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      Trends of the leprosy control indicators in Benin from 2006 to 2018

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          Abstract

          Background

          Leprosy, or Hansen’s disease, is a chronic infectious disease caused by Mycobacterium leprae. The purpose of this study was to describe the epidemiological characteristics of leprosy in Benin from 2006 to 2018.

          Methods

          This descriptive retrospective study included data from January 2006 to December 2018. The data of all patients treated in the leprosy treatment centres (LTCs) of the Republic of Benin were obtained from the LTC registers and analysed using Stata/SE 11.0 software. Quantum GIS (Geographic Information System) version 2.18.23 software was used for mapping. The main indicators of leprosy were calculated according to the World Health Organization (WHO) recommendations.

          Results

          During the study period, a total of 2785 (annual average of 214) new cases of leprosy were diagnosed. The median age of the patients was 38 years, with extremes ranging from 6 to 88 years. The sex ratio (males/females) was 1.18 (1509/1276). The departments of Plateau, Atacora, and Zou were the most endemic; their leprosy detection rate per 100,000 population during these thirteen years were 6.46 (479/7414297), 5.38 (534/9932880) and 5.19 (526/10134877), respectively. The leprosy detection rate declined from 3.8 to 1.32 per 100,000 inhabitants. The proportion of paediatric cases varied from 8.56 to 2.67% as the proportion of multibacillary forms increased from 72.95 to 90%. From 2006 to 2018, 622 leprosy patients detected had grade 2 disability (G2D) at screening, indicating an average rate of 5.06 (622/122877474) cases with G2D per million population. The proportion of grade 2 disabilities increased from 21.23 to 32% during the study period. The majority of new leprosy cases among foreign-born persons were Nigerian (85.71%). The completion of multidrug therapy (MDT) for paucibacillary (PB) and multibacillary (MB) leprosy cases ranged from 96.36 to 95.65% and from 90.53 to 94.12%, respectively.

          Conclusion

          In Benin, leprosy remains a major health challenge; it is important to revitalize the epidemiological surveillance system to achieve its elimination by 2030.

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          Most cited references20

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          Leprosy now: epidemiology, progress, challenges, and research gaps.

          Leprosy continues to be a challenge to health worldwide, with about 250,000 new cases being detected every year. Despite widespread implementation of effective multidrug therapy, leprosy has not been eliminated. A third of newly diagnosed patients have nerve damage and might develop disabilities, although the proportion varies according to several factors, including level of self-care. Women who develop leprosy continue to be especially disadvantaged, with rates of late diagnosis and disability remaining high in this subgroup. Leprosy was not a specified disease in the Millennium Development Goals, but improvements in the other areas they cover, such as education and levels of poverty, will help leprosy patients and services. We review data and make recommendations for research on diagnosis, treatment, and prevention, such as further use of molecular analysis of the Mycobacterium leprae genome, implementation of BCG vaccination, and administration of chemoprophylaxis to household contacts. We also suggest development of tools for early diagnosis and detection of infection and nerve damage, and formulation of strategies to manage the chronic complications of leprosy, such as immune-mediated reactions and neuropathy. Copyright © 2011 Elsevier Ltd. All rights reserved.
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            Gender and leprosy: case studies in Indonesia, Nigeria, Nepal and Brazil.

            There appear to be regional differences in gender ratios of leprosy patients being diagnosed and treated. In Asian countries, more men than women are registered whilst in Africa female patients outnumber males. The Netherlands Leprosy Relief (NLR) therefore initiated research into factors underlying these regional gender differences. Between 1997 and 1999, leprosy control teams in Indonesia, Nigeria, Nepal and Brazil supported by social/public health scientists, conducted comparative exploratory research. They looked at three groups of potential explanatory factors: biological, socio-cultural/economic and service-related. The studies were partially quantitative (analysis of the records of patients who according to prescription could have completed treatment) and partially qualitative (interviews/focus group discussions with patients, their relatives, community members and health staff on perceptions of leprosy, its socio-economic consequences, treatment and cure). Biological factors appeared similar in the four countries: irrespective of the M/F ratio, more men than women were registered with multibacillary (MB) leprosy. Strong traditions, the low status of women, their limited mobility, illiteracy and poor knowledge of leprosy appeared to be important sociocultural factors explaining why women were under reporting. Yet, accessible, well reputed services augmented female participation and helped to diminish stigma, which in three out of the four societies seemed greater for women than for men. These positive effects could still be higher if the services would enhance community and patient education with active participation of patients and ex-patients themselves.
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              Innovative tools and approaches to end the transmission of Mycobacterium leprae

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                Author and article information

                Contributors
                ronaldgnimavo@gmail.com
                djoparf@gmail.com
                ghislainsop@yahoo.fr
                esaianagonou@yahoo.fr
                yvesbaro@yahoo.fr
                awadagni@gmail.com
                jghouezo@gmail.com
                rochchristianjohnson@gmail.com
                Journal
                BMC Public Health
                BMC Public Health
                BMC Public Health
                BioMed Central (London )
                1471-2458
                18 August 2020
                18 August 2020
                2020
                : 20
                : 1254
                Affiliations
                [1 ]Centre de Dépistage et de Traitement de la Lèpre et de l’Ulcère de Buruli « Raoul et Madeleine Follereau, Pobè, Bénin
                [2 ]GRID grid.412037.3, ISNI 0000 0001 0382 0205, Institut Régional de Santé Publique- Comlan Alfred Quenum, , Université d’Abomey Calavi, ; Ouidah, Bénin
                [3 ]Fondation Raoul Follereau, Paris, France
                [4 ]GRID grid.412037.3, ISNI 0000 0001 0382 0205, Centre Inter Facultaire de Formation et de Recherche en Environnement pour le Développement Durable, , Université d’Abomey Calavi, ; Abomey Calavi, Bénin
                [5 ]GRID grid.463453.3, Programme National de Lutte contre la Lèpre et l’Ulcère de Buruli, Ministère de la Santé, ; Cotonou, Bénin
                [6 ]Centre de Dépistage et de Traitement de l’Ulcère de Buruli de Lalo, Lalo, Bénin
                Article
                9341
                10.1186/s12889-020-09341-w
                7433205
                32811449
                19cf17ba-43d8-4ed1-b5fd-2e1280be0af9
                © The Author(s) 2020

                Open AccessThis article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article's Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/. The Creative Commons Public Domain Dedication waiver ( http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated in a credit line to the data.

                History
                : 16 January 2020
                : 3 August 2020
                Categories
                Research Article
                Custom metadata
                © The Author(s) 2020

                Public health
                epidemiology,leprosy,benin
                Public health
                epidemiology, leprosy, benin

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