BACKGROUND Dogs are the main peridomiciliary reservoir of Leishmania infantum thus the correct diagnosis of infection is essential for the control of the transmission and treatment as well. However, the diagnosis is based on serological assays that are not fully effective. OBJECTIVE We aimed to establish an effective serological assay for the diagnosis of L. infantum infected dogs using Leishmania-derived recombinant antigens. METHODS Leishmania derived rK39-, rK28-, rKR95-based enzyme-linked immunosorbent assay (ELISA) was standardized using symptomatic and asymptomatic L. infantum-infected dogs. Then 2,530 samples from inquiry in endemic areas for VL were evaluated and the results compared with recommended assays by the Brazilian Ministry of Health (MH algorithm). Further samples from a cohort of 30 dogs were searched. FINDINGS For rK39-, rK28- and rKR95-ELISA the sensitivity was around 97% and specificity 100%. The positivity of these three ELISA in the inquiry samples was 27-28%, around 10% higher than the assays currently in use. When cohort samples were searched, we observed likely false-negative results (> 65%) with supposedly negative samples that turned positive six months later with the assays in use (MH algorithm). MAIN CONCLUSIONS For the diagnosis of L. infantum-infected dogs, rK39-based ELISA showed better diagnostic performance than other assays in use in Brazil and worldwide.

Uma análise espaço-temporal da leishmaniose visceral americana (LVA) em Bauru, São Paulo, Brasil, foi realizada com base em 239 casos diagnosticados entre junho de 2003 e outubro de 2008. A análise espacial da doença demonstrou que os casos ocorreram especialmente na área urbana da cidade. A incidência anual de LVA foi calculada, demonstrando que a taxa mais elevada foi verificada em 2006 (19,55/100 mil habitantes). O fato foi confirmado pela análise da série histórica, que também apresentou uma tendência positiva durante o período analisado. O presente estudo permitiu concluir que a doença esteve aglomerada na região sudoeste de Bauru no ano de 2006, e que tal área pode exigir atenção especial com relação às medidas de controle e prevenção.

A space-time analysis of American visceral leishmaniasis (AVL) in humans in the city of Bauru, São Paulo State, Brazil was carried out based on 239 cases diagnosed between June 2003 and October 2008. Spatial analysis of the disease showed that cases occurred especially in the city's urban areas. AVL annual incidence rates were calculated, demonstrating that the highest rate occurred in 2006 (19.55/100,000 inhabitants). This finding was confirmed by the time series analysis, which also showed a positive tendency over the period analyzed. The present study allows us to conclude that the disease was clustered in the Southwest side of the city in 2006, suggesting that this area may require special attention with regard to control and prevention measures.

Uma análise espaço-temporal da leishmaniose visceral americana (LVA) em Bauru, São Paulo, Brasil, foi realizada com base em 239 casos diagnosticados entre junho de 2003 e outubro de 2008. A análise espacial da doença demonstrou que os casos ocorreram especialmente na área urbana da cidade. A incidência anual de LVA foi calculada, demonstrando que a taxa mais elevada foi verificada em 2006 (19,55/100 mil habitantes). O fato foi confirmado pela análise da série histórica, que também apresentou uma tendência positiva durante o período analisado. O presente estudo permitiu concluir que a doença esteve aglomerada na região sudoeste de Bauru no ano de 2006, e que tal área pode exigir atenção especial com relação às medidas de controle e prevenção.

A space-time analysis of American visceral leishmaniasis (AVL) in humans in the city of Bauru, São Paulo State, Brazil was carried out based on 239 cases diagnosed between June 2003 and October 2008. Spatial analysis of the disease showed that cases occurred especially in the city's urban areas. AVL annual incidence rates were calculated, demonstrating that the highest rate occurred in 2006 (19.55/100,000 inhabitants). This finding was confirmed by the time series analysis, which also showed a positive tendency over the period analyzed. The present study allows us to conclude that the disease was clustered in the Southwest side of the city in 2006, suggesting that this area may require special attention with regard to control and prevention measures.