The future incidence of leprosy: a scenario analysis

A. Meima, William Cairns Stewart Smith, G. J. Van Oortmarssen, J. H. Richardus, D. F. Habbema

Research output: Contribution to journalArticle

79 Citations (Scopus)

Abstract

Objective To investigate the impact of the current strategy for the elimination of leprosy on its incidence and to assess the consequences of failure to sustain this strategy.

Methods Scenarios for assessing the impact of the elimination strategy were implemented in a computer simulation program. The scenarios reflected the assumptions made regarding contagiousness, transmission and bacille Calmette-Guerin (BCG) vaccination. The trend in case detection rate for the main countries in which leprosy was endemic during 1985-98 was fitted, and incidence up to 2020 was projected.

Findings Owing to the gradual shortening of delays in detection up to 1998, and because of the low relapse rate that occurs with multidrug treatment MDT, incidence is predicted to decrease beyond 2000 in all scenarios. The annual decline was a few per cent higher when favourable assumptions were made about protection and coverage of BCG vaccination. Overall, the predicted annual decline in incidences ranged from 2% to 12%.

Conclusion The elimination strategy reduces transmission, but the decline may be slow. Relaxation of control after 2005 is unjustified given the uncertainty about the rate of decline and the adverse effects of longer delays in detection. A long-term strategy for leprosy control should be adopted.

Original languageEnglish
Pages (from-to)373-380
Number of pages7
JournalBulletin of the World Health Organization
Volume82
Publication statusPublished - May 2004

Keywords

  • leprosy/diagnosis/drug therapy/epidemiology
  • drug therapy
  • combination
  • BCG vaccine
  • treatment outcome
  • incidence
  • forecasting
  • computer simulation
  • models, theoretical
  • PUBLIC-HEALTH PROBLEM
  • TUBERCULOSIS-CONTROL
  • ELIMINATING LEPROSY
  • CONTROL PROGRAM
  • CHINA
  • IMPAIRMENTS
  • PROSPECTS
  • OPTIMISM
  • COHORT
  • TRENDS

Cite this

Meima, A., Smith, W. C. S., Van Oortmarssen, G. J., Richardus, J. H., & Habbema, D. F. (2004). The future incidence of leprosy: a scenario analysis. Bulletin of the World Health Organization, 82, 373-380.

The future incidence of leprosy: a scenario analysis. / Meima, A.; Smith, William Cairns Stewart; Van Oortmarssen, G. J.; Richardus, J. H.; Habbema, D. F.

In: Bulletin of the World Health Organization, Vol. 82, 05.2004, p. 373-380.

Research output: Contribution to journalArticle

Meima, A, Smith, WCS, Van Oortmarssen, GJ, Richardus, JH & Habbema, DF 2004, 'The future incidence of leprosy: a scenario analysis', Bulletin of the World Health Organization, vol. 82, pp. 373-380.
Meima A, Smith WCS, Van Oortmarssen GJ, Richardus JH, Habbema DF. The future incidence of leprosy: a scenario analysis. Bulletin of the World Health Organization. 2004 May;82:373-380.
Meima, A. ; Smith, William Cairns Stewart ; Van Oortmarssen, G. J. ; Richardus, J. H. ; Habbema, D. F. / The future incidence of leprosy: a scenario analysis. In: Bulletin of the World Health Organization. 2004 ; Vol. 82. pp. 373-380.
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