03450nas a2200313   4500000000100000008004100001260004400042653003100086653001700117653001900134100001500153700002100168700001300189700001700202700001900219700001400238700001200252700001200264700002000276700001200296700002500308700001600333245011300349856007300462300000800535490000600543520257300549022001403122       2025                            d  bSpringer Science and Business Media LLC10aMycobacterium lepraemurium10aEpidemiology10aTrend analysis1 aFastenau A1 aVan Heesewijk NS1 aWillis M1 aSaunderson P1 aSchlumberger F1 aMurtaza A1 aIqbal M1 aSalam A1 aUnterkircher SC1 aTreml E1 aOrtuño-Gutiérrez N1 aHambridge T00aTracing leprosy trends in Pakistan: a two-decade analysis of geographic and demographic shifts (2001–2023)  uhttps://link.springer.com/content/pdf/10.1186/s44263-025-00228-9.pdf  a1-90 v33 a<p><strong>Background</strong></p>

<p>Leprosy, or Hansen’s disease, is caused by Mycobacterium leprae and can lead to severe disabilities, social marginalisation and reduced quality of life. The disease remains a public health challenge in many low- and middle-income countries, including Pakistan. This study aimed to examine trends in leprosy cases diagnosed in Pakistan from 2001 to 2023, focusing on key epidemiological indicators such as sex, leprosy subtype, age, child cases, disability proportion and geographic distribution to reveal insights into the current situation and to inform strategies for improving case detection.</p>

<p><strong>Methods</strong></p>

<p>This retrospective study analysed data from the Marie Adelaide Leprosy Centre (MALC), which operates 205 treatment centres across Pakistan. Leprosy cases diagnosed between 2001 and 2023 were examined for sociodemographic and clinical characteristics, including sex, age, and leprosy subtype. Descriptive statistics were presented for leprosy cases diagnosed during this period, and maps were created to illustrate geographic trends and distributions in leprosy incidence over four 5-year intervals between 2003 and 2022.</p>

<p><strong>Results</strong></p>

<p>A total of 10,573 new leprosy cases were recorded with a median age of 36&nbsp;years. Most cases (79.3%) were multibacillary (MB) leprosy. Until 2013, the majority of patients were male, but the proportion of female cases has steadily increased since then, rising from 40.4% in 2021 to 50.0% in 2023. The highest incidence was observed in Karachi, Sindh, and northern regions, including Khyber Pakhtunkhwa and Gilgit-Baltistan. The overall incidence of new cases declined steadily from 971 in 2001 to 236 in 2023. A decline in child cases and grade 2 disability proportions was also observed. Over the study period, 852 cases (8.1%) occurred in children under 15&nbsp;years of age, while in 2023 specifically, 7.6% of new cases were in children and 17.4% presented with grade 2 disability, both key indicators for monitoring leprosy epidemiology. However, a substantial increase in the MB proportion was observed in 2023.</p>

<p><strong>Conclusions</strong></p>

<p>These findings indicate significant progress in leprosy control in Pakistan, but also highlight persistent transmission in specific regions. Targeted interventions in high-burden areas, along with sustained community-based case-finding and early diagnosis efforts, are essential for continued progress toward leprosy elimination in Pakistan.</p>
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