37.2.4  Prevention and control of leishmaniasis

Several prevention and control measures are available for leishmaniasis. The general principles will already be familiar to you from the earlier discussion of schistosomiasis.

  • Integrated vector control (IVC) measures, aimed at reducing the numbers of sandflies by indoor residual spraying of the inside and outside walls of houses, doorways, animal houses, and possible breeding sites of the sandflies (Figure 37.11); use of insecticide treated bed nets (ITNs) for sleeping under at night; and environmental management to reduce the breeding sites of sandflies.
  • Rapid case detection and referral to the nearest health centre or hospital prevents the transmission of the parasite to others. Cases of leishmaniasis will be treated using intravenous or intramuscular drugs such as pentostam or amphotericin B. You cannot prescribe these drugs, which must be given under medical supervision.
  • Investigate and control epidemics in epidemic-prone areas: early identification and management of epidemics of leishmaniasis helps to control the disease from spreading to the wider population.
  • Education in the community about the causes and modes of transmission of leishmaniasis.
Spraying with insecticides
Figure 37.11  Spraying breeding sites of sandflies with insecticides.

  • What actions would you educate community members to take to protect themselves and their children from leishmaniasis?

  • You would encourage them to use ITNs at night and not to sleep unprotected out of doors, so as to avoid sandfly bites; they should welcome spraying teams to treat their houses with insecticide, and eliminate rubbish heaps and other locations where sandflies like to lay their eggs. They should seek early diagnosis and treatment of any suspected cases.

37.2.3  Clinical manifestation and diagnosis of leishmaniasis

37.3  Onchocerciasis