Observational studyInfectious diseases of poverty2021
Geospatial epidemiology of leprosy in northwest Bangladesh: a 20-year retrospective observational study.
Observational study in Infectious diseases of poverty, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 10 papers.
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Who cites it
10 citing papers in PubMed.
- Risk factors and leprosy incidence among contacts in Bangladesh: A multilevel analysis.PLoS neglected tropical diseases · 2025Trial
- Acceptability and challenges of community-based rehabilitation (CBR) of leprosy patients with grade-2 disability in Bangladesh.PLOS global public health · 2026Article
- Assessing the Feasibility of an Intensified Extended Contact Survey (IECS) Compared to Passive Household Screening for Leprosy in Bangladesh.Tropical medicine and infectious disease · 2025Article
- High-risk spatiotemporal patterns of leprosy in the southeastern region of Yunnan province from 2010 to 2022: an analysis at the township level.BMC public health · 2024Article
- Article
- Spatiotemporal pattern of leprosy in southwest China from 2010 to 2020: an ecological study.BMC public health · 2024Observational
- Burden of leprosy and associated risk factors for disabilities in Tanzania from 2017 to 2020.PloS one · 2024Article
- Identifying clusters of leprosy patients in India: A comparison of methods.PLoS neglected tropical diseases · 2022Article
- Determining target populations for leprosy prophylactic interventions: a hotspot analysis in Indonesia.BMC infectious diseases · 2022Article
- [Epidemiology of leprosy in Chad from 2015 to 2019].The Pan African medical journal · 2022Article
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Authors and funding
9 authors.
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Abstract
backgroundLeprosy is known to be unevenly distributed between and within countries. High risk areas or 'hotspots' are potential targets for preventive interventions, but the underlying epidemiologic mechanisms that enable hotspots to emerge, are not yet fully understood. In this study, we identified and characterized leprosy hotspots in Bangladesh, a country with one of the highest leprosy endemicity levels globally.
methodsWe used data from four high-endemic districts in northwest Bangladesh including 20 623 registered cases between January 2000 and April 2019 (among ~ 7 million population). Incidences per union (smallest administrative unit) were calculated using geospatial population density estimates. A geospatial Poisson model was used to detect incidence hotspots over three (overlapping) 10-year timeframes: 2000-2009, 2005-2014 and 2010-2019. Ordinal regression models were used to assess whether patient characteristics were significantly different for cases outside hotspots, as compared to cases within weak (i.e., relative risk (RR) of one to two), medium (i.e., RR of two to three), and strong (i.e., RR higher than three) hotspots.
resultsNew case detection rates dropped from 44/100 000 in 2000 to 10/100 000 in 2019. Statistically significant hotspots were identified during all timeframes and were often located at areas with high population densities. The RR for leprosy was up to 12 times higher for inhabitants of hotspots than for people living outside hotspots. Within strong hotspots (1930 cases among less than 1% of the population), significantly more child cases (i.e., below 15 years of age) were detected, indicating recent transmission. Cases in hotspots were not significantly more likely to be detected actively.
conclusionsLeprosy showed a heterogeneous distribution with clear hotspots in northwest Bangladesh throughout a 20-year period of decreasing incidence. Findings confirm that leprosy hotspots represent areas of higher transmission activity and are not solely the result of active case finding strategies.
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