Abstract
Leprosy remains endemic in some regions and is a global health concern. However, the possible causes and risk factors of the disease remain unclear. Data in Wenshan, China were collected from the Wenshan Institute of Dermatology (1986–2015); data in Nepal were obtained from the Leprosy Control Division, Department of Health Services, Nepal (2011 to 2015); and data from Indonesia, India, and Brazil were collected from WHO records. We assessed the epidemiological trends of leprosy in Wenshan and compared the features of possible causes and risk factors with those of other countries. We then performed a descriptive and statistical analysis to make our study more purposeful and definitive. A total of 3,376 cases were detected in Wenshan from 1986 to 2015. The overall prevalence rate (PR) of leprosy presented a decreasing trend with a peak (4.9/10,000 population) in 1986. The detection of new leprosy cases was higher in males than in females. Visible deformity increased every year since 2005 with a disability of 34.8% in 2015 among new cases. In Nepal, 2,461 leprosy patients received multi-drug therapy (MDT) in 2015 which corresponded to the PR of 0.89/10,000 population. Geographic latitude and socio-economic situations appeared to be the main causes of leprosy, and the healthcare condition was an important factor associated with leprosy incidence. The introduction of MDT effectively reduced leprosy prevalence worldwide. Wenshan (China), Nepal, and other countries share similarities in various aspects with respect to socio-cultural features, geographical distribution, environmental factors, and economic situation, which may contribute to leprosy being endemic in these areas.
Highlights
Leprosy, known as Hansen’s disease, is an infectious disease caused by the bacillus Mycobacterium leprae and results in a chronic infection in humans that affects the peripheral nerves, skin, and other organs such as eyes, mucous membranes, bones, and testes [1]
From 1986 to 2015, a total of 3,376 leprosy cases were detected in Wenshan
The prevalence rate (PR) in Wenshan had declined between 1986 and 1989 from 4.9/10,000 to 1.2/10,000 after the implementation of fixedduration multi-drug therapy (MDT); after that, it remained at 1.0/10,000 till 1997 based on the annual input of new patients infected before MDT (Figure 1)
Summary
Known as Hansen’s disease, is an infectious disease caused by the bacillus Mycobacterium leprae and results in a chronic infection in humans that affects the peripheral nerves, skin, and other organs such as eyes, mucous membranes, bones, and testes [1]. Some researchers believe that leprosy is transmitted by inhalation of droplets containing the pathogenic bacteria, Mycobacterium leprae (M. leprae). Some insist that leprosy can be transmitted via skin contact or other means. Infection of M. leprae results in anesthetic skin lesions, enlarged peripheral nerves, and acid-fast bacilli in the skin smear as the typical clinical signs of leprosy [2]. Delayed diagnosis and treatment can lead to nerve damage presenting loss of muscle function or paralysis, even permanent disability [3]. A study examined the origin and distribution of leprosy with the use of comparative genomics in 2005, indicating that leprosy most likely originated in Africa and spread to India, the New World via the slave trade, and Europe [4]
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