Recent Food Shortage Is Associated with Leprosy Disease in Bangladesh: A Case-Control Study

Abstract

BackgroundLeprosy is remaining prevalent in the poorest areas of the world. Intensive control programmes with multidrug therapy (MDT) reduced the number of registered cases in these areas, but transmission of Mycobacterium leprae continues in most endemic countries. Socio-economic circumstances are considered to be a major determinant, but uncertainty exists regarding the association between leprosy and poverty. We assessed the association between different socio-economic factors and the risk of acquiring clinical signs of leprosy.Methods and Findings We performed a case-control study in two leprosy endemic districts in northwest Bangladesh. Using interviews with structured questionnaires we compared the socio-economic circumstances of recently diagnosed leprosy patients with a control population from a random cluster sample in the same area. Logistic regression was used to compare cases and controls for their wealth score as calculated with an asset index and other socio-economic factors. The study included 90 patients and 199 controls. A recent period of food shortage and not poverty per se was identified as the only socio-economic factor significantly associated with clinical manifestation of leprosy disease (OR 1.79 (1.06–3.02); p = 0.030). A decreasing trend in leprosy prevalence with an increasing socio-economic status as measured with an asset index is apparent, but not statistically significant (test for a trend: OR 0.85 (0.71–1.02); p = 0.083).ConclusionsRecent food shortage is an important poverty related predictor for the clinical manifestation of leprosy disease. Food shortage is seasonal and poverty related in northwest Bangladesh. Targeted nutritional support for high risk groups should be included in leprosy control programmes in endemic areas to reduce risk of disease.

Leprosy and Health Vulnerability in Belo Horizonte, Minas Gerais

“…3,8 Tal fato é corroborado ao analisar a distribuição espacial da hanseníase no mundo. Em países desenvolvidos, poucos novos casos são registrados e, quando detectados, são encontrados principalmente entre os imigrantes de países onde a doença ainda é endêmica.…”

“…6 Há muito se discute que as condições de alto risco para a distribuição e propagação da endemia hansênica são, em sua maioria, relacionadas à pobreza. 7 Altas taxas de desnutrição, 8 aglomeração domiciliar 9 e baixa escolaridade 10 são alguns dos fatores já identificados.…”

Socio‐economic and environmental effects influencing the development of leprosy in Bahia, north‐eastern Brazil

“…Income inequality is inversely associated to health status (Wilkinson & Pickett 2006). In Brazil, inequality is engrained in the differences across regions and educational levels (Salardi 2005), labour market segmentation, and discrimination against women and non-White people (Lustig & Lopez-Calva 2013 cultural factors (Skidmore 2004 (Feenstra et al 2011). Urbanity, inequality, great number of dwellers by residence and migration are all closely interrelated.…”

Interaction of Nutrition and Infections Globally: An Overview

“…Due to the circumstances, most of the data are anecdotal and are not derived from well-designed studies [6]. In line with these observations, a case-control study in Bangladesh reported an association between the occurrence of leprosy and a period of food shortage [7]. …”