Understanding the problem
Knowing that a solution based on synthetic biology can take years to be developed and that the problem of leishmaniasis in Foz do Iguaçu is urgent, we also decided to think of a social measure that could alleviate the disease situation in less time. We realized that one of the ways in which we could help was in combating the underreporting of cases of the disease in the city.
This initiative came when Pank, our great inspiration, started the treatment for visceral leishmaniasis (VL). Her tutors, members of our team, came across a large number of cases of the disease at veterinary clinics and heard from veterinary professionals that there was an exorbitant number of cases in Foz do Iguaçu. That's when we realized that there was a strong demand for a solution to leishmaniasis in our city.
Looking for data on the number of infected dogs in the city of Foz do Iguaçu, it called our attention that the numbers published in the city's newspapers were relatively low compared to those reported to us by veterinarians. Therefore, we began to suspect that there could be an underreporting of canine visceral leishmaniasis (CVL) cases in the city. We then decided to contact the city's Zoonoses Control Center (CCZ), the public health unit responsible for the control and prevention of zoonoses, to access the official numbers.
In a meeting with the CCZ, we met Renata Defante, coordinator of the data processing, research and development sector, and Giselli Kurtz, the zoonoses control program coordinator. In addition to providing us with data on canine leishmaniasis in the city of Foz do Iguaçu, they clarified many of our doubts.
At this meeting, Renata and Giselli explained that the number of cases of CVL in Foz do Iguaçu is for sure underreported. This is because private veterinary clinics in the city are not reporting the diagnoses they make to the CCZ, even though it is mandatory. In other words, the official numbers of cases of canine leishmaniasis refer only to cases that were diagnosed by the CCZ itself, which is probably the smallest part of them. They also explained that it would be essential to obtain this data, so that appropriate action could be taken.
Another critical piece of evidence that helped us confirm that there was underreporting of CVL cases in Foz do Iguaçu was the study "More than the eyes can see: The worrying scenario of canine leishmaniasis in the Brazilian side of the triple border", which inferred that 23.8% of the dogs in the city are carriers of the parasite. We spoke via Google Meet with the leader of the study, Professor Vanete Soccol, who showed us the importance of notifying cases of canine leishmaniasis to the authorities so that public agencies understand how severe the disease is in the city and what measures need to be taken.
Dr. Soccol also told us that when she ran studies in Foz do Iguaçu, she contacted the authorities about underreporting CVL cases in the city, but she did not get satisfactory answers.
To better understand the veterinarians' point of view, we contacted Thaila Soares, who works as a veterinarian in Foz do Iguaçu. With her, we discovered that most of the city's veterinarians are not aware of the mandatory notification of CVL cases to the CCZ, and that, even those who know, end up not notifying them because they find the procedure complicated.
Another important point for the resistance of veterinarians to notify cases of leishmaniasis, pointed out by Thaila, Renata and Giselli, was that, as they were complying with a recommendation from the Ministry of Health, the CCZ was directing that dogs positive for CVL and not treated should be euthanized
Therefore, we concluded that we needed to bridge the gap between the CCZ and the veterinarians, so that the last ones could know the importance of notification. With this in mind, we sought to talk to Foz do Iguaçu's city councilor, Carol Dedonatti , who is also an animal protector. We met with her via Google Meet.
Carol Dedonatti already knew about our project thanks to social networks and was very interested in helping us. She referred us to one of her assistants, Daniel de Oliveira, to help us with whatever we needed.
In order to plan how to take more concrete steps, we organized a meeting with Daniel, Giselli Kurtz and the veterinarian Pamela Patrício to discuss what actions should be taken to reduce underreporting of CVL cases in Foz do Iguaçu.
As a result of the meeting, Daniel came up with the idea of calling a public hearing to emphasize the mandatory reporting of CVL, highlighting the urgency of more public awareness initiatives and suggesting measures to facilitate reporting for veterinarians.
Public Hearing
Public hearings are public meetings held in the council chamber in order to communicate between different sectors of society and public authorities. Usually, some public representative calls the audience and exhibitors are called to present their perspectives.
Councilwoman Carol Dedonatti convened the audience and invited the following speakers to compose the work table: Agatha Mendes, representative of the SynFronteras team; Renata Defante, CCZ representative; and Kelvinson Viana, PhD in Parasitology and our secondary PI
As a result of the hearing, the councilwoman promised to propose a complementary bill to reinforce the mandatory notification of CVL cases and to increase its disclosure to already trained veterinarians, those who are still graduating and the general population. In the final remarks, Rose Meri da Rosa, from the Health Surveillance Board, representative of the Municipal Health Department, commented on the use of technology to make notification less bureaucratic. She said that based on what was discussed at the hearing, a space on the City Hall will be studied to be a page for notifications of CVL
