Are leprosy case numbers reliable?

• Published in: The Lancet infectious diseases 2018-02, Vol.18 (2), p.135-137
• Main Authors: Salgado, Claudio Guedes, Barreto, Josafá Gonçalves, da Silva, Moisés Batista, Goulart, Isabela Maria Bernardes, Barreto, Jaison Antônio, de Medeiros Junior, Nesio Fernandes, Nery, José Augusto, Frade, Marco Andrey Cipriani, Spencer, John Stewart
• Format: Article
• Language: English
• Subjects: Epidemiologic Methods; Humans; Incidence; Infectious diseases; Leprosy; Leprosy - epidemiology; Population; Prevalence; Serology; Surveillance; World Health Organization
• ISSN: 1473-3099; 1474-4457
• DOI: 10.1016/S1473-3099(18)30012-4

The NCDR for a country was almost always higher than the point prevalence rate because patients with paucibacillary leprosy who were entered into the system early during the year would complete their treatment and not be included in the number of registered patients at the end of the year. [...]in 2016, 214 783 new cases were detected, whereas only 171 948 individuals were registered for prevalence at the end of the year. In Brazil, the only country that has still not attained the goal of fewer than one new case per 10 000, surveys by several leprologists who use active surveillance of schoolchildren and their household contacts reveal more hidden cases than the national NCDR reported through passive case diagnosis, including in areas of the country considered as having low endemicity,5,6 and thousands of hidden cases have been found in India.7 These findings illustrate the importance of active surveillance and additional case-finding among the household contacts of newly diagnosed cases by experienced dermatologists. Global situation, Wkly Epidemiol Rec, Vol. 77, 2002, 1-8 3 WHO, Regional Office for the Eastern Mediterranean, Report on the regional seminar on future trends in leprosy elimination, 2000, World Health Organization, Regional Office for the Eastern Mediterranean, Alexandria 4 WHO, Regional Office for Africa, Progress towards the reduction of the burden of leprosy 2000-2011, 2012, World Health Organization, Regional Office for Africa, Brazzaville 5 MAC Frade, NA de Paula, CM Gomes, Unexpectedly high leprosy seroprevalence detected using a random surveillance strategy in midwestern Brazil: a comparison of ELISA and a rapid diagnostic test, PLoS Negl Trop Dis, Vol. 11, 2017, e0005375 6 FB Filho, NA De Paula, MN Leite, Evidence of hidden leprosy in a supposedly low endemic area of Brazil, Mem Inst Oswaldo Cruz, Vol. 112, 2017, 1-7 7 WHO, Oct 18, 2016, (accessed Sept 25, 2017).