TY - JOUR
T1 - Measuring endemicity and burden of leprosy across countries and regions
T2 - A systematic review and delphi survey
AU - Ogunsumi, Dorcas O.
AU - Lal, Vivek
AU - Puchner, Karl Philipp
AU - van Brakel, Wim
AU - Schwienhorst-Stich, Eva Maria
AU - Kasang, Christa
AU - Chukwu, Joseph
AU - Kreibich, Saskia
AU - Parisi, Sandra
AU - Richardus, Jan Hendrik
AU - Blok, David J.
N1 - Funding Information:
We thank Wichor M. Bramer from the Erasmus MC Medical Library for developing the search strategies for the bibliographic databases, and all experts who participated in the Delphi survey.
Publisher Copyright:
© 2021 Ogunsumi et al.
PY - 2021/9/20
Y1 - 2021/9/20
N2 - Background Leprosy is a chronic infectious disease caused by Mycobacterium leprae, the annual new case detection in 2019 was 202,189 globally. Measuring endemicity levels and burden in leprosy lacks a uniform approach. As a result, the assessment of leprosy endemicity or burden are not comparable over time and across countries and regions. This can make program planning and evaluation difficult. This study aims to identify relevant metrics and methods for measuring and classifying leprosy endemicity and burden at (sub)national level. Methods We used a mixed-method approach combining findings from a systematic literature review and a Delphi survey. The literature search was conducted in seven databases, searching for endemicity, burden and leprosy. We reviewed the available evidence on the usage of indica-tors, classification levels, and scoring methods to measure and classify endemicity and bur-den. A two round Delphi survey was conducted to ask experts to rank and weigh indicators, classification levels, and scoring methods. Results The literature review showed variation of indicators, levels, and cut-off values to measure leprosy endemicity and/or burden. The most used indicators for endemicity include new case detection rate (NCDR), new cases among children and new cases with grade 2 disabil-ity. For burden these include NCDR, MB cases, and prevalence. The classification levels ‘high’ and ‘low’ were most important. It was considered most relevant to use separate scoring methods for endemicity and burden. The scores would be derived by use of multiple indicators. Conclusion There is great variation in the existing method for measuring endemicity and burden across countries and regions. Our findings contribute to establishing a standardized uniform approach to measure and classify leprosy endemicity and burden at (sub)national level, which would allow effective communication and planning of intervention strategies.
AB - Background Leprosy is a chronic infectious disease caused by Mycobacterium leprae, the annual new case detection in 2019 was 202,189 globally. Measuring endemicity levels and burden in leprosy lacks a uniform approach. As a result, the assessment of leprosy endemicity or burden are not comparable over time and across countries and regions. This can make program planning and evaluation difficult. This study aims to identify relevant metrics and methods for measuring and classifying leprosy endemicity and burden at (sub)national level. Methods We used a mixed-method approach combining findings from a systematic literature review and a Delphi survey. The literature search was conducted in seven databases, searching for endemicity, burden and leprosy. We reviewed the available evidence on the usage of indica-tors, classification levels, and scoring methods to measure and classify endemicity and bur-den. A two round Delphi survey was conducted to ask experts to rank and weigh indicators, classification levels, and scoring methods. Results The literature review showed variation of indicators, levels, and cut-off values to measure leprosy endemicity and/or burden. The most used indicators for endemicity include new case detection rate (NCDR), new cases among children and new cases with grade 2 disabil-ity. For burden these include NCDR, MB cases, and prevalence. The classification levels ‘high’ and ‘low’ were most important. It was considered most relevant to use separate scoring methods for endemicity and burden. The scores would be derived by use of multiple indicators. Conclusion There is great variation in the existing method for measuring endemicity and burden across countries and regions. Our findings contribute to establishing a standardized uniform approach to measure and classify leprosy endemicity and burden at (sub)national level, which would allow effective communication and planning of intervention strategies.
UR - http://www.scopus.com/inward/record.url?scp=85116444938&partnerID=8YFLogxK
U2 - 10.1371/journal.pntd.0009769
DO - 10.1371/journal.pntd.0009769
M3 - Article
C2 - 34543282
AN - SCOPUS:85116444938
SN - 1935-2727
VL - 15
JO - PLoS Neglected Tropical Diseases
JF - PLoS Neglected Tropical Diseases
IS - 9
M1 - e0009769
ER -
