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Trends in leprosy case detection worldwide since 1985
Abraham Meima1, Jan H Richardus, J Dik F Habbema
1Department of Public Health, Erasmus MC, University Medical Center Rotterdam, PO Box 1738, 3000 DR Rotterdam, The Netherlands. a.meima@erasmusmc.nl
Leprosy Review
|April 10, 2004
Summary
Leprosy case detection has not declined globally, with several countries maintaining high detection rates. Current metrics like prevalence are insufficient for monitoring epidemiological changes or guiding control efforts effectively.
Area of Science:
- Epidemiology
- Public Health
- Infectious Disease Control
Background:
- Leprosy case detection and case detection rate (CDR) trends since 1985 are analyzed at regional and national levels.
- Understanding these trends is crucial for assessing the effectiveness of leprosy control programs and identifying areas needing further intervention.
Purpose of the Study:
- To describe trends in leprosy case detection and CDR from 1985 to 1998 across endemic countries.
- To evaluate the adequacy of current leprosy control metrics, such as prevalence, for monitoring epidemiological shifts.
Main Methods:
- Construction of time series data for case detection (1985-1998) for 33 endemic countries (top 33) and 14 individual countries (top 14).
- Derivation of case detection rates (CDRs) using population statistics.
- Analysis of regional (WHO Region) and national-level data, with a focus on contributions from key countries like India and Brazil.
Main Results:
- Global leprosy case detection has not shown a general decline; cumulative case detection in the top 33 countries (excluding India) nearly doubled between 1985 and 1998.
- India and Brazil were consistently the top contributors to case detection. In 1998, seven of the top 14 countries had CDRs above 2 per 10,000.
- Decreasing CDR trends were observed in only four of the top 14 countries (Guinea, China, Vietnam, Philippines).
Conclusions:
- There is no evidence of a widespread decline in leprosy case detection, and several countries exhibit high CDRs, indicating ongoing transmission.
- Leprosy prevalence is an inadequate indicator for monitoring epidemiological changes and making informed decisions regarding control strategies.
- Further research is essential to clarify trends in leprosy transmission and incidence, as current data are insufficient for effective public health policy.