Tulane University, New Orleans, Lousiana, USA.
Emerg Infect Dis. 2011 Jul;17(7):1202-8. doi: 10.3201/eid1707.102036.
An increasing proportion of Hansen disease cases in the United States occurs among migrants from the Micronesian region, where leprosy prevalence is high. We abstracted surveillance and clinical records of the National Hansen's Disease Program to determine geographic, demographic, and clinical patterns. Since 2004, 13% of US cases have occurred in this migrant population. Although Hawaii reported the most cases, reports have increased in the central and southern states. Multibacillary disease in men predominates on the US mainland. Of 49 patients for whom clinical data were available, 37 (75%) had leprosy reaction, neuropathy, or other complications; 17 (37%) of 46 completed treatment. Comparison of data from the US mainland with Hawaii and country-of-origin suggests under-detection of cases in pediatric and female patients and with paucibacillary disease in the United States. Increased case finding and management, and avoidance of leprosy-labeled stigma, is needed for this population.
美国的麻风病病例中，越来越多的是来自密克罗尼西亚地区的移民，而该地区的麻风病发病率很高。我们从国家麻风病防治计划的监测和临床记录中提取信息，以确定地理、人口统计学和临床模式。自 2004 年以来，美国的病例中有 13%发生在这一移民群体中。尽管夏威夷报告的病例最多，但在中南部各州的报告也有所增加。美国大陆的男性多菌型疾病更为普遍。在可提供临床数据的 49 名患者中，37 名（75%）有麻风反应、神经病变或其他并发症；46 名患者中有 17 名（37%）完成了治疗。与美国大陆、夏威夷和原籍国的数据进行比较表明，在美国，儿童和女性患者的病例检出率较低，少菌型疾病的检出率也较低。对于这一人群，需要增加病例发现和管理，并避免麻风病标签污名化。
