Abstract

Recent mathematical and statistical modeling of leprosy incidence data provides estimates of the current undiagnosed population and projections of diagnosed cases, as well as ongoing transmission. Furthermore, modeling studies have been used to evaluate the effectiveness of proposed intervention strategies, such as postleprosy exposure prophylaxis and novel diagnostics, relative to current approaches. Such modeling studies have revealed both a slow decline of new cases and a substantial pool of undiagnosed infections. These findings highlight the need for active case detection, particularly targeting leprosy foci, as well as for continued research into innovative accurate, rapid, and cost-effective diagnostics. As leprosy incidence continues to decline, targeted active case detection primarily in foci and connected areas will likely become increasingly important.

Highlights

  • Leprosy, caused by the Mycobacterium leprae bacterium, persists in at least 122 countries

  • Modeling studies have been used to evaluate the effectiveness of proposed intervention strategies, such as postleprosy exposure prophylaxis and novel diagnostics, relative to current approaches

  • Such modeling studies have revealed both a slow decline of new cases and a substantial pool of undiagnosed infections. These findings highlight the need for active case detection, targeting leprosy foci, as well as for continued research into innovative accurate, rapid, and cost-effective diagnostics

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Summary

Policy Lessons From Quantitative Modeling of Leprosy

Modeling studies have been used to evaluate the effectiveness of proposed intervention strategies, such as postleprosy exposure prophylaxis and novel diagnostics, relative to current approaches Such modeling studies have revealed both a slow decline of new cases and a substantial pool of undiagnosed infections. These findings highlight the need for active case detection, targeting leprosy foci, as well as for continued research into innovative accurate, rapid, and cost-effective diagnostics. In 1991 the World Health Organization (WHO) established the target of eliminating leprosy as a public health problem, defined as a prevalence of

MATHEMATICAL MODELING OF LEPROSY
Feasibility of Global Interruption of Leprosy Transmission
Geographical Variation
Impact of Additional Control Strategies and Tools
Future Steps and Data Needs
CONCLUSIONS
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