Measuring endemicity and burden of leprosy across countries and regions: A systematic review and Delphi survey

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...

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Bibliographic Details
Published in:	PLoS neglected tropical diseases Vol. 15; no. 9; p. e0009769
Main Authors:	Ogunsumi, Dorcas O, Lal, Vivek, Puchner, Karl Philipp, van Brakel, Wim, Schwienhorst-Stich, Eva-Maria, Kasang, Christa, Chukwu, Joseph, Kreibich, Saskia, Parisi, Sandra, Richardus, Jan Hendrik, Blok, David J
Format:	Journal Article
Language:	English
Published:	United States Public Library of Science 01-09-2021 Public Library of Science (PLoS)
Subjects:	Classification Communication Cost of Illness Countries Delphi Technique Detection Disability Endemic Diseases Endemism Engineering and Technology Global Health Health surveys Humans Indicators Infectious diseases Leprosy Leprosy - epidemiology Levels Literature reviews Measurement methods Medicine and Health Sciences Methods People and places Polls & surveys Regions Research and Analysis Methods Secondary data analysis Surveying Surveys Systematic review Tropical diseases India Brazil Bangladesh Indonesia
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Summary:	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. 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 indicators, classification levels, and scoring methods to measure and classify endemicity and burden. A two round Delphi survey was conducted to ask experts to rank and weigh indicators, classification levels, and scoring methods. 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 disability. 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. 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.
Bibliography:	new_version ObjectType-Article-1 SourceType-Scholarly Journals-1 ObjectType-Feature-2 content type line 23 ObjectType-Undefined-3 The authors have declared that no competing interests exist.
ISSN:	1935-2735 1935-2727 1935-2735
DOI:	10.1371/journal.pntd.0009769