Abstract
BackgroundLeprosy is a neglected disease that poses a significant challenge to public health in Uganda. The disease is endemic in Uganda, with 40% of the districts in the country affected in 2016, when 42 out of 112 districts notified the National Tuberculosis and Leprosy Program (NTLP) of at least one case of leprosy. We determined the spatial and temporal trends of leprosy in Uganda during 2012–2016 to inform control measures.MethodsWe analyzed quarterly leprosy case-finding data, reported from districts to the Uganda National Leprosy Surveillance system (managed by NTLP) during 2012–2016. We calculated new case detection by reporting district and administrative regions of treatment during this period. New case detection was defined as new leprosy cases diagnosed by the Uganda health services divided by regional population; population estimates were based on 2014 census data. We used logistic regression analysis in Epi-Info version 7.2.0 to determine temporal trends. Population estimates were based on 2014 census data. We used QGIS software to draw choropleth maps showing leprosy case detection rates, assumed to approximate the new case detection rates, per 100,000 population.ResultsDuring 2012–2016, there was 7% annual decrease in reported leprosy cases in Uganda each year (p = 0.0001), largely driven by declines in the eastern (14%/year, p = 0.0008) and central (11%/year, p = 0.03) regions. Declines in reported cases in the western (9%/year, p = 0.12) and northern (4%/year, p = 0.16) regions were not significant. The combined new case detection rates from 2012 to 2016 for the ten most-affected districts showed that 70% were from the northern region, 20% from the eastern, 10% from the western and 10% from the central regions.ConclusionThere was a decreasing trend in leprosy new case detection in Uganda during 2012–2016; however, the declining trends were not consistent in all regions. The Northern region consistently identified more leprosy cases compared to the other regions. We recommend evaluation of the leprosy surveillance system to ascertain the leprosy situation.
Highlights
Leprosy is a neglected disease that poses a significant challenge to public health in Uganda
Description of the leprosy surveillance system in Uganda In Uganda Ministry of Health, leprosy is managed under the National Tuberculosis and Leprosy Programme (NTLP); a Central Unit of the NTLP is responsible for policy formulation, planning, resource mobilization and monitoring
Of the 10 most-affected districts during 2012–2016, 60% were from the northern region, 20% were from the eastern region, 10% were from the western region and 10% were from the central region (Fig. 5)
Summary
Leprosy is a neglected disease that poses a significant challenge to public health in Uganda. We determined the spatial and temporal trends of leprosy in Uganda during 2012–2016 to inform control measures. Known as Hansen’s disease, is a chronic bacterial infection caused by Mycobacterium leprae. The disease may affect the nerves, skin, eyes, and nasal mucosa; if left untreated, nerve damage may cause paralysis of hands and feet and disfigurement [1]. Transmission of leprosy occurs through direct and indirect contact with infectious sources [1,2,3,4]. Due to the slow-growing nature of the bacteria and the long incubation period, it may be difficult to determine the infection source [5]. Leprosy is treated by prolonged multidrug therapy involving a combination of antibiotics such as dapsone, rifampicin, and clofazimine [1, 7, 8]
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