02886nas a2200289 4500000000100000008004100001260001200042653003900054653002900093653002400122653001200146653003000158100001100188700001100199700001100210700001000221700001100231700001000242700001000252700001100262700000900273245017300282300001200455490000800467520210700475022001402582 2024 d c03/202410aEstimated annual percentage change10aGlobal Burden of Disease10ainfluencing factors10aleprosy10aSpatial–temporal trends1 aShen L1 aDing J1 aWang Y1 aFan W1 aFeng X1 aLiu K1 aQin X1 aShao Z1 aLi R00aSpatial-temporal trends in leprosy burden and its associations with socioeconomic and physical geographic factors: results from the Global Burden of Disease Study 2019. a172-1820 v2303 a

Objectives: The purpose of our study was to assess the multiscalar changes in leprosy burden and its associated risk factors over the last three decades.

Study Design: We conducted an in-depth examination of leprosy's spatial-temporal trends at multiple geographical scale (global, regional, and national), utilizing information from Global Burden of Disease, Injuries, and Risk Factors Study (GBD 2019).

Methods: Incidence and the estimated annual percentage change (EAPC) in age-standardized incidence rate (ASIR) of leprosy were determined, with countries categorized based on leprosy incidence changes. We examined socioeconomic and physical geography influences on leprosy incidence via Spearman correlation analysis, using ternary phase diagrams to reveal the synergetic effects on leprosy occurrence.

Results: Globally, incident cases of leprosy decreased by 27.86% from 1990 to 2019, with a reduction in ASIR (EAPC = -2.53), yet trends were not homogeneous across regions. ASIR and EAPC correlated positively with sociodemographic index (SDI), and an ASIR growth appeared in high SDI region (EAPC = 3.07). Leprosy burden was chiefly distributed in Tropical Latin America, Oceania, Central Sub-Saharan Africa, and South Asia. Negative correlations were detected between the incidence of leprosy and factors of SDI, GDP per capita, urban population to total population, and precipitation, whereas the number of refugee population, temperature, and elevation showed opposite positive results.

Conclusions: Despite a global decline in leprosy over the past three decades, the disparities of disease occurrence at regional and national scales still persisted. Socioeconomic and physical geographic factors posed an obvious influence on the transmission risk of leprosy. The persistence and regional fluctuations of leprosy incidence necessitate the ongoing dynamic and multilayered control strategies worldwide in combating this ancient disease.

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