**Acknowledgements**

Control measure should be applied before the period of greatest risk and aimed at the protecting people at higher risk in the geographical area in which there has been transmission, whether that area is intradomiciliary or extradomiciliary. Additionally, the hours of greatest risk should be considered. The rainy season has been identified as the time when there is a greater risk transmission in foci and a higher density of vectors; therefore, control measures should be implemented before the rainy season begins. However, these findings must be vali-

Various vector control measures are available, including the use of bed nets or curtains impregnated with insecticides (even hammocks) and spraying of insecticides inside houses

In the case of bed nets, it is necessary to take into account the type of material and size of the holes and educate the community so they will not wash the mosquito net and damage the residual effect and nature of the material (regardless of whether it is impregnated). For example, nylon tulle or polyester bed nets are most effective because the residual effects of the insecticide are much higher; additionally, in these bed nets, the holes are very small and prevent *Lutzomyia* passing through the mosquito net. While bed nets are generally well accepted by most communities, acceptance must be considered individually in each community because it can vary from one community to another. For example, color has been identified as one factor that may affect the degree of acceptance of bed nets. If a mosquito net is not impregnated with insecticide, *Lutzomyia* species may get through even very small holes.

In foci where transmission occurs in an intra- and/or peridomicile, the infection of pets (and people with lesions) has been hypothesized to demonstrate that in these foci, the disease affects both women and men. Proper treatment of people may serve as a control measure of transmission in foci where humans are reservoirs and provide support for the implementa-

Finally, implementing primary health education to inform the community about issues related to the disease will increase knowledge about why the disease occurs, what causes it, what transmits it and how it heals. Recognizing the parasite that causes the disease (causative agent), transmitting insect, its behavioral habits, clinical manifestations of the disease, and

Individuals in these communities need to understand that it is necessary to perform some diagnostic procedures before initiating treatment and that there are options for treating the disease. These treatments are provided free of charge by the Ministry of Health through the sectional health services for all people with a diagnosis of leishmaniasis with any of its clinical presentations. Additionally, explaining the need to complete treatment to prevent the emergence of drug resistance, relapse, and complications in the mucosae and educating community members about some important measures that can contribute to avoiding con-

It is important to emphasize during primary education that control measures (mosquito nets) should be provided to the populations at greatest risk. Specifically, children should be pro-

(in those foci where transmission is intra- and peridomiciliary).

However, when it is impregnated, vectors will not go through the bed net.

mucosal compromise will help to promote disease control.

dated in each foci.

50 The Epidemiology and Ecology of Leishmaniasis

tion of better methods of control.

tact with insect vectors are crucial.

The authors are grateful for the strong support of the TDR program at World Health Organization, the University of Antioquia and Colciencias (Grant CT-695-2014).
