A cross-sectional approach including dog owner characteristics as predictors of visceral leishmaniasis infection in dogs

Teixeira, Ana Izabel Passarella; Silva, Debora Marcolino; de Freitas, Lúcia Rolim Santana; Romero, Gustavo Adolfo Sierra

doi:10.1590/0074-02760190349

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ORIGINAL ARTICLE • Mem. Inst. Oswaldo Cruz 115 • 2020 • https://doi.org/10.1590/0074-02760190349 copy

A cross-sectional approach including dog owner characteristics as predictors of visceral leishmaniasis infection in dogs

Authorship SCIMAGO INSTITUTIONS RANKINGS

BACKGROUND

Visceral leishmaniasis (VL) is relevant for human and animal public health. Several factors have been associated with the risk of Leishmania infantum infection in dogs. However, dog owner characteristics have been rarely explored.

OBJECTIVES

To estimate the prevalence and to identify the associated factors for VL infection including dog owners characteristics.

METHODS

A cross-sectional study was conducted including dogs from an endemic canine visceral leishmaniasis (CVL) region in the Federal District, Brazil. The infection was detected using parasitological, serological, and molecular methods. The associated factors were identified through Poisson regression modelling.

FINDINGS

The prevalence of infection was 26.25% [95% confidence interval (CI): 20.05 to 33.57]. The associated factors were: short coat prevalence ratio (PR) = 2.33 (95% CI: 1.02 to 5.22); presence of backyard with predominance of soil and/or vegetation PR = 4.15 (95% CI: 1.35 to 12.77); and highest gross family income score PR = 2.03 (95% CI: 1.16 to 3.54).

MAIN CONCLUSION

This is the first study that relates higher socioeconomic status of dog owners as an independent factor associated with higher prevalence of VL infection, along with other strongly associated factors related to receptive environment for phlebotomines. Our findings strengthen the need for exploration of the biological and behavioural bases linking dog owner characteristics to the risk of canine infection in prospective cohort studies.

Key words:
canine visceral leishmaniasis; risk factors; prevalence; cross-sectional study; serology

Instituto Oswaldo Cruz, Ministério da Saúde Av. Brasil, 4365 - Pavilhão Mourisco, Manguinhos, 21040-900 Rio de Janeiro RJ Brazil, Tel.: (55 21) 2562-1222, Fax: (55 21) 2562 1220 - Rio de Janeiro - RJ - Brazil
E-mail: memorias@fiocruz.br

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[1] + Corresponding author: gromero@unb.br

Class	Points	Mean gross family income in Brazilian Reais (BRL)
A1	42-46	11,037
A2	35-41	6,006
B1	29-34	3,118
B2	23-28	1,865
C1	18-22	1,277
C2	14-17	895
D	8-13	895
E	0-7	895

Findings		Infected	Non-infected	p-value
Bodily condition	Obese/Normal	35/42 (83.33%)	99/116 (85.34%)	0.131
	Thin	3/42 (7.14%)	14/116 (12.06%)
	Cachectic	4/42 (9.53%)	3/116 (2.58%)
Mucosal paleness	None	34/42 (80.95%)	98/116 (84.48%)	0.597
Mucosal paleness	Present	8/42 (19.05%)	18/116 (15.52%)	0.597
Dehydration	None	40/42 (95.24%)	113/116 (97.41%)	0.926
	Mild	1/42 (2.38%)	2/116 (1.71%)
	Moderate to intense	1/42 (2.38%)	1/116 (0.85%)
Mild muscle atrophy of the limbs	None	41/42 (97.62%)	115/116 (99.14%)	0.451
Mild muscle atrophy of the limbs	Present	1/42 (2.38%)	1/116 (0.85%)	0.451
Skin lesions	None	29/42 (69.05%)	80/118 (68.96%)	0.992
Skin lesions	Present	13/42 (30.96%)	36/116 (31.04%)	0.992
Hepatosplenomegaly	None	35/40 (87.50%)	107/116 (92.24%)	0.366
Hepatosplenomegaly	Present	5/40 (12.50%)	9/116 (7.76%)	0.366
Conjunctivitis and/or Keratitis	None	35/42 (83.33%)	107/116 (92.24%)	0.247
	Unilateral and mild	2/42 (4.76%)	2/116 (1.72%)
	Severe unilateral/bilateral	5/42 (11.90%)	7/116 (6.03%)
Uveitis and/or Blepharitis	None	39/42	110/115	0.481
Uveitis and/or Blepharitis	Present	3/42 (7.14%)	5/115 (4.35%)	0.481
Lymph adenomegaly	None	24/42 (57.14%)	73/116 (62.93%)	0.803
	1 to 2 lymph nodes	12/42 (28.57%)	29/116 (25.0%)
	3 or more / widespread	6/42 (14.28%)	14/116 (12.07%)
Mouth ulcers or nodules	None	41/42 (97.62%)	116/116 (100.0%)	0.096
Mouth ulcers or nodules	Present	1/42 (2.38%)	0/116 (0%)	0.096
Diarrhea	None	39/42 (92.86%)	111/116 (95.69%)	0.473
Diarrhea	Present	3/42 (7.14%)	5/116 (4.31%)	0.473
Claudication	None	42/42 (100.0%)	115/116 (99.14%)	0.546
Claudication	Present	0 (0%)	1/116 (0.85%)	0.546
Erythema (1 to 25% of the body surface)	None	42/42 (100.00%)	114/116 (98.28%)	0.392
Erythema (1 to 25% of the body surface)	Present	0 (0%)	2/116 (1.72%)	0.392
Dry exfoliative dermatitis	None	32/42 (76.19%)	94/116 (81.03%)	0.739
	1 to 25% of the body	7/42 (16.67%)	13/116 (11.21%)
	> 25 to 40% of the body	2/42 (4.76%)	4/116 (3.44%)
	> 40% of the body	1/42 (2.38%)	5/116 (4.31%)
Ulcerative dermatitis	None	38/42 (90.48%)	112/116 (96.55%)	0.306
	1 to 25% of the body	3/42 (7.14%)	3/116 (2.58%)
	> 25% of the body	1/42 (2.38%)	1/116 (0.85%)
	-	-	-
Nodular dermatitis	None	39/42 (92.86%)	114/116 (99.24%)	0.086
Nodular dermatitis	Present	3/42 (7.14%)	2/116 (1.72%)	0.086
Pustular dermatitis	None	41/42 (97.62%)	115/116 (99.24%)	0.451
Pustular dermatitis	Present	1/42 (2.38%)	1/116 (0,86%)	0.451
Alopecia	None	36/42 (85.71%)	105/116 (90.52%)	0.766
	1 to 25% of the body	3/42 (7.14%)	8/116 (6.89%)
	> 25% of the body	3/42 (7.14%)	3/116 (2.59%)
Altered pigmentation	None	40/42 (95.24%)	111/116 (95.69%)	0.903
Altered pigmentation	Present	2/42 (4.76%)	5/116 (4.31%)	0.903
Hyperkeratosis of truffles and cushions	None	39/42 (92.86%)	114/116 (98.28%)	0.086
Hyperkeratosis of truffles and cushions	Present	3/42 (7.14%)	2/116 (1.72%)	0.086
Onychogryphosis	None	38/42 (90.48%)	114/116 (98.28%)	0,023
Onychogryphosis	Present	4/42 (9.52%)	2/116 (1.72%)	0,023

Variables	Categories	N	Exposure	Proportion of infected dogs among the exposed dogs	Proportion of infected dogs among nonexposed dogs	p value^*	Prevalence ratio (95% CI)
Sex	0-Male 1 - Female	160	Being female	19/71 (26.7%)	23/89 (25.8%)	0.896	1.04 (0.61 to 1.74)
Coat	0- Non-short coat 1- Short coat	155	Having short coat	37/119 (31.1%)	5/36 (13.9%)	0.042	2.24 (0.90 to 5.27)
Coat colour	0 - Non-light colour 1 - Light-colour	143	Having light-colour coat	18/50 (36.0%)	20/93 (21.5%)	0.061	1.67 (0.98 to 2.86)
Body structure	0 - Normal or obese 1 - Any degree of thinness	160	Being thin	7/20 (35.0%)	35/140 (25.0%)	0.342	1.40 (0.72 to 2.72)
Animals with clinical signs > 2 points	0 - Up to 1 point 1 - Greater than 2 points	158	Having 2 or more clinical score points	22/73 (30.1%)	19/85 (22.4%)	0.266	1.35 (0.80 to 2.29)

Variables	Categories	N	Exposure	Proportion of infected dogs among the exposed dogs	Proportion of infected dogs among nonexposed dogs	p value^*	Prevalence ratio (95% CI)
Presence of other animals (any species)	0 - no 1 - yes	156	Dog whose owner declared that his pet lives with other animals	28/116 (24.1%)	14/40 (35.0%)	0.182	0.69 (0.41 to 1.17)
Having a backyard in a residential area	0 - no 1 - yes	156	The dog lives in a residence with a backyard.	41/143 (28.7%)	1/13 (7.7%)	0.188	3.73 (0.56 to 24.94)
Backyard area with a predominance of land and / or vegetation	0 - no 1 - yes	156	The dog lives in a residence with a backyard with a grassy area or land	39/117 (33.3%)	3/39 (7.7%)	0.002	4.33 (1.42 to 13.24)
Presence of accumulated organic matter in the backyard	0 - no 1 - yes	156	Presence of organic matter in the backyard (plant debris, organic waste)	23/70 (32.9%)	19/86 (22.1%)	0.132	1.49 (0.88 to 2.50)
Residence with screened windows	0 - no 1 - yes	156	The residence has screened windows	3/21 (14.3%)	39/135 (28.9%)	0.160	0.49 (0.17 to 1.48)

Variables	Categories	N	Exposure	Proportion of infected dogs among the exposed dogs	Proportion of infected dogs among non-exposed dogs	p value^*	Prevalence ratio (95% CI)
Animal was vaccinated against any disease.	0 - no 1 - yes	156	Having received any dose of vaccine to prevent any disease	30/127 (23.6%)	12/29 (41.4%)	0.052	0.57 (0.33 to 0.97)
Owner knows symptoms of VL in humans	0 - negative or ignored 1 - yes	155	Animal whose owner declared to knowing what are the HVL symptoms	8/17 (47.1%)	34/138 (24.6%)	0.127	1.91 (1.07 to 3.42)
The owner showed up with the dog in at least one consultation with the veterinarian in the past year	0 - no 1 - yes	155	Animal whose owner stated that he or she took the dog to at least one consultation with a veterinarian in the past year	4/31 (12.9%)	37/124 (29.8%)	0.056	0.43 (0.17 to 1.12)
Highest gross family income score	0 - up to 16 points 1 - >16 points	156	Having an earning power score of 16 points or more	29/89 (32.6%)	13/67 (19.4%)	0.066	1.68 (0.95 to 2.98)

Variables	Non-adjusted prevalence ratio (95% CI)	Adjusted prevalence ratio (95% CI)	p value
Coat (short)	2.24 (0.91-5.27)	2.33 (1.02-5.22)	0.044
Backyard area with a predominance of land and/or vegetation	4.33 (1.42-13.24)	4.15 (1.35-12.77)	0.013
Highest family gross income score	1.68 (0.95-2.98)	2.03 (1.16-3.55)	0.014