Trends in leprosy case detection in Rwanda 1995-2011: analysis of 17 years

Abstract

Background: Leprosy, or Hansen's disease, is a chronic, infectious disease caused by Mycobacterium leprae. It remains one of the leading causes of deformity and physical disability. We analyzed the laboratory records to assess trends in prevalence rate (PR) and case detection rate (CDR) in Rwanda. Methods: A retrospective laboratory records review of detected leprosy cases over a 17-year period (1995–2011) was conducted at the National Reference Laboratory. Skin biopsy samples were analyzed microscopically using Ziehl Neelsen (ZN) staining technique to identify Hansen's bacilli. Results: Cumulatively 266 suspected cases were reported between 1995 and 2011. Among suspected cases, 77 (28.9%) were laboratory confirmed as having leprosy. Among detected cases,76.6% were males and 23.4% females. The male-female ratio is 3:1. The registered leprosy cases over the past 17 years are 77 cases and the prevalence rate (PR) is 0.005/10,000 population. A graudual decrease of PR was oberved over the eight (8) past years from 0.015 per 10,000 population in 2003 to 0.003 per 10,000 population in 2010. From 1995 to 2011 CDR did not exceed 1 per 10,000 population. Multibacillary (MB) patients having bacteriological index ranging from 1+ to 4+ were highly represented (94.4%) in the last five (5) years while the paucibacillary patients were less represented 5.6%. Conclusion: Laboratory review demonstrates a considerable tendency of decline in PR and CDR trends up to date. Early case detection and sustainable leprosy control program remains the cornerstone to reduce physical and socioeconomic burden of leprosy in the country.