em Cadeia da Polimerase, Vigilância em Saúde Pública, Saúde Única