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Spatial heterogeneity in projected leprosy trends in India
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نویسنده
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brook c.e. ,beauclair r. ,ngwenya o. ,worden l. ,ndeffo-mbah m. ,lietman t.m. ,satpathy s.k. ,galvani a.p. ,porco t.c.
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منبع
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parasites and vectors - 2015 - دوره : 8 - شماره : 1
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چکیده
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Background: leprosy is caused by infection with mycobacterium leprae and is characterized by peripheral nerve damage and skin lesions. the disease is classified into paucibacillary (pb) and multibacillary (mb) leprosy. the 2012 london declaration formulated the following targets for leprosy control: (1) global interruption of transmission or elimination by 2020,and (2) reduction of grade-2 disabilities in newly detected cases to below 1 per million population at a global level by 2020. leprosy is treatable,but diagnosis,access to treatment and treatment adherence (all necessary to curtail transmission) represent major challenges. globally,new case detection rates for leprosy have remained fairly stable in the past decade,with india responsible for more than half of cases reported annually. methods: we analyzed publicly available data from the indian ministry of health and family welfare,and fit linear mixed-effects regression models to leprosy case detection trends reported at the district level. we assessed correlation of the new district-level case detection rate for leprosy with several state-level regressors: tb incidence,bcg coverage,fraction of cases exhibiting grade 2 disability at diagnosis,fraction of cases in children,and fraction multibacillary. results: our analyses suggest an endemic disease in very slow decline,with substantial spatial heterogeneity at both district and state levels. enhanced active case finding was associated with a higher case detection rate. conclusions: trend analysis of reported new detection rates from india does not support a thesis of rapid progress in leprosy control. © 2015 brook et al.
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کلیدواژه
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India; Leprosy; Linear mixed effects regression; Mycobacterium leprae
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آدرس
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department of ecology and evolutionary biology,princeton university,princeton,nj, United States, international centre for reproductive health,ghent university,ghent,belgium,south african department of science and technology,dst,national research foundation,nrf,centre of excellence in epidemiological modelling and analysis,sacema,stellenbosch university,stellenbosch, South Africa, south african department of science and technology,dst,national research foundation,nrf,centre of excellence in epidemiological modelling and analysis,sacema,stellenbosch university,stellenbosch, South Africa, francis i. proctor foundation,university of california,san francisco,ca, United States, yale university,school of public health,new haven,ct, United States, francis i. proctor foundation,university of california,san francisco,ca,united states,department of ophthalmology,university of california,san francisco,san francisco,ca,united states,department of epidemiology and biostatistics,university of california,san francisco,san francisco,ca, United States, school of public health,kiit university,bhubaneswar,odisha, India, yale university,school of public health,new haven,ct, United States, francis i. proctor foundation,university of california,san francisco,ca,united states,department of ophthalmology,university of california,san francisco,san francisco,ca,united states,department of epidemiology and biostatistics,university of california,san francisco,san francisco,ca, United States
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Authors
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