Cited by 119Research on Leishmaniasis StudiesParasitic Diseases Research and TreatmentVector-borne infectious diseases

The DOI matches its Crossref record; 32 of the 32 references it cites were found in a registry or an index; none of the 25 sources its claims cite is checked for support yet.

Leishmania infantum and Dirofilaria immitis infections in Italy, 2009–2019: changing distribution patterns

Open access
Mendoza-Roldan, Jairo, Benelli, Giovanni, Panarese, Rossella, Iatta, Roberta, Furlanello, Tommaso, Beugnet, Frederic, Zatelli, Andrea, Otranto, Domenico·2020·Parasites & Vectors

Published version of a preprint

Abstract

Background: For long time, canine leishmaniosis (CanL) was considered endemic in the southern, central, and insular regions of Italy, whereas heartworm disease (HW) caused by Dirofilaria immitis was considered endemic in the northern region and in the swampy Po Valley. Following the reports of new foci of both diseases, in this study we update the distribution patterns and occurrence of new foci of CanL and HW discussing the main drivers for the changes in the epidemiology of these two important zoonotic canine vector-borne diseases. Methods: Based on the statistical analyses of serological assays ( n = 90,633) on L. infantum exposure and D. immitis infection performed by two reference diagnostic centres in Italy over a ten-year period (2009–2019) irrespective of the anamnesis of dogs. The distribution patterns of both parasites are herein presented along with the occurrence of new foci. Results: Results highlighted the changing distribution patterns of L. infantum vs D. immitis infection in Italy. CanL is endemic in some areas of northern regions and HW has endemic foci in central and southern regions and islands. Significant differences in L. infantum exposure and HW infection prevalence among the study macroareas were detected. The overall results of the positive tested samples were 28.2% in southern Italy and islands, 29.6% in central Italy and 21.6% in northern Italy for L. infantum and 2.83% in northern Italy, 7.75% in central Italy and 4.97% in southern Italy and islands for HW. HW positivity significantly varied over years ( χ 2 = 108.401, df = 10, P < 0.0001), gradually increasing from 0.77% in 2009 to 8.47% in 2016–2017. Conclusions: New potential epidemiological scenarios are discussed according to a range of factors (e.g. environmental modifications, occurrence of competent insect vectors, transportation of infected animals to non-endemic areas, chemoprophylaxis or vector preventative measures), which may affect the current distribution. Overall, the results advocate for epidemiological surveillance programmes, more focussed preventative and control measures even in areas where few or no cases of both diseases have been diagnosed.

Overview

AI snapshot

Written from the paper’s full text.

TL;DR

This retrospective analysis of 90,633 canine serological tests from Italy (2009–2019) documents changing distributions of *Leishmania infantum* and *Dirofilaria immitis*, with canine leishmaniosis expanding in northern Italy and heartworm showing higher prevalence in central and southern regions/islands than in the historically endemic north. The authors argue for broader epidemiological surveillance and control measures across Italy.

Key findings

  • *L. infantum* positivity by macroarea was 28.2% in southern Italy and islands, 29.6% in central Italy, and 21.6% in northern Italy (χ² = 218.564, df = 2, P < 0.0001); *D. immitis* positivity was 2.83% in northern Italy, 7.75% in central Italy, and 4.97% in southern Italy and islands (χ² = 114.879, df = 2, P < 0.0001).
  • Heartworm positivity varied significantly over years (χ² = 108.401, df = 10, P < 0.0001), gradually increasing from 0.77% in 2009 to 8.47% in 2016–2017.
  • In northern Italy, *L. infantum* prevalence increased from 2.1% in 1999–2009 to 21.6% in 2009–2019; in Bologna province it rose from 6.6% (2007–2009) to 17.16% in this study.
  • The changing distribution patterns were not random: contingency analyses were significant for *L. infantum* (macroarea χ² = 486.62, df = 2, P < 0.0001; year χ² = 827.903, df = 10, P < 0.0001) and *D. immitis* (macroarea χ² = 104.545, df = 2, P < 0.0001; year χ² = 99.070, df = 10, P < 0.0001).

Methods

  • Retrospective analysis of two diagnostic reference centre databases totaling 90,633 serum samples from dogs in Italy: database A included 64,375 records (2009–2019), and database B included 26,258 records (2015–2019); exclusions were 78 and 70 samples with uncertain origin, plus 423 northern/central samples excluded due to transportation bias, and no anamnestic data were available.
  • Serological assays included ELISA tests (Novatec® for CanL, Dirocheck Zoetis® for HW; VetLine® Leishmania for CanL, Filarcheck 96® for HW) and an indirect semi-quantitative immunofluorescence test (MegaFLUO LEISH® for leishmaniosis).
  • Statistical analysis used weighted generalized linear models with a binomial distribution and fixed factors for macroarea/year and region/year, plus contingency analysis; distribution maps were generated with QGIS version 3.4.4-Madeira.

Limitations

  • Stated: the anamnesis of animals was not available, so travelling history from/to historically endemic areas and the effect of relocation of infected animals from southern to northern Italy could not be fully assessed.
  • Stated: *D. immitis* testing was low (10.5% of all requested serological tests), especially in southern regions; in southern Italy and islands, limited samples in 2009–2014 (n = 117) versus 2015–2019 (n = 1729) likely contributed to the non-significant year effect for *D. immitis* (χ² = 16.145, df = 10, P = 0.136).
  • Evident from the text: reliance on passive diagnostic databases may reflect clinician awareness and request behaviour rather than true prevalence, and uneven sample sizes plus missing data for several provinces limit geographic inference.

Model-written summary. Check it against the paper before relying on it.

Integrity signals

Registry

Crossref · 10.1186/s13071-020-04063-9

Cites

32 of 32 references verified0 citation errors · 0 not checkable

Statistics

Nothing to recompute.

Figures

Fig. 1 Map of Italy showing the three main areas with their respective administrative regions
Fig. 1 Map of Italy showing the three main areas with their respective administrative regionsCC BY · PubMed Central
Fig. 2 Pattern of mean annual seroprevalence of canine leishmaniosis in the three main macroareas of Italy. The cumulative prevalence (CP) is also shown
Fig. 2 Pattern of mean annual seroprevalence of canine leishmaniosis in the three main macroareas of Italy. The cumulative prevalence (CP) is also shownCC BY · PubMed Central
Fig. 3 Pattern of mean annual seroprevalence for Dirofilaria immitis in the three main macroareas of Italy. The cumulative prevalence (CP) is also shown
Fig. 3 Pattern of mean annual seroprevalence for Dirofilaria immitis in the three main macroareas of Italy. The cumulative prevalence (CP) is also shownCC BY · PubMed Central
Fig. 4 Distribution map with number of cases (2009–2019) per province of CanL in Italy
Fig. 4 Distribution map with number of cases (2009–2019) per province of CanL in ItalyCC BY · PubMed Central
Fig. 5 Distribution map with number of cases (2009–2019) per province of HW in Italy
Fig. 5 Distribution map with number of cases (2009–2019) per province of HW in ItalyCC BY · PubMed Central

Verification

Claims the paper makes

28 Own result · 13 Not checked yet · 8 Own interpretation

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Show all 17 claims

  • It may state two separate claims as one. 28
  • Probably not a substantial claim. 5
32 of 32
  • The paper relies on this without support.

    The serological samples submitted to the two diagnostic centres are representative of the canine population in each Italian macroarea.

    “Databases from two diagnostic reference centres (hereafter reported as database A and B) were analysed (total number of serum samples = 90,633).”
  • The paper relies on this without support.

    The geographical origin of the samples reflects the location where the dogs acquired L. infantum or D. immitis infection.

    “Conversely, a major hindrance of this study could be that the anamnesis of animals was not available (e.g. their travelling history from/to historically endemic areas for both diseases) [5, 22].”
  • The paper relies on this without support.

    The diagnostic tests used in database A accurately detect L. infantum exposure and D. immitis infection.

    “Different serological (Novatec® kit for CanL and Dirocheck Zoetis® for HW) enzyme-linked immune sorbent assay (ELISA) tests were used.”
  • The paper relies on this without support.

    The absence of anamnesis (e.g., travelling history) does not substantially bias the observed distribution patterns.

    “However, for all included samples in both datasets no anamnestic data were available.”
4 of 4

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Citations

Cites

Show all 32 references

Research works printed but not linked: 2

  1. QGIS Development Team. QGIS geographic information system. Open Source Geospatial Foundation Project, Versão. 2015;2:7.
  2. Genchi C, Solari Basano F, Marrone RV, Petruschke G. Canine and feline heartworm in Europe with special emphasis on Italy. In: Proceedings of the Heartworm Symposium ʼ98, 1–3 May, Tampa, Florida, USA; 1998. p. 75–82.

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Metadata

Authors
Mendoza-Roldan, J., Benelli, G., Panarese, R., Iatta, R., Furlanello, T., Beugnet, F., Zatelli, A., & Otranto, D.
Affiliations
  • University of Pisa (IT)
  • University of Bari Aldo Moro (IT)
  • Bu-Ali Sina University (IR)
Corresponding author
Otranto, Domenico
Venue
Parasites & Vectors
Published
2020-04-15
Volume
13
Issue
1
Pages
193-193
ISSN
1756-3305 (ISSN-L)
OpenAlex
W3015911297
Cited by
119
References
32
Citations by year
2026: 9 · 2025: 19 · 2024: 16 · 2023: 12 · 2022: 26 · 2021: 25 · 2020: 11
FWCI
13.87
Type
journal article
Language
en
Open access
Locations
  • Parasites & Vectors (publishedVersion, cc-by)
  • Research Square (acceptedVersion, cc-by)
  • PubMed Central (publishedVersion, cc-by)
  • PubMed (publishedVersion)
  • CINECA IRIS Institutial research information system (University of Pisa) (submittedVersion, cc-by)
  • DOAJ (DOAJ: Directory of Open Access Journals) (submittedVersion, cc-by-sa)
  • CINECA IRIS Institutional Research Information System (University of Bari Aldo Moro) (submittedVersion, cc-by)
  • CINECA IRIS Institutional Research Information System (University of Bari Aldo Moro) (submittedVersion)
Topics
  • Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Research on Leishmaniasis Studies
  • Health Sciences › Medicine › Infectious Diseases › Parasitic Diseases Research and Treatment
  • Life Sciences › Immunology and Microbiology › Parasitology › Vector-borne infectious diseases
Keywords
canine leishmaniasis, heartworm disease, Leishmania infantum, Dirofilaria immitis, disease distribution, new foci, seroprevalence, Italy, disease surveillance, environmental change
MeSH terms
Animals, Dirofilaria immitis, Dirofilariasis, Dog Diseases, Dogs, Insect Vectors, Italy, Leishmaniasis, Psychodidae, Serologic Tests, Zoonoses, Leishmania infantum

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