Epidemiological characteristics of leprosy during the period 2005–2020: A retrospective study based on the Chinese surveillance system

Abstract

BackgroundJiangsu Province is located in the Yangtze River Delta region, with a total area of 107,200 square kilometers. Since 1949, over 55,000 cases have been registered, with Taixing accounting for the highest number of patients. The proportion of new cases with MB and G2D was higher compared to other regions. As a result, Jiangsu has been considered a priority area for public health interventions in China.MethodsThis paper mainly described the population, time, and spatial distribution of the newly detected leprosy cases in Jiangsu Province between 2005 and 2020. In this study, all the data were entered into Microsoft Excel and SPSS for the descriptive analysis. ArcGIS was applied to create statistical maps, and Geoda was used to conduct spatial autocorrelation analysis with local Moran's I statistics (LISA). The epidemiological data were obtained from LEPMIS. In addition, population data were obtained from the Statistical Yearbook of Jiangsu Province.ResultsDuring the study period, 363 new cases were reported. Of these, 232 were men and 131 were women (1.77:1). The mean age at diagnosis was 60.56 years, and no adolescent cases were identified. Three hundred and twenty-seven (90.08%) were diagnosed with MB and 36 (9.92%) with PB. 31.68% (115/363) of the patients presented with G2D. Farmers accounted for 74.9%, and most cases were identified in skin clinics (248, 68.32%). We observed a decreasing trend in detection rate, with a higher concentration of new cases diagnosed between July and October. Spatial analysis showed that the new cases were primarily distributed in the northwest of Jiangsu province, and Suqian has the highest incidence of leprosy. Special attention should be paid to Wuzhong, a county with a potential risk of inter-provincial transmission. Furthermore, 55 new cases came from other Chinese provinces but lived in Jiangsu.ConclusionThe NCDR of leprosy decreased, but the new cases showed disabilities, a sign of the late diagnosis. The results indicated that some regions were still suffering from the burden of leprosy. Thus, we recommend that the government should adopt effective strategies to promote leprosy control. The main priorities for eliminating new cases were to provide sustainable financial support, improve the quality of clinical services, strengthen preventive intervention and rehabilitation services for disabilities, provide health education among high-risk populations, and explore new approaches.

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“…Improvements in treatment explain the decrease in most symptoms over the periods, while a greater awareness and responsibility for health among individuals is linked to other location of symptoms. Similar studies found that skin symptoms on the limbs are the most common [27,38,50].…”

“…The male predominance is also mentioned by other authors [25,[27][28][29][30][31][32][33][34][35]. This male predominance could be related to the under-diagnosis of women: their physical examination was less thorough due to cultural customs and limited access to health services [2,31].…”

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“…The Jiangsu Province used to have one of the most considerable rates in China, with a total of 56,176 leprosy cases detected and registered from 1949 to 2020. A previous study [8] showed that, during the period of 2005-2020, there was a 31.68% of newly discovered G2D patients and it was significantly higher than in other endemic areas of China, such as Yunnan, Sichuan, and Guizhou. However, leprosy burden is often misinterpreted as the eradication or the absence of major complications in Jiangsu.…”

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“…WHO telah menargetkan eliminasi kusta sebagai tujuan kesehatan masyarakat untuk mengurangi insiden global menjadi <1/100.000 pada tahun 2000, dan sebagian besar negara telah mencapai tujuan tersebut (5). Namun, kusta terus tercatat di lebih dari 120 negara, dengan 200.000 kasus baru dilaporkan setiap tahunnya.…”