A one health approach to leishmaniasis in a slum: another piece of a global scenario.

OBJECTIVE: Visceral leishmaniasis (VL) is a severe vector-borne and zoonotic disease transmitted by phlebotomine sand flies. In the New World, is caused by the protozoan Leishmania infantum, having a great burden on human and animal health. Besides, environmental, and socioeconomic factors are significantly associated with the epidemiological pattern of the disease. VL continues to expand worldwide and in Brazil this situation is no different, reaching territories where it did not occur before, especially among marginalized populations in peri-urban areas. From a one health perspective, this paper details the first environmental health survey in one of the Brazilian marginalized communities, considered a new focus of VL.METHODS: In a qualitative approach, we combine entomological collections, records, and field observations to provide a comprehensive assessment of environmental conditions. RESULTS: The results highlight the need for monitoring the sand fly species found, as well as further studies for the real delimitation of their roles in the transmission of Le. infantum. The findings also suggest that bad housing conditions, lack of sanitation and the presence of arthropod vectors were associated with the occurrence of VL. Yet, we argue that many of the results found are quite similar across regions, and that the findings are not just a regional report but can reflect the reality of different parts of Brazil and the world.CONCLUSION: A one health approach is essential to truly face VL, addressing the health risks at the animal–human–ecosystems interface, without ignoring the social context involved. DESCRIPTORS: One health, Environmental health, Neglected tropical diseases, Health inequalities, Leishmaniasis, Vectors, Sand flies.