03117nas a2200229   4500000000100000008004100001653000900042653002600051653001900077653003200096100001600128700001400144700001400158700001300172700001500185245017300200856023200373300001300605490000700618520224800625022001402873       2019                            d10aDogs10ainsectice-impregnated10aVector control10aVisceral leishmaniasis (VL)1 aCourtenay O1 aBazmani A1 aParvizi P1 aReady PD1 aCameron MM00aInsecticide-impregnated dog collars reduce infantile clinical visceral leishmaniasis under operational conditions in NW Iran: A community-wide cluster randomised trial.  uhttps://www.ncbi.nlm.nih.gov/pubmed/?term=Insecticide%E2%80%93impregnated+dog+collars+reduce+infantile+clinical+visceral+leishmaniasis+under+operational+conditions+in+NW+Iran%3A+A+community%E2%80%93wide+cluster+randomised+trial  ae00071930 v133 a<p><strong>OBJECTIVE: </strong>To assess the effectiveness of community-wide deployment of insecticide-impregnated collars for dogs- the reservoir of Leishmania infantum-to reduce infantile clinical visceral leishmaniasis (VL).</p>

<p><strong>METHODS: </strong>A pair matched-cluster randomised controlled trial involving 40 collared and 40 uncollared control villages (161 [95% C.L.s: 136, 187] children per cluster), was designed to detect a 55% reduction in 48 month confirmed VL case incidence. The intervention study was designed by the authors, but implemented by the Leishmaniasis Control Program in NW Iran, from 2002 to 2006.</p>

<p><strong>RESULTS: </strong>The collars provided 50% (95% C.I. 17·8%-70·0%) protection against infantile VL incidence (0·95/1000/yr compared to 1·75/1000/yr). Reductions in incidence were observed across 76% (22/29) of collared villages compared to pair-matched control villages, with 31 fewer cases by the end of the trial period. In 11 paired villages, no further cases were recorded post-intervention, whereas in 7 collared villages there were 9 new clinical cases relative to controls. Over the trial period, 6,835 collars were fitted at the beginning of the 4 month sand fly season, of which 6.9% (95% C.I. 6.25%, 7.56%) were lost but rapidly replaced. Collar coverage (percent dogs collared) per village varied between 66% and 100%, with a mean annual coverage of 87% (95% C.I. 84·2, 89·0%). The variation in post-intervention clinical VL incidence was not associated with collar coverage, dog population size, implementation logistics, dog owner compliance, or other demographic variables tested. Larger reductions and greater persistence in incident case numbers (indicative of transmission) were observed in villages with higher pre-existing VL case incidence.</p>

<p><strong>CONCLUSION: </strong>Community-wide deployment of collars can provide a significant level of protection against infantile clinical VL, achieved in this study by the local VL Control Program, demonstrating attributes desirable of a sustainable public health program. The effectiveness is not dissimilar to the community-level protection provided against human and canine infection with L. infantum.</p>
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