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Wang Y, Xiao D, Wu M, Qing L, Yang T, Xiao P, Deng D. Epidemiological Characteristics and Factors Associated with Cure of Leprosy in Chongqing, China, from 1949 to 2019. Am J Trop Med Hyg 2023; 108:165-173. [PMID: 36410327 PMCID: PMC9833069 DOI: 10.4269/ajtmh.22-0474] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/25/2022] [Accepted: 09/15/2022] [Indexed: 11/23/2022] Open
Abstract
Chongqing is one of the focuses of leprosy control in China. Although leprosy control in Chongqing has achieved remarkable results over the years, there are also some problems, such as recurrent epidemics and insufficient early detection in some areas. The aim of this study was to analyze the epidemiological characteristics of leprosy in Chongqing, from 1949 to 2019 and explore the potential factors sociated with cure of leprosy to provide a basis for improving leprosy prevention and treatment strategies in Chongqing. Epidemiological indicators such as incidence and prevalence rates were used to evaluate the prevalence of leprosy. The epidemiological characteristics and control situation of leprosy in patients were analyzed using demographic characteristics, diagnosis, and treatment. Survival analysis was conducted to explore factors associated with the cure of leprosy. From 1949 to 2019, 3,703 cases of leprosy were registered in Chongqing. The incidence of leprosy in the city peaked at 0.853/105 in 1960 and remained below 0.100/105 after 2003. The number of high incidence areas decreased significantly, but they were mainly concentrated in the northeast and southeast regions. The early detection rate increased yearly from 1949 to 2019, and the rate of grade 2 disability ranged from 38.2% to 21.7%, with a fluctuating downward trend after 1960. Male, young age, employment as a farmer, delayed diagnosis, and multibacillary leprosy were risk factors for leprosy cure. Chongqing should continue to strengthen leprosy monitoring to improve the early detection of leprosy and focus on sociated risk factors to carry out multiple strategies.
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Affiliation(s)
- Yunna Wang
- School of Public Health, Chongqing Medical University, Chongqing City, China
| | - Dayong Xiao
- Chongqing Center for Disease Control and Prevention, Chongqing City, China
| | - Mingyue Wu
- Information Center of West China Hospital, Sichuan University, Chengdu, China
| | - Liyuan Qing
- School of Public Health, Chongqing Medical University, Chongqing City, China
| | - Tong Yang
- School of Public Health, Chongqing Medical University, Chongqing City, China
| | - Peng Xiao
- Chongqing Center for Disease Control and Prevention, Chongqing City, China
| | - Dan Deng
- School of Public Health, Chongqing Medical University, Chongqing City, China
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Grantz KH, Chabaari W, Samuel RK, Gershom B, Blum L, Worden L, Ackley S, Liu F, Lietman TM, Galvani AP, Prajna L, Porco TC. Spatial distribution of leprosy in India: an ecological study. Infect Dis Poverty 2018; 7:20. [PMID: 29580296 PMCID: PMC5870368 DOI: 10.1186/s40249-018-0402-y] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/07/2017] [Accepted: 03/07/2018] [Indexed: 12/05/2022] Open
Abstract
Background As leprosy elimination becomes an increasingly realistic goal, it is essential to determine the factors that contribute to its persistence. We evaluate social and economic factors as predictors of leprosy annual new case detection rates within India, where the majority of leprosy cases occur. Methods We used correlation and linear mixed effect regressions to assess whether poverty, illiteracy, nighttime satellite radiance (an index of development), and other covariates can explain district-wise annual new case detection rate and Grade 2 disability diagnoses. Results We find only weak evidence of an association between poverty and annual new case detection rates at the district level, though illiteracy and satellite radiance are statistically significant predictors of leprosy at the district level. We find no evidence of rapid decline over the period 2008–2015 in either new case detection or new Grade 2 disability. Conclusions Our findings suggest a somewhat higher rate of leprosy detection, on average, in poorer districts; the overall effect is weak. The divide between leprosy case detection and true incidence of clinical leprosy complicates these results, particularly given that the detection rate is likely disproportionately lower in impoverished settings. Additional information is needed to distinguish the determinants of leprosy case detection and transmission during the elimination epoch.
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Affiliation(s)
- Kyra H Grantz
- Department of Biology, University of Florida, Gainesville, FL, USA.,Emerging Pathogens Institute, University of Florida, Gainesville, FL, USA
| | - Winnie Chabaari
- DST/NRF Center for Excellence in Epidemiological Modeling and Analysis (SACEMA), Stellenbosch, South Africa.,Stellenbosch University, Stellenbosch, South Africa
| | - Ramolotja Kagiso Samuel
- DST/NRF Center for Excellence in Epidemiological Modeling and Analysis (SACEMA), Stellenbosch, South Africa.,Stellenbosch University, Stellenbosch, South Africa
| | - Buri Gershom
- African Institute of Mathematical Sciences, Muizenberg, South Africa
| | - Laura Blum
- University of California, Berkeley, CA, USA
| | - Lee Worden
- Francis I. Proctor Foundation for Research in Ophthalmology, University of California, San Francisco, CA, USA
| | - Sarah Ackley
- Francis I. Proctor Foundation for Research in Ophthalmology, University of California, San Francisco, CA, USA
| | - Fengchen Liu
- Francis I. Proctor Foundation for Research in Ophthalmology, University of California, San Francisco, CA, USA
| | - Thomas M Lietman
- Francis I. Proctor Foundation for Research in Ophthalmology, University of California, San Francisco, CA, USA.,Department of Ophthalmology, University of California, San Francisco, CA, USA.,Department of Epidemiology and Biostatistics, University of California, San Francisco, CA, USA
| | | | | | - Travis C Porco
- Francis I. Proctor Foundation for Research in Ophthalmology, University of California, San Francisco, CA, USA. .,Department of Ophthalmology, University of California, San Francisco, CA, USA. .,Department of Epidemiology and Biostatistics, University of California, San Francisco, CA, USA.
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