Trends of case detection and other indicators of leprosy in China during 1985-2002

Objective: To analyze the trends of case detection and other indicators of leprosy in China during 1985-2002

Methods: Data reported by each province were collected by China National Leprosy Database in Nanjing P.R.China. All data about registered cases were put into computer for analysis.

Results: Although China achieved the goal of elimination of leprosy at country level in 1981, there are still about 1600~2000 new leprosy cases detected each year. From 1985 to 2002, a total of 49477 leprosy new cases had been detected. Among them, 64.8% were multibacillary cases and 25.4% had grade 2 disability. The child cases aged below 15 years accounted for 3.7% of total cases. Five thousand, eight hundred and twenty-four cases and 303 cases relapsed after dapsone (DDS) mono-therapy and multidrug therapy (MDT), respectively. Case detection had shown a marked reduction from 0.47/100000 in 1985 to 0.18/100000 in 1993 although there were several spurts due to operational factors. From 1994, the case detection had shown no significant decline. The grade 2 disability among the new patients decreased from 31.4% in 1985 to 23.4% in 2002. The child case detection rate among new cases fluctuated between 2.7%-3.6% in the last four years for the present review. The incidence of relapse declined after the introduction of DDS mono-therapy. However, it increased after the introduction of MDT. The number of relapse cases after DDS mono-therapy came down, but after MDT it went up.

Conclusions: China experiences in leprosy control show that it will take a long time with continuing present leprosy control activities to bring down the case detection and other indicators to a very low level even after reaching the elimination goal of leprosy.

Key words: leprosy; epidemiology; case-detection

By Dr. Shen Jianping