September 22, 2017
The World Health Organisation’s annual statistics on leprosy, which were released this month, provide data about the current state of the disease from 143 countries – the highest number of countries ever providing data on this important issue.
The data tells us that global leprosy case detection increased slightly in 2016 compared with 2015. In total, 214,783 new leprosy cases were reported from 143 countries in 2016. This is up from 210,758 new cases (from 136 countries) reported in 2015.
There were 176,948 people registered for Multi Drug Therapy at the end of this year.
However if we look at the longer term trend, we see that the number of new case detections is slowly decreasing, but is stubbornly resistant to major change. It is clear that we need new strategies to help us dramatically influence this trend.
Case detection in “global priority countries” remains a key challenge. The data shows that over 95% of the new cases detected across the globe were from these 22 countries. While India accounts for over 60% of the new cases, the other countries with more than 1000 new cases in 2016 were Bangladesh, Brazil, Democratic Republic of the Congo, Ethiopia, India, Indonesia, Madagascar, Mozambique, Myanmar, Nepal, Nigeria and Philippines.
In these countries, the new data from the WHO also show the challenge of delayed diagnosis and existing impairments. A significant number of people are still being diagnosed with existing visible impairments (what used to be classified as Grade 2 disabilities), showing the need for improvement in early case detection.
There has also been slow progress on ensuring that women affected by leprosy are accurately diagnosed. Detection rates for leprosy have historically been higher for men than women, and it has been thought that the disease affects men much more than women. Recent research has challenged the gender imbalance theory, but the WHO global statistics on leprosy released this month still show that women make up less than 40% of new cases. It may be that because women are often “hidden” in poor communities, with reduced access to formal services, that they’re not being diagnosed at the same rate as men.
The high number of countries reporting leprosy cases emphasises the need for a wide range of health workers to be able to suspect and diagnose leprosy cases.
With the push for universal health coverage, it will be vital for all those in the leprosy community, including groups of people affected, to ensure that population groups at risk of leprosy receive adequate attention, especially for early detection.