>b<Nova estratégia de controle da leishmaniose visceral americana em cães utilizando coleiras impregnadas com deltametrina na cidade de Bauru, estado de São Paulo>/b<

A leishmaniose visceral (LV) &#233; uma zoonose classificada como doen&#231;a tropical negligenciada, atualmente n&#227;o preven&#237;vel e transmitida por vetor artr&#243;pode. &#201; um crescente problema global de sa&#250;de p&#250;blica uma vez que as atuais medidas de controle baseadas, entre outras coisas, no diagn&#243;stico e elimina&#231;&#227;o do reservat&#243;rio canino, n&#227;o t&#234;m sido capazes de reduzir a transmiss&#227;o e a expans&#227;o territorial da doen&#231;a. A presen&#231;a de c&#227;es em &#225;rea urbana, domiciliados ou comunit&#225;rios, pode aumentar o risco para humanos, uma vez que c&#227;es s&#227;o os principais reservat&#243;rios do parasita no ciclo urbano. A utiliza&#231;&#227;o de coleiras impregnadas com deltametrina a 4% em c&#227;es soronegativos, diagnosticados em inqu&#233;ritos sorol&#243;gicos caninos em &#225;rea de transmiss&#227;o, pode ser uma estrat&#233;gia eficaz no controle da LV. Nesta pesquisa foi analisada a efetividade de uma estrat&#233;gia alternativa de controle da doen&#231;a fundamentada na substitui&#231;&#227;o da eutan&#225;sia pela aplica&#231;&#227;o de coleira impregnada com deltametrina nos c&#227;es sororreagentes, identificados em inqu&#233;ritos feitos em &#225;reas de transmiss&#227;o. A nova medida de controle, aqui denominada encoleiramento estrat&#233;gico, foi empregada pelo Centro de Controle de Zoonoses de Bauru, SP entre os anos de 2018 e 2019. A avalia&#231;&#227;o da efetividade dessa estrat&#233;gia foi feita por meio de uma an&#225;lise prospectiva, comparando-se a incid&#234;ncia da presen&#231;a de anticorpos anti-leishmania identificada pelos testes diagn&#243;sticos oficiais (TR-DPP e ELISA), entre os c&#227;es de dois bairros do munic&#237;pio de Bauru, SP, sendo um deles onde se praticou a eutan&#225;sia de c&#227;es sororreagentes e outro somente, o aqui denominado, encoleiramento estrat&#233;gico. Foram avaliados resultados de testes sorol&#243;gicos aplicados em amostras de soro coletadas da totalidade dos c&#227;es dos dois bairros, em tr&#234;s tempos consecutivos, com intervalos de cerca de 200 dias entre eles. As compara&#231;&#245;es das incid&#234;ncias foram feitas entre as coortes, nos tr&#234;s tempos distintos, e dentro de cada coorte, nos mesmos tempos. A compara&#231;&#227;o entre as taxas de incid&#234;ncia de reatividade sorol&#243;gica nos dois bairros durante o per&#237;odo do estudo mostrou que a medida de encoleiramento estrat&#233;gico foi 4 vezes mais efetiva que a eutan&#225;sia na redu&#231;&#227;o da soropositividade dos c&#227;es. Os resultados deste estudo mostram que o encoleiramento estrat&#233;gico apresenta-se como uma medida promissora para ser empregada no controle da LV em c&#227;es de &#225;reas end&#234;micas, em especial por prescindir de eutan&#225;sia dos animais infectados, um procedimento controverso e de impacto negativo na sociedade. Visceral leishmaniasis (VL) is a zoonosis classified as a neglected tropical disease, currently not preventable and transmitted by an arthropod vector. VL is a growing global public health problem because current control measures, based on diagnosis and elimination of the source of infection, among other things, have not been able to reduce the transmission and territorial expansion of the disease. The presence of domiciled, semi-domiciled or stray dogs in urban areas can increase the risk for humans, because dogs are the main reservoir of the parasite in the urban cycle. Recent studies have shown that the use of 4% deltamethrin-impregnated collars in seronegative dogs diagnosed in canine serological surveys carried out in the transmission area can be an effective strategy in the control of VL, however, in these studies the controversial euthanasia of positive dogs was part of the measures of control evaluated. In this study, an alternative strategy to control the disease was analyzed, based on replacing euthanasia with the application of a collar impregnated with deltamethrin in seroreactive dogs identified in surveys carried out in areas of transmission. The new strategy, here called strategical collaring, was employed by the Center for Zoonosis Control (CZC) in the municipality of Bauru, SP throughout 2018 and 2019. The evaluation of the effectiveness of this strategy was carried out through a prospective analysis, in order to compare the incidence of antibodies identified by official diagnostic tests (TR-DPP and ELISA) among dogs from two districts of the city of Bauru SP, one of them where the euthanasia of infected dogs was practiced as a method of VL control and the other, the strategical collaring. Results of serological tests applied to serum samples collected from all the dogs in the two neighborhoods were evaluated, in three consecutive times, with intervals of about 200 days between them. Comparisons of incidences were made between cohorts at three different times and within each cohort at the same times. The comparison between the incidence rates of serological reactivity in the two neighborhoods during the study period showed that the strategical collaring measure was up to 4 times more effective than euthanasia in reducing the seropositivity of dogs. The results of this study show that reverse collaring is a promising measure to be used in the control of VL in dogs in endemic areas, especially as it does not require euthanasia of infected animals, a controversial procedure with a negative impact on society.