Leprosy disease burden, active transmission and late presentation at the lowest administrative level in Nigeria: A spatial approach

Background: Leprosy is one of the neglected tropical diseases on the global watch of the WHO, with a commitment to globally eliminate the disease by 2020. This study utilises spatial analytics to identify areas of high leprosy burden, active transmission and delayed presentation at the lowest administrative level in Nigeria.
Methods: The study is an ecological study of secondary data of newly diagnosed leprosy cases reported to the Nigerian National TB and Leprosy Control Programme in 2016. The 774 LGAs were used as the unit of geographical analysis. The global Moran’s I and Local Moran’s I (LISA) test were used to measure spatial autocorrelation for annual leprosy case detection, childhood case detection and Grade 2 disability.
Results: A total of 2835 new leprosy cases were notified in 2016. Majorities were male (60·5%) and multi-bacillary 2026 (71·5%). A total of 200 (7·1%) were children aged 0–14 years and 286 (10·1%) had Grade 2 disability. The leprosy case detection rate for 2016 was 1·7 per 100,000 population, while the annual case detection rate in children 0–14 years was 0·12 per 100,000 population; the Grade 2 disability rate was 0·17 per 100,000. Significant clustering was observed for annual leprosy case detection, recent transmission and for delayed presentation.
Conclusion: A significant clustering of leprosy case detection, active transmission and delayed diagnosis was observed in the country. The identification of these hot spot LGAs will provide valuable information to programme managers in the implementation of targeted activities for the elimination of the disease in Nigeria.