Treatment, Control and Prevention
| Most cases of cutaneous leishmaniasis do not require therapy since they are self-limiting. A variety of therapeutic agents have been used for treatment of human mucocutaneous leishmaniasis. |
| The canine visceral leishmaniasis (Kala-azar) has been treated by European veterinarians for many years. In Brazil, therapeutic protocols for dogs have been evaluated over the last 4 years, but treatment of infected dogs is not recommended due to the potential risk to public health. The control policy adopted by the Brazilian Ministry of Health includes early treatment of human infections, strategic use of insecticides, and elimination of seropositive dogs. |
| The currently used protocol was proposed by Ferrer in 1997. The drugs most commonly used are: Meglumine Antimoniate (Glucantime®) associated with Allopurinol (Zyloric®), Aminosidine (Gabbriomycin®), and, recently, Amphotericin B (Fungizone®). All these drugs require a multiple dose regimen, and this will depend on the patient's condition and owner cooperation. |
| It issuggested that maintenence treatment should be kept with allopurinol, because it is not possible to ensure that dogs will not relapse if treatment is discontinued. |
| The use of collars containing insecticides, shampoos or sprays effective to protect dogs from sandfly bites must be continuously used for all patients under treatment. |
| The vector control is one of the most important aspects of disease control.. The sandfly is vulnerable to the same insecticides as the malaria vector. |
| Residual insecticide spraying of houses and animal shelters will have an impact on transmission only when the vector is restricted to the intra- and peridomestic area. |