Epidemiological situation of leprosy in a province in China: a long time to diagnosis and a high rate of deformity

Zhang, Qingping; Ge, Li; Li, Chao; Lin, Zhao-Xing; Chen, Ping

doi:10.1186/s12889-020-09933-6

Cited by 11 publications

(7 citation statements)

References 10 publications

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“…The NCDR of leprosy declined to 0.25 cases per 100,000 population in 2020 from 0.62 cases per 100,000 population in 2011. This downward trend was consistent with the results of studies in other provinces and cities [ 31 ] and the whole country [ 10 ]. This implies that the prevalence of leprosy in Yunnan has been controlled and remains at a low epidemic level.…”

Section: Discussionsupporting

confidence: 92%

The state of the leprosy epidemic in Yunnan, China 2011–2020: A spatial and spatiotemporal analysis, highlighting areas for intervention

Chen

Shui

2021

PLoS Negl Trop Dis

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Background Despite public health efforts to reduce the leprosy burden in Yunnan, China, leprosy remains an important public health problem in some specific areas. We analyzed the epidemiological characteristics and spatial distribution of leprosy in Yunnan, China, and provide data to guide disease prevention and control efforts. Methodology/principal findings The surveillance data of newly detected leprosy cases in Yunnan, China, during 2011–2020 were extracted from the LEPROSY MANAGEMANT INFORMATION SYSTEM IN CHINA (LEPMIS), and spatial distribution analysis, spatial autocorrelation analysis, and spatiotemporal scanning were performed with ArcGIS 10.6.1, GeoDa 1.8.8, and SaTScan 9.4.3 software, respectively. A total of 1907 newly detected leprosy cases were reported in Yunnan, China, during 2011–2020. The new case detection rate (NCDR) decreased from 0.62 in 2011 to 0.25 in 2020, with an annual incidence of 0.41/100,000 population. The proportions of multibacillary (MB) cases, cases in female patients, cases causing grade 2 physical disability (G2D), and cases in pediatric patients were 67.07%, 33.93%, 17.99%, and 2.83%, respectively. The number of counties with an incidence above 1/100,000 population decreased from 30 in 2011 to 8 in 2020. The Moran’s I of leprosy in Yunnan, China, during 2011–2020 ranged from 0.076 to 0.260, indicating the presence of spatial clusters. Local spatial autocorrelation (LSA) analysis showed that high-high cluster areas (hot spots) were mainly distributed in the southeastern, northern, and northwestern regions. Spatiotemporal scanning showed three clusters with high NCDRs. The probably primary clusters, occurring during January 1, 2011–December 31, 2015, covered 11 counties in the southeastern region (RR = 5.046515, LRR = 271.749664, P = 0.000). Conclusion The number of leprosy cases in Yunnan decreased overall, although some high-NCDR regions remained. Geographic information system (GIS) analysis coupled with spatial analysis indicated regions with leprosy clusters. Continuous leprosy prevention and control strategies in Yunnan Province should be established, and interventions in high-risk regions should be prioritized and further strengthened.

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Section: Discussionsupporting

confidence: 92%

The state of the leprosy epidemic in Yunnan, China 2011–2020: A spatial and spatiotemporal analysis, highlighting areas for intervention

Chen

Shui

2021

PLoS Negl Trop Dis

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“…New pediatric leprosy cases were more common in males, with a male to female ratio of 1.71:1. Similar results were discovered in a previous study in some provinces, such as Shaanxi in China [ 27 ]. The sex ratio results were also consistent with the findings in other countries or areas [ 15 ].…”

Section: Discussionsupporting

confidence: 91%

Leprosy among new child cases in China: Epidemiological and clinical analysis from 2011 to 2020

et al. 2023

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Background Leprosy, caused by Mycobacterium leprae infection, mainly affects skin and peripheral nerves and may further lead to disability and deformity if not treated timely. The new case detection rate of leprosy in children reflects the active transmission of leprosy infection. This study aims to present the epidemiology and clinical characteristics of new leprosy cases in children in China from 2011 to 2020. Methodology/Principal findings All data from leprosy patients younger than 15 years old were extracted from the Leprosy Management Information System in China (LEPMIS). Statistical Package for the Social Sciences (SPSS) version 17.0 was used for descriptive and analytical statistics of the epidemiological and clinical indicators by the Mann-Whitney test, Kruskal-Wallis test, and Fisher’s exact test. And geographical distribution was analyzed by ArcGIS 10.6.1. A total of 152 pediatric new cases of leprosy were found over the last decade. The new case detection rate of pediatric leprosy cases decreased from 0.13 to 0.02 per 1,000,000 population over the last ten years. New pediatric cases had a higher new case detection rate in Guizhou, Sichuan, and Yunnan Provinces. All but 7 provinces in China achieved zero new child case for consecutive five years. The onset of leprosy peaked between 10 and 14 years of age, and the male to female ratio was 1.71:1. Pediatric patients were predominantly infected from symptomatic household adult contacts. Multibacillary leprosy (MB) was the most common. However, a low proportion of patients developed leprosy reaction and grade 2 disability. Conclusions/Significance The new case detection rate of pediatric leprosy cases has decreased over the past ten years in China. Spatial analysis indicated clusters in high-endemic areas. Leprosy transmission has stopped in the majority of provinces in China. However, sporadic cases may continue to exist for a long time. Active surveillance especially contact tracing should be focused on in future plan for management of leprosy, and interventions in leprosy clusters should be prioritized.

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“…The experienced long path to diagnosis coincided with worldwide studies on diagnostic delay [ 3 , 5 , 26 ]; Hansen`s disease is often found after many years and therefore with already existing disabilities [ 3 , 27 , 28 ]. In a quantitative study from north-eastern Colombia, the mean delay in diagnosis has been reported to be 33.5 months [ 5 ].…”

Section: Discussionmentioning

confidence: 99%

Body map stories from Colombia: experiences of people affected by leprosy and the influence of peers during diagnosis and treatment

Barbosa Ladino,

Jiménez Betancourth,

Vásquez Acevedo

et al. 2024

Int J Equity Health

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Introduction Almost one third of people affected by leprosy in Colombia suffer from disability, which often results from delayed diagnosis and treatment. We aimed to explore the experience of people affected by leprosy during the process of diagnosis and treatment and if and how this experience was influenced by peers. Methods A qualitative study using body map stories was conducted from October 2019 to February 2020 in Colombia. Adult people affected by leprosy were recruited through patient associations in different cities. We conducted three sessions with an average duration of 2–3 h per participant, during which the participants created a painted map of their body and chose symbols to represent their experience, while being engaged in an informal interview. The sessions were audio recorded, transcribed verbatim and analyzed thematically by an interdisciplinary team, consisting of physicians, social workers and a person affected by leprosy. Results The 17 study participants (11 female) were aged 20 to 70 years. Leprosy-related manifestations ranged from no to advanced disability. Some participants were active members of associations for people affected by leprosy. Three main themes were identified during analysis: (1) A long pathway to diagnosis, (2) Therapy as a double-edged sword and (3) The influence of other people affected by leprosy. The participants described an often years-long process until being diagnosed, which was marked by insecurities, repeated misdiagnosis, and worsening mental and physical health. Delayed diagnosis was related to late health care seeking, but also to inadequate health communication, lack of leprosy-related knowledge and negligence among health care workers. A high desire to cure motivated the participants to take their medication rigorously, despite the high treatment burden. Support from peers, either within the own social environment or provided from associations, contributed to a faster diagnosis and increased therapy adherence. Peers helped to recognize the symptoms, urged patients to seek care, recommended physicians with leprosy-related knowledge and provided a realistic example of both disease severity and curability. Conclusion People affected by leprosy experience a significant burden during the process of diagnosis and treatment. Involving well-trained peers could foster early diagnosis, treatment compliance and prevention of disability.

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Epidemiological situation of leprosy in a province in China: a long time to diagnosis and a high rate of deformity

Cited by 11 publications

References 10 publications

The state of the leprosy epidemic in Yunnan, China 2011–2020: A spatial and spatiotemporal analysis, highlighting areas for intervention

The state of the leprosy epidemic in Yunnan, China 2011–2020: A spatial and spatiotemporal analysis, highlighting areas for intervention

Leprosy among new child cases in China: Epidemiological and clinical analysis from 2011 to 2020

Body map stories from Colombia: experiences of people affected by leprosy and the influence of peers during diagnosis and treatment

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