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countries should step up prevention initiatives to encourage a slow decline in new cases
New cases of loss are decreasing, but not at the predicted rate. To accelerate the annual decline, states should check contacts and treat acceptable contacts with a single dose of rifampicin, as recommended by the World Health Organization (WHO) in its guidelines.
“Researching evidence with one–the dose of rifampicin given as prophylaxis after exposure to newly diagnosed patients showed a 50-60% reduction in leprosy over the next 2 years, ” said Dr. Erwin Cooreman, Team Leader, WHO Global Leprosy Program. “Programs should identify and manage the contacts of people with leprosy.”
In addition to maintaining case detection, contact and treatment, all countries must adopt innovative approaches.
In 2019, a total of 202,185 new cases were discovered globally. Brazil, India and Indonesia are at the top of the list with more than 10,000 cases, while 13 other countries1 each recorded 1,000–10,000 cases.
Also, in 2019, there were 6506 fewer new cases of loss than in 2018. The decrease occurred in all WHO regions, but most in the WHO region of Southeast Asia, where 4708 fewer cases were recorded.
|
WHO region |
Number of cases |
Percentage |
|
Southeast Asia |
143 787 |
71.1 |
|
America |
29 936 |
14.8 |
|
Africa |
20 205 |
10.0 |
|
Eastern Mediterranean |
4 211 |
2.1 |
|
Western Pacific |
4 004 |
2.0 |
|
Europe |
42 |
<0.1 |
|
IN TOTAL |
202 185 |
100.0 |
Gender and children
Out of a total of 202,185 new cases, 78,625 (38.9%) occurred among the female population. The share of women was lower in the African region: 29.3% (5842 out of 19,950).
For children, most countries have collected information on new cases of grade 2 (G2D) disability. Globally, 10,813 new cases of G2D were detected (5.3%), of which 370 were reported in children in 2019.
Cases of children indirectly indicate continuous transmission in the community and they are closely monitored. During 2019, 14,891 new cases were detected in children (under <15 years of age) among 202,185 cases, representing 7.4%. New cases of children have shown a declining trend, falling below 15,000 for the first time.
Drug resistance
Only 11 countries provided data on antimicrobial resistance, which was required as a basic statistic. Of the 205 tests conducted, 18 showed resistance.
Two new cases have been infected with strains resistant to two antimicrobial agents used in the treatment of leprosy, suggesting that resistance testing should be conducted in highly endemic countries and countries with laboratory capabilities.
2030 goals
The draft Global Loss Strategy for 2021-2030 is in line with the new roadmap on neglected tropical diseases. The goal is to eliminate leprosy by 2030, which includes the following goals:
- 120 countries with zero indigenous cases;
- the number of new cases reduced to about 63,000 worldwide;
- the rate of new G2D cases decreased to 0.12 per million population; and
- the detection rate of new cases of children was reduced to 0.77 per million child population.
In order to make progress towards these goals, active leadership of states is needed. This should be supported by the significant engagement of people affected by leprosy, the accelerated efforts of all partners, and the continued supply of free multi-drug treatment and rifampicin.
Read Updating global leprosy (Hansen’s disease), 2019: time to step up prevention initiatives
1 The 13 countries that reported 1,000 to 10,000 cases were: Bangladesh, the Democratic Republic of the Congo, Ethiopia, Madagascar, Mozambique, Myanmar, Nepal, Nigeria, the Philippines, Somalia, South Sudan, Sri Lanka and the United Republic of Tanzania.
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