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Background   Leishmania infantum  and  Dirofilaria immitis  are among the most important canine vector-borne pathogens (CVBPs) of zoonotic concern in Europe. In endemic areas for both of these CVBPs, the use of systemic ectoparasiticides, such as afoxolaner (NexGard®; Boehringer Ingelheim Animal Health), may have the potential for controlling these infections. The aim of this study was to assess, for the first time, the insecticidal efficacy of NexGard® in decreasing the transmission of  D. immitis  and  L. infantum  to sheltered dogs living in a hyperendemic area, compared to the year before treatment, as well as its impact on the abundance of mosquito and sand fly populations.    Methods  All dogs ( n  = 179) enrolled in the study were divided into two groups based on their infection status at enrollment: a non-infected group (G1) and an infected group (G2; infected with  D. immitis ,  L. infantum  or both). The study was conducted from March 2020 to March 2021. In order to exclude all animals infected with  L. infantum  and  D. immitis  before March 2020 (sampling time: T0), dogs in G1 were sampled in June (T1; i.e. T0 + 90 days) and in October 2020 (T2; i.e. T0 + 210 days). From March to September 2020, all animals (G1 and G2) were weighed and treated monthly with NexGard®. Animals in G1 were tested for the last time in March 2021 (T3; i.e. T0 + 330 days) for assessing post-treatment incidence rate of infection and prevention efficacy.    Results  The post-treatment incidence of  D. immitis  was 3.7% (1/27; 95% confidence interval [CI]: 0.2–18.1) and that of  L. infantum  was 3.6% (3/83; 95% CI: 1.0–10.1). Considering the annual incidence in 2019 and 2020, the protective efficacy against  D. immitis  and  L. infantum  infections was 94.2 and 64%, respectively. Of the female mosquitoes collected ( n  = 146), only one pool out of 50 tested positive for  D. immitis  DNA, whereas out of 1252 female  Sergentomya minuta  specimens collected, only four tested positive for  L. infantum  (0.3%).    Conclusions  Afoxolaner is efficacious in decreasing the rate of transmission of both  D. immitis  and  L. infantum ; however, comparison of the pre- and post-treatment period demonstrated that there was a significant difference only in the seasonal incidences of  D. immitis  infection. Preventive measures are recommended throughout the year in endemic areas to reduce the risk of pathogen transmission to animals and humans.    Graphical abstract

parasites and vectors

Efficacy of afoxolaner (NexGard®) in preventing the transmission of Leishmania infantum and Dirofilaria immitis to sheltered dogs in a highly endemic area