ArticlePLoS neglected tropical diseases2026
Temporal and spatial patterns of Leprosy in Uganda, 2020-2024: A nationwide surveillance analysis.
Article in PLoS neglected tropical diseases, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
introductionDespite sustained elimination efforts, leprosy transmission persists in Uganda. The World Health Organization's Towards Zero Leprosy strategy targets zero infections and Grade 2 Disability (G2D) by 2030. Uganda's National TB and Leprosy Strategic Plan aims to reduce child cases to <3% and G2D to <5%. We assessed temporal trends and spatial distribution of leprosy in Uganda from 2020-2024 to evaluate progress toward these targets.
methodsWe conducted a descriptive analysis using national surveillance data from the District Health Information System 2 (DHIS2). Newly diagnosed leprosy cases reported between 2020 and 2024 were analyzed by age, sex, clinical type, and disability grade. Incidence was calculated using annual mid-year population estimates from the Uganda Bureau of Statistics. Temporal trends were assessed using the Mann-Kendall test and Sen's slope estimator. Spatial distribution of incidence, child cases, and G2D proportions was examined using QGIS at the regional and district levels.
resultsBetween 2020 and 2024, Uganda reported 1,935 new leprosy cases, with an overall incidence of 8.8 per 1,000,000 population. Multibacillary disease accounted for 86% of cases, and 21% presented with Grade 2 Disability (G2D). Children aged ≤15 years comprised 14% of cases, consistently exceeding the national elimination target of 3%. No significant monotonic trend was observed in overall incidence (p = 0.89), child proportion (p = 0.069), or G2D proportion (p = 0.14). Spatial analysis demonstrated persistent concentration of high incidence in the West Nile region, with 9 of 13 districts bearing the highest disease burden. Elevated G2D proportions were observed intermittently in the Teso and Ankole regions.
conclusionLeprosy incidence in Uganda remained relatively stable from 2020 to 2024; however, persistently high proportions of multibacillary disease, child cases, and G2D indicate ongoing transmission and delayed diagnosis in specific regions. Targeted interventions, including strengthened contact tracing and active case detection in high-burden areas, are essential to accelerate progress toward national elimination goals.
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