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Zhang M, Qiao L, Sun P, Jiang H, Shi Y, Zhang W, Mei Y, Yu M, Wang H. Spatiotemporal pattern of leprosy in southwest China from 2010 to 2020: an ecological study. BMC Public Health 2024; 24:465. [PMID: 38355478 PMCID: PMC10865634 DOI: 10.1186/s12889-024-17859-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/23/2023] [Accepted: 01/23/2024] [Indexed: 02/16/2024] Open
Abstract
BACKGROUND Despite many efforts to control leprosy worldwide, it is still a significant public health problem in low- and middle-income regions. It has been endemic in China for thousands of years, and southwest China has the highest leprosy burden in the country. METHODS This observational study was conducted with all newly detected leprosy cases in southwest China from 2010 to 2020. Data were extracted from the Leprosy Management Information System (LEPMIS) database in China. The Joinpoint model was used to determine the time trends in the study area. Spatial autocorrelation statistics was performed to understand spatial distribution of leprosy cases. Spatial scan statistics was applied to identify significant clusters with high rate. RESULTS A total of 4801 newly detected leprosy cases were reported in southwest China over 11 years. The temporal trends declined stably. The new case detection rate (NCDR) dropped from 4.38/1,000,000 population in 2010 to 1.25/1,000,000 population in 2020, with an average decrease of 12.24% (95% CI: -14.0 to - 10.5; P < 0.001). Results of global spatial autocorrelation showed that leprosy cases presented clustering distribution in the study area. Most likely clusters were identified during the study period and were frequently located at Yunnan or the border areas between Yunnan and Guizhou Provinces. Secondary clusters were always located in the western counties, the border areas between Yunnan and Sichuan Provinces. CONCLUSIONS Geographic regions characterized by clusters with high rates were considered as leprosy high-risk areas. The findings of this study could be used to design leprosy control measures and provide indications to strengthen the surveillance of high-risk areas. These areas should be prioritized in the allocation of resources.
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Affiliation(s)
- Mengyan Zhang
- Department of Epidemiology and Biostatistics, School of Public Health, Nanjing Medical University, Nanjing, Jiangsu, China
- Institute of Dermatology, Chinese Academy of Medical Sciences & Peking Union Medical College, Nanjing, Jiangsu, China
- National Centre for Leprosy Control, China CDC, Nanjing, Jiangsu, China
- Jiangsu Key Laboratory of Molecular Biology for Skin Diseases and STIs, Nanjing, Jiangsu, China
| | - Longchong Qiao
- Department of Epidemiology and Biostatistics, School of Public Health, Nanjing Medical University, Nanjing, Jiangsu, China
- Institute of Dermatology, Chinese Academy of Medical Sciences & Peking Union Medical College, Nanjing, Jiangsu, China
- National Centre for Leprosy Control, China CDC, Nanjing, Jiangsu, China
- Jiangsu Key Laboratory of Molecular Biology for Skin Diseases and STIs, Nanjing, Jiangsu, China
| | - Peiwen Sun
- Institute of Dermatology, Chinese Academy of Medical Sciences & Peking Union Medical College, Nanjing, Jiangsu, China
- National Centre for Leprosy Control, China CDC, Nanjing, Jiangsu, China
| | - Haiqin Jiang
- Department of Epidemiology and Biostatistics, School of Public Health, Nanjing Medical University, Nanjing, Jiangsu, China
- Institute of Dermatology, Chinese Academy of Medical Sciences & Peking Union Medical College, Nanjing, Jiangsu, China
- National Centre for Leprosy Control, China CDC, Nanjing, Jiangsu, China
- Jiangsu Key Laboratory of Molecular Biology for Skin Diseases and STIs, Nanjing, Jiangsu, China
| | - Ying Shi
- Institute of Dermatology, Chinese Academy of Medical Sciences & Peking Union Medical College, Nanjing, Jiangsu, China
- National Centre for Leprosy Control, China CDC, Nanjing, Jiangsu, China
| | - Wenyue Zhang
- Institute of Dermatology, Chinese Academy of Medical Sciences & Peking Union Medical College, Nanjing, Jiangsu, China
- National Centre for Leprosy Control, China CDC, Nanjing, Jiangsu, China
| | - Youming Mei
- Institute of Dermatology, Chinese Academy of Medical Sciences & Peking Union Medical College, Nanjing, Jiangsu, China
- National Centre for Leprosy Control, China CDC, Nanjing, Jiangsu, China
| | - Meiwen Yu
- Institute of Dermatology, Chinese Academy of Medical Sciences & Peking Union Medical College, Nanjing, Jiangsu, China.
- National Centre for Leprosy Control, China CDC, Nanjing, Jiangsu, China.
| | - Hongsheng Wang
- Department of Epidemiology and Biostatistics, School of Public Health, Nanjing Medical University, Nanjing, Jiangsu, China.
- Institute of Dermatology, Chinese Academy of Medical Sciences & Peking Union Medical College, Nanjing, Jiangsu, China.
- National Centre for Leprosy Control, China CDC, Nanjing, Jiangsu, China.
- Jiangsu Key Laboratory of Molecular Biology for Skin Diseases and STIs, Nanjing, Jiangsu, China.
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Narang T, Almeida JG, Kumar B, Rao PN, Suneetha S, Andrey Cipriani Frade M, Salgado CG, Dogra S. Fixed duration multidrug therapy (12 months) in leprosy patients with high bacillary load - Need to look beyond. Indian J Dermatol Venereol Leprol 2024; 90:64-67. [PMID: 37609736 DOI: 10.25259/ijdvl_278_2023] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/16/2023] [Accepted: 06/08/2023] [Indexed: 08/24/2023]
Affiliation(s)
- Tarun Narang
- Department of Dermatology, Venereology and Leprology, Postgraduate Institute of Medical Education and Research, Chandigarh, India
| | - Joel G Almeida
- Public Health and Epidemiology, Public Health Consultancy, Mumbai, India
| | - Bhushan Kumar
- Department of Dermatology, Silver Oaks Hospital, SAS Nagar, Punjab, India
| | - P Narasimha Rao
- Department of Dermatology, Bhaskar Medical College, Telangana, Hyderabad, India
| | - Sujai Suneetha
- Institute for Specialized Services in Leprosy (INSSIL), Nireekshana, Hyderabad, India
| | - Marco Andrey Cipriani Frade
- Department of Medical Clinics, Dermatology Division, Ribeirão Preto Medical School, University of São Paulo, Ribeirão Preto, São Paulo, Brazil
| | | | - Sunil Dogra
- Department of Dermatology, Venereology and Leprology, Postgraduate Institute of Medical Education and Research, Chandigarh, India
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The burden of physical disability among patients with newly detected leprosy in Yunnan, China, 1990-2020: A population-based, cross-sectional survey. PLoS Negl Trop Dis 2022; 16:e0010719. [PMID: 36219605 PMCID: PMC9553049 DOI: 10.1371/journal.pntd.0010719] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/14/2021] [Accepted: 08/05/2022] [Indexed: 11/19/2022] Open
Abstract
BACKGROUND Physical disability is the main complication of leprosy. Although understanding the leprosy rate, prevalence, spatiotemporal distribution, and physical nerve characteristic trends is crucial for the implementation of leprosy control programs and identification of remaining challenges, these data are still unclear. We assessed physical disability trends among newly detected leprosy cases over the past 31 years in 129 counties and territories in Yunnan, China. METHODOLOGY/PRINCIPAL FINDINGS We analyzed the data of newly detected leprosy cases from the Leprosy Management Information System in Yunnan, China, from 1990-2020. All available data related to physical disability were analyzed, including demographic characteristics (sex, age, ethnicity, education level); clinical characteristics (diagnosis duration, detection mode, contact history, leprosy reaction, skin lesions, nerve lesions, disability classification); World Health Organization (WHO) leprosy physical disability indicators; and nerve and eyes, hands and feet (EHF) involvement. A total of 10758 newly diagnosed leprosy cases were identified, and 7328 (65.60%), 1179 (10.55%) and 2251 (20.15%) were associated with grade 0, 1, and 2 disability (G0D, G1D, and G2D), respectively. Male sex, older age, Han ethnicity, urban employment, a longer diagnosis duration, a contact history, greater nerve involvement, and tuberculoid-related forms of leprosy were associated with increased prevalence rates of physical disability. The rates of physical disability in newly detected leprosy cases per 1 million population decreased from 5.41, 2.83, and 8.24 in 1990 to 0.29, 0.25, and 0.54 per 1 million population in 2020, with decreases of 94.64%, 91.17%, and 93.44% in G2D, G1D and total physical disability (G1D + G2D) rates, respectively. In the same period, the proportions of G2D, G1D and total physical disability decreased from 28.02%, 14.65%, and 42.67% in 1990 to 10.08%, 11.76%, and 21.85% in 2020, with decreases of 64.03%, 19.73%, and 48.79%, respectively. Nerve thickening was more common than nerve tenderness, and claw hand, plantar insensitivity, and lagophthalmos were the most frequently reported EHF-related disabilities. CONCLUSIONS Despite general progress in reducing the prevalence of leprosy-related physical disability, the proportion of physical disability among leprosy disease remains high, especially in specific counties. This implies that leprosy cases are being detected at a later stage and that transmission in the community still exists. Further efforts focusing on early detection are crucial for leprosy control and the elimination of the disease burden.
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Zhou Z, Pierneef L, van Hooij A, Geluk A. Detection of anti-M. leprae antibodies in healthy children in China: A systematic review of Chinese literature. FRONTIERS IN TROPICAL DISEASES 2022. [DOI: 10.3389/fitd.2022.963674] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022] Open
Abstract
Leprosy is an infectious disease caused by Mycobacterium leprae (M. leprae) that mainly involves the skin and peripheral nerves, causing lifelong deformities and social stigma. As evident from the practically stable number of new cases reported worldwide during the past decade, transmission is still ongoing. On route to leprosy elimination, an appropriate tool is needed to monitor M. leprae transmission. M. leprae-specific antibodies indicate infection with M. leprae, but do not differentiate between present and past infection. Nevertheless, detection of M. leprae infection in young children per definition indicates recent infection. Hence, seroprevalence in young children can be used to monitor recent M. leprae transmission. Despite having eliminated leprosy in most parts of the country, studies on transmission conducted in China are not sufficiently reported in the English literature. Therefore, we performed a systematic review of Chinese literature describing serological studies in healthy children in (former) leprosy endemic areas in China, available in the Chinese databases: China National Knowledge Infrastructure (CNKI), China Science and Technology Journal Database (VIP), and Wanfang Database. From the 710 articles identified in these three Chinese databases, only four full-text articles fulfilled all inclusion criteria regarding sufficiently detailed descriptions of anti-M. leprae antibodies in healthy children. Two additional papers were identified through snowballing, resulting in a total of six articles considered for this review reporting quantitative serological data from three Chinese provinces between 1987 and 2003. All studies used ELISAs to quantify antibody levels. Seroprevalence in healthy children ranged from 7.93% (Yunnan) to 32.35% (Jiangsu). If the same method was used (in Jiangsu), direct comparison of studies at different time points indicated that decrease in disease prevalence (0.28 to 0.16 per 100,000) or new case detection rate (2.6 to 1.0 per 100,000) from 1987-1991 corresponded to decrease in anti-M. leprae antibody seroprevalence (30.86% to 22.61%) in healthy children. Thus, these findings are consistent with the previous finding that anti-M. leprae antibody seroprevalence in young children represents a surrogate indicator to monitor transmission.
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Barbosa CC, Bezerra GSN, Xavier AT, de Albuquerque MDFPM, do Bonfim CV, de Medeiros ZM, de Souza WV. Systematic Review of Survival Analysis in Leprosy Studies-Including the Following Outcomes: Relapse, Impairment of Nerve Function, Reactions and Physical Disability. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:12155. [PMID: 36231457 PMCID: PMC9566694 DOI: 10.3390/ijerph191912155] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 07/04/2022] [Revised: 08/29/2022] [Accepted: 09/08/2022] [Indexed: 06/16/2023]
Abstract
Leprosy is a public health problem in South American, African and Oceanian countries. National programs need to be evaluated, and the survival analysis model can aid in the construction of new indicators. The aim of this study was to assess the period of time until the outcomes of interest for patients with or exposed to leprosy by means of survival analysis surveys. This review researched articles using the databases of PubMed, Science Direct, Scopus, Scielo and BVS published in English and Portuguese. Twenty-eight articles from Brazil, India, Bangladesh, the Philippines and Indonesia were included. The Kaplan-Meier method, which derives the log-rank test, and Cox's proportional hazards regression, which obtains the hazard ratio, were applied. The mean follow-up until the following outcomes were: (I) leprosy (2.3 years) in the population who were exposed to it, (II) relapse (5.9 years), (III) clinical manifestations before, during and after treatment-nerve function impairment (5.2 years), leprosy reactions (4.9 years) and physical disability (8.3 years) in the population of patients with leprosy. Therefore, the use of survival analysis will enable the evaluation of national leprosy programs and assist in the decision-making process to face public health problems.
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Affiliation(s)
- Celivane Cavalcanti Barbosa
- Department of Collective Health, Aggeu Magalhães Institute, Oswaldo Cruz Foundation, Recife 50740-465, Brazil
| | | | - Amanda Tavares Xavier
- Postgraduate Health Sciences, University of Pernambuco, Recife 50100-130, Brazil
- Department of Parasitology, Aggeu Magalhães Institute, Oswaldo Cruz Foundation, Recife 50740-465, Brazil
| | | | - Cristine Vieira do Bonfim
- Postgraduate Program in Public Health, Federal University of Pernambuco, Recife 50670-901, Brazil
- Social Research Division, Joaquim Nabuco Foundation, Ministry of Education, Recife 52171-010, Brazil
| | - Zulma Maria de Medeiros
- Postgraduate Health Sciences, University of Pernambuco, Recife 50100-130, Brazil
- Department of Parasitology, Aggeu Magalhães Institute, Oswaldo Cruz Foundation, Recife 50740-465, Brazil
| | - Wayner Vieira de Souza
- Department of Collective Health, Aggeu Magalhães Institute, Oswaldo Cruz Foundation, Recife 50740-465, Brazil
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Cao Y, Li M, Haihambo N, Zhu Y, Zeng Y, Jin J, Qiu J, Li Z, Liu J, Teng J, Li S, Zhao Y, Zhao X, Wang X, Li Y, Feng X, Han C. Oscillatory properties of class C notifiable infectious diseases in China from 2009 to 2021. Front Public Health 2022; 10:903025. [PMID: 36033737 PMCID: PMC9402928 DOI: 10.3389/fpubh.2022.903025] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/23/2022] [Accepted: 07/19/2022] [Indexed: 01/22/2023] Open
Abstract
Background Epidemics of infectious diseases have a great negative impact on people's daily life. How it changes over time and what kind of laws it obeys are important questions that researchers are always interested in. Among the characteristics of infectious diseases, the phenomenon of recrudescence is undoubtedly of great concern. Understanding the mechanisms of the outbreak cycle of infectious diseases could be conducive for public health policies to the government. Method In this study, we collected time-series data for nine class C notifiable infectious diseases from 2009 to 2021 using public datasets from the National Health Commission of China. Oscillatory power of each infectious disease was captured using the method of the power spectrum analysis. Results We found that all the nine class C diseases have strong oscillations, which could be divided into three categories according to their oscillatory frequencies each year. Then, we calculated the oscillation power and the average number of infected cases of all nine diseases in the first 6 years (2009-2015) and the next 6 years (2015-2021) since the update of the surveillance system. The change of oscillation power is positively correlated to the change in the number of infected cases. Moreover, the diseases that break out in summer are more selective than those in winter. Conclusion Our results enable us to better understand the oscillation characteristics of class C infectious diseases and provide guidance and suggestions for the government's prevention and control policies.
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Affiliation(s)
- Yanxiang Cao
- The National Clinical Research Center for Mental Disorders & Beijing Key Laboratory of Mental Disorders, Beijing Anding Hospital, Capital Medical University, Beijing, China
- Advanced Innovation Center for Human Brain Protection, Capital Medical University, Beijing, China
| | - Meijia Li
- Faculty of Psychology and Center for Neuroscience, Vrije Universiteit Brussel, Brussels, Belgium
| | - Naem Haihambo
- Faculty of Psychology and Center for Neuroscience, Vrije Universiteit Brussel, Brussels, Belgium
| | - Yuyao Zhu
- College of Environmental Sciences and Engineering, Peking University, Beijing, China
| | - Yimeng Zeng
- State Key Laboratory of Cognitive Neuroscience and Learning & IDG/McGovern Institute for Brain Research, Beijing Normal University, Beijing, China
| | - Jianhua Jin
- Zhongshan School of Medicine, Sun Yat-sen University, Guangzhou, China
| | - Jinyi Qiu
- School of Artificial Intelligence, Beijing Normal University, Beijing, China
| | - Zhirui Li
- Baoding First Central Hospital, Baoding, China
| | - Jiaxin Liu
- Department of Psychology, University of Washington, Washington, SA, United States
| | - Jiayi Teng
- School of Psychology, Philosophy and Language Science, University of Edinburgh, Edinburgh, United Kingdom
| | - Sixiao Li
- Faculty of Arts, Humanities and Cultures, School of Music, University of Leeds, Leeds, United Kingdom
| | - Yanan Zhao
- China Academy of Chinese Medical Sciences, Institute of Acupuncture and Moxibustion, Beijing, China
| | - Xixi Zhao
- The National Clinical Research Center for Mental Disorders & Beijing Key Laboratory of Mental Disorders, Beijing Anding Hospital, Capital Medical University, Beijing, China
- Advanced Innovation Center for Human Brain Protection, Capital Medical University, Beijing, China
| | - Xuemei Wang
- The National Clinical Research Center for Mental Disorders & Beijing Key Laboratory of Mental Disorders, Beijing Anding Hospital, Capital Medical University, Beijing, China
- Advanced Innovation Center for Human Brain Protection, Capital Medical University, Beijing, China
| | - Yaqiong Li
- The National Clinical Research Center for Mental Disorders & Beijing Key Laboratory of Mental Disorders, Beijing Anding Hospital, Capital Medical University, Beijing, China
- Advanced Innovation Center for Human Brain Protection, Capital Medical University, Beijing, China
| | - Xiaoyang Feng
- Institute of Mental Health, Peking University Sixth Hospital, Beijing, China
| | - Chuanliang Han
- Shenzhen Key Laboratory of Neuropsychiatric Modulation and Collaborative Innovation Center for Brain Science, Guangdong Provincial Key Laboratory of Brain Connectome and Behavior, CAS Center for Excellence in Brain Science and Intelligence Technology, Chinese Academy of Sciences, Brain Cognition and Brain Disease Institute, Shenzhen Institute of Advanced Technology, Shenzhen–Hong Kong Institute of Brain Science, Shenzhen Fundamental Research Institutions, Shenzhen, China
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Risk factors for physical disability in patients with leprosy disease in Yunnan, China: Evidence from a retrospective observational study. PLoS Negl Trop Dis 2021; 15:e0009923. [PMID: 34758025 PMCID: PMC8580233 DOI: 10.1371/journal.pntd.0009923] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/12/2021] [Accepted: 10/18/2021] [Indexed: 11/19/2022] Open
Abstract
BACKGROUND Leprosy is potentially debilitating. The risk factors related to physical disabilities associated with leprosy disease in Yunnan, China was not clear. METHODOLOGY/PRINCIPAL FINDINGS We studied 10644 newly detected leprosy patients from Yunnan, China, from 1990 to 2019. Factors associated with Grade 1 (G1D) and Grade 2 (G2D) physical disabilities or overall physical disabilities (combined G1D and G2D) associated with leprosy were analyzed using multinomial and ordinal logistic regression analyses. The following factors were associated with the development of physical disability in these patients with leprosy: delayed diagnosis [odds ratio (OR): 5.652, 4.399, and 2.275; 95% confidence intervals (CIs): 4.516-7.073, 3.714-5.212, and 2.063-2.509; for ≥ 10, 5-10 y, and 2-5 years, respectively], nerve damage (OR: 3.474 and 2.428; 95% CI: 2.843-4.244, and 1.959-3.008; for 2 and 1 damaged nerves, respectively), WHO classification of PB (OR: 1.759; 95% CI: 1.341-2.307), Ridley-Jopling classification (OR: 1.479, 1.438, 1.522 and 1.239; 95% CI: 1.052-2.079, 1.075-1.923, 1.261-1.838, and 1.072-1.431; for TT, BT, BB, and BL when compared with LL, respectively), advanced age (OR: 1.472 and 2.053; 95% CI: 1.106-1.960 and 1.498-2.814; for 15-59 and over 60 years old, respectively), zero skin lesions (OR: 1.916; 95% CI: 1.522-2.413), leprosy reaction (OR: 1.528; 95% CI: 1.195-1.952), rural occupation (OR: 1.364; 95% CI: 1.128-1.650), Han ethnicity (OR: 1.268; 95% CI: 1.159-1.386), and male sex (OR: 1.128; 95% CI: 1.024-1.243). CONCLUSIONS Delayed diagnosis, nerve damage, no skin lesions, WHO and Ridley-Jopling classifications, leprosy reactions, advanced age, rural occupation, Han ethnicity, and male sex were associated with disability in leprosy patients. Identifying risk factors could help to prevent physical disability.
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Chen X, Shui TJ. The state of the leprosy epidemic in Yunnan, China 2011-2020: A spatial and spatiotemporal analysis, highlighting areas for intervention. PLoS Negl Trop Dis 2021; 15:e0009783. [PMID: 34613961 PMCID: PMC8494331 DOI: 10.1371/journal.pntd.0009783] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/25/2021] [Accepted: 09/01/2021] [Indexed: 11/18/2022] Open
Abstract
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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Affiliation(s)
- Xiaohua Chen
- Beijing Tropical Medicine Research Institute, Beijing Friendship Hospital, Capital Medical University, Beijing, China
- Beijing Key Laboratory for Research on Prevention and Treatment of Tropical Diseases, Capital Medical University, Beijing, China
| | - Tie-Jun Shui
- Yunnan Center for Disease Control and Prevention, Yunnan, China
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