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Spatial distribution and temporal trends of leprosy in Uganda, 2012–2016: a retrospective analysis of public health surveillance data

Authors
  • Aceng, Freda Loy1, 2
  • Kawuma, Herman-Joseph2, 3
  • Majwala, Robert1, 3
  • Lamunu, Maureen2, 3
  • Ario, Alex Riolexus1
  • Rwabinumi, Frank Mugabe2
  • Harris, Julie R.4
  • Zhu, Bao-ping5, 6
  • 1 Uganda Public Health Fellowship Program, Kampala, Uganda , Kampala (Uganda)
  • 2 National Tuberculosis and Leprosy Program, Ministry of Health, Kampala, Uganda , Kampala (Uganda)
  • 3 German Leprosy and TB Relief Association, Kampala, Uganda , Kampala (Uganda)
  • 4 Workforce and Institute Development Branch, Division of Global Health Protection, Center for Global Health, US Centers for Disease Control and Prevention, Atlanta, USA , Atlanta (United States)
  • 5 US Centers for Disease Control and Prevention, Kampala, Uganda , Kampala (Uganda)
  • 6 Center for Global Health, Centers for Disease Control and Prevention, Atlanta, USA , Atlanta (United States)
Type
Published Article
Journal
BMC Infectious Diseases
Publisher
Springer (Biomed Central Ltd.)
Publication Date
Nov 29, 2019
Volume
19
Issue
1
Identifiers
DOI: 10.1186/s12879-019-4601-3
Source
Springer Nature
Keywords
License
Green

Abstract

BackgroundLeprosy is a neglected disease that poses a significant challenge to public health in Uganda. The disease is endemic in Uganda, with 40% of the districts in the country affected in 2016, when 42 out of 112 districts notified the National Tuberculosis and Leprosy Program (NTLP) of at least one case of leprosy. We determined the spatial and temporal trends of leprosy in Uganda during 2012–2016 to inform control measures.MethodsWe analyzed quarterly leprosy case-finding data, reported from districts to the Uganda National Leprosy Surveillance system (managed by NTLP) during 2012–2016. We calculated new case detection by reporting district and administrative regions of treatment during this period. New case detection was defined as new leprosy cases diagnosed by the Uganda health services divided by regional population; population estimates were based on 2014 census data. We used logistic regression analysis in Epi-Info version 7.2.0 to determine temporal trends. Population estimates were based on 2014 census data. We used QGIS software to draw choropleth maps showing leprosy case detection rates, assumed to approximate the new case detection rates, per 100,000 population.ResultsDuring 2012–2016, there was 7% annual decrease in reported leprosy cases in Uganda each year (p = 0.0001), largely driven by declines in the eastern (14%/year, p = 0.0008) and central (11%/year, p = 0.03) regions. Declines in reported cases in the western (9%/year, p = 0.12) and northern (4%/year, p = 0.16) regions were not significant. The combined new case detection rates from 2012 to 2016 for the ten most-affected districts showed that 70% were from the northern region, 20% from the eastern, 10% from the western and 10% from the central regions.ConclusionThere was a decreasing trend in leprosy new case detection in Uganda during 2012–2016; however, the declining trends were not consistent in all regions. The Northern region consistently identified more leprosy cases compared to the other regions. We recommend evaluation of the leprosy surveillance system to ascertain the leprosy situation.

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