Scientometric analysis of chemotherapy of canine leishmaniasis (2000-2020)

Abstract

Background: Zoonotic visceral leishmaniasis by Leishmania infantum is a first-order pathology in canine veterinary clinics in endemic areas. Moreover, canine infections are considered the main reservoir for human disease; despite their importance in the control of the disease within a One Health approach, no scientometric study has been published. Aims of the study included analyzing the impact of canine leishmaniasis (CanL) on the scientific literature, drugs or combinations used, trends in the period from 2000 to 2020 and efficacy criteria employed.

Methods: A Web of Science (WOS)-based analysis of publications on CanL and chemotherapy of the disease in the period 2000-2020 was carried out using a stepwise methodology. Data were analyzed by year, geographical origin, chemical groups, drugs and combinations, and efficacy criteria.

Results: Reports on CanL (n = 3324) represented < 16% of all publications on leishmaniasis (n = 20,968), and of these around 18% (n = 596) were related to chemotherapy. Publication records on CanL followed the distribution of the infection by L. infantum in endemic areas although Mediterranean countries were overrepresented in the reports on chemotherapy of CanL. Publications on the main antileishmanial drugs used in clinical practice showed a sustained tendency in the period analyzed. Pentavalent antimonials (Sb^V), alone or in combination with allopurinol, represented > 50% of all publications on chemotherapy of CanL despite the availability of more recently marketed drugs.

Conclusions: Chemotherapy of CanL still relies on Sb^V and combinations and to a lesser extent on miltefosine (MIL). Reports on chemotherapy are scarce and mostly publicly funded, and the variability of experimental conditions hampers the direct comparison of the efficacy of drugs, combinations and schedules. The vast majority of reports on efficacy do not include any information on supportive therapy; this reduces the actual value of the studies if intended for the practical management of the disease. Complete reports on the chemotherapy (etiological + symptomatic) would add value to the trials performed.

Keywords: Allopurinol; Amphotericin; Antimonials; Canine leishmaniasis; Chemotherapy; Leishmania infantum; Leishmania spp.; Miltefosine; SbV.

Fig. 1

Evolution of articles recovered from WOS in the period 2000–2020. Values given are normalized numbers of publications on leishmaniasis (….), canine leishmaniasis, CanL (- - -) and therapeutics of canine leishmaniasis (__).

Fig. 2

Relationship between publications on leishmaniasis and canine leishmaniasis (a) and canine leishmaniasis and chemotherapy of the dog infection (b). Each dot corresponds to a country.

Fig. 3

Temporal evolution (2000–2020) of WOS covered published reports on the main antileishmanial drugs used in veterinary clinics. Allopurinol (-.-.- ); amphotericin (- - -); antimonials (Sb^V) (___); miltefosine (…….). Insert. Number of articles on the combination of Sb^V + allopurinol and miltefosine + allopurinol throughout the study period.