The Lingering Occurrence of Leprosy in Trinidad in To the 21st Century

Abstract

Objective: The aim of this study is to track the occurrence of Hansen’s disease (HD) to define the attainment of the goal of elimination, and to describe the ongoing epidemiological features of leprosy in the first decade of the 21st century. Design and Methods: The data for the study was derived from the National Hansen’s Disease Registry of the Ministry of Health for the period 1972-2015. The annual cumulative incidence rate (CIR) per 10 000 populations as well as prevalence was used to measure the occurrence of HD for the period 1972-2015. In order to test a statistically significant trend Poisson regression was used. The Mann-Kendall test was used to determine the significance of trends, a p-value of <0.05 was considered significant. Results: A peak CIR occurred in 1973 i.e.1.3 per 10 000 population (95% CI 1.5-1.1). Subsequently from 1974 the CIR for HD in Trinidad declined steadily, realizing a decline of 86%. There were no major outliers except for two small peaks 1994 and 2001; hence no smoothing techniques or transformations were necessary. The Mann-Kendall test was highly significant for trends (p=0.01). In addition the prevalence rate also fell to <1 per 10 000 population. Conclusions: Consequently Trinidad and Tobago has met the WHO criterion for the elimination of HD i.e. <1 case per 10 000 population since 1974.