Meima Abraham, van Veen Natasja H J, Richardus Jan H
Department of Public Health, Erasmus MC, University Medical Center Rotterdam, Rotterdam, The Netherlands.
Trop Med Int Health. 2008 Feb;13(2):241-6. doi: 10.1111/j.1365-3156.2007.01996.x.
To explore the relationship between leprosy incidence trends and the future prevalence of World Health Organization (WHO) grade 2 impairment caused by leprosy.
Three scenarios were defined to estimate incidences and prevalences of leprosy impairment beyond 2000, assuming 6%, 12% and 18% annual declines in case detection rate respectively, and 6% impairment among new patients. Case detection data from 1985 to 2000 were used for projecting leprosy incidences up to 2020. To estimate future prevalences of WHO grade 2 impairment, the survival of existing and new impaired individuals was calculated.
In the 6% scenario, 410 000 new patients will be detected in 2010 and 250 000 in 2020. The number of people living with WHO grade 2 impairment in these years will be 1.3 and 1.1 million, respectively. The 12% scenario predicts that 210 000 new patients will be detected in 2010 and 70 000 in 2020. The grade 2 prevalences will be 1.2 and 0.9 million, respectively. In the 18% scenario, the incidence will be 110 000 in 2010 and 20 000 in 2020, and the grade 2 prevalences will be 1.1 and 0.8 million, respectively.
Declines in numbers of people living with grade 2 impairment lag behind trends in leprosy incidence. The prevalence of people with grade 2 decreases much slower than leprosy incidence and case detection in all three scenarios. This implies that a substantial number of people will live with impairment and will need support, training in self-care and other prevention of disability interventions in the next decades.
探讨麻风发病率趋势与世界卫生组织（WHO）认定的2级麻风所致损伤未来患病率之间的关系。
定义了三种情景来估计2000年以后麻风损伤的发病率和患病率，分别假设病例发现率每年下降6%、12%和18%，且新患者中有6%出现损伤。利用1985年至2000年的病例发现数据来预测直至2020年的麻风发病率。为估计WHO 2级损伤的未来患病率，计算了现有和新出现损伤个体的存活情况。
在6%的情景下，2010年将发现410000名新患者，2020年为250000名。这些年份中患有WHO 2级损伤的人数将分别为130万和110万。12%的情景预测2010年将发现210000名新患者，2020年为70000名。2级患病率将分别为120万和90万。在18%的情景下，2010年发病率将为110000，2020年为20000，2级患病率将分别为110万和80万。
2级损伤患者数量的下降滞后于麻风发病率趋势。在所有三种情景下，2级患者的患病率下降速度远慢于麻风发病率和病例发现率。这意味着在未来几十年中，大量患者将有损伤，需要得到支持、自我护理培训以及其他预防残疾的干预措施。
