{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,23]],"date-time":"2026-10-23T20:51:07Z","timestamp":1792788667863,"version":"4.5.0"},"reference-count":19,"publisher":"Public Library of Science (PLoS)","issue":"10","license":[{"start":{"date-parts":[[2022,10,11]],"date-time":"2022-10-11T00:00:00Z","timestamp":1665446400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"name":"Health Commission of Yunnan Province","award":["2017NS098"],"award-info":[{"award-number":["2017NS098"]}]}],"content-domain":{"domain":["www.plosntds.org"],"crossmark-restriction":false},"short-container-title":["PLoS Negl Trop Dis"],"abstract":"<jats:sec id=\"sec001\">\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Physical disability is the main complication of leprosy. Although understanding the leprosy rate, prevalence, spatiotemporal distribution, and physical nerve characteristic trends is crucial for the implementation of leprosy control programs and identification of remaining challenges, these data are still unclear. We assessed physical disability trends among newly detected leprosy cases over the past 31 years in 129 counties and territories in Yunnan, China.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"sec002\">\n                    <jats:title>Methodology\/Principal findings<\/jats:title>\n                    <jats:p>We analyzed the data of newly detected leprosy cases from the Leprosy Management Information System in Yunnan, China, from 1990\u20132020. All available data related to physical disability were analyzed, including demographic characteristics (sex, age, ethnicity, education level); clinical characteristics (diagnosis duration, detection mode, contact history, leprosy reaction, skin lesions, nerve lesions, disability classification); World Health Organization (WHO) leprosy physical disability indicators; and nerve and eyes, hands and feet (EHF) involvement. A total of 10758 newly diagnosed leprosy cases were identified, and 7328 (65.60%), 1179 (10.55%) and 2251 (20.15%) were associated with grade 0, 1, and 2 disability (G0D, G1D, and G2D), respectively. Male sex, older age, Han ethnicity, urban employment, a longer diagnosis duration, a contact history, greater nerve involvement, and tuberculoid-related forms of leprosy were associated with increased prevalence rates of physical disability. The rates of physical disability in newly detected leprosy cases per 1 million population decreased from 5.41, 2.83, and 8.24 in 1990 to 0.29, 0.25, and 0.54 per 1 million population in 2020, with decreases of 94.64%, 91.17%, and 93.44% in G2D, G1D and total physical disability (G1D + G2D) rates, respectively. In the same period, the proportions of G2D, G1D and total physical disability decreased from 28.02%, 14.65%, and 42.67% in 1990 to 10.08%, 11.76%, and 21.85% in 2020, with decreases of 64.03%, 19.73%, and 48.79%, respectively. Nerve thickening was more common than nerve tenderness, and claw hand, plantar insensitivity, and lagophthalmos were the most frequently reported EHF-related disabilities.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"sec003\">\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Despite general progress in reducing the prevalence of leprosy-related physical disability, the proportion of physical disability among leprosy disease remains high, especially in specific counties. This implies that leprosy cases are being detected at a later stage and that transmission in the community still exists. Further efforts focusing on early detection are crucial for leprosy control and the elimination of the disease burden.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1371\/journal.pntd.0010719","type":"journal-article","created":{"date-parts":[[2022,10,11]],"date-time":"2022-10-11T13:22:24Z","timestamp":1665494544000},"page":"e0010719","update-policy":"https:\/\/doi.org\/10.1371\/journal.pntd.corrections_policy","source":"Crossref","is-referenced-by-count":12,"title":["The burden of physical disability among patients with newly detected leprosy in Yunnan, China, 1990\u20132020: A population-based, cross-sectional survey"],"prefix":"10.1371","volume":"16","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-5722-705X","authenticated-orcid":true,"given":"Xiaohua","family":"Chen","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2224-0545","authenticated-orcid":true,"given":"Tie-Jun","family":"Shui","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"340","published-online":{"date-parts":[[2022,10,11]]},"reference":[{"key":"pntd.0010719.ref001","doi-asserted-by":"crossref","first-page":"80","DOI":"10.1128\/CMR.00079-13","article-title":"Leprosy in the 21st century","volume":"28","author":"C White","year":"2015","journal-title":"Clin Microbiol Rev"},{"key":"pntd.0010719.ref002","first-page":"417","article-title":"Global leprosy (Hansen disease) update, 2019: time to step-up prevention initiatives","volume":"95","author":"World Health Organization","year":"2020","journal-title":"Wkly Epidemiol Rec"},{"key":"pntd.0010719.ref003","volume-title":"Global leprosy (Hansen\u2019s disease) strategy 2021\u20132030","author":"World Health Organization","year":"2021"},{"key":"pntd.0010719.ref004","volume-title":"Global leprosy strategy 2016\u20132020: accelerating towards a leprosy-free world","author":"World Health Organization","year":"2016"},{"key":"pntd.0010719.ref005","article-title":"National Health and Family Planning Commission of the People\u2019s Republic of China","year":"2018","journal-title":"Diagnosis for leprosy (WS 291\u20132018)"},{"key":"pntd.0010719.ref006","volume-title":"Technical report series 847","author":"World Health Organization","year":"1998"},{"key":"pntd.0010719.ref007","doi-asserted-by":"crossref","first-page":"600","DOI":"10.1590\/0037-8682-0100-2013","article-title":"Clinical variables associated with leprosy reactions and persistence of physical impairment","volume":"46","author":"DT Oliveira","year":"2013","journal-title":"Rev Soc Bras Med Trop"},{"key":"pntd.0010719.ref008","doi-asserted-by":"crossref","first-page":"2769","DOI":"10.3390\/ijerph15122769","article-title":"Analysis of social determinants of health and disability scores in leprosy-affected persons in Salem, Tamil Nadu, India","volume":"15","author":"M Heidinger","year":"2018","journal-title":"Int J Environ Res Public Health"},{"key":"pntd.0010719.ref009","volume-title":"Accelerating towards a leprosy-free world. Monitoring and evaluation guide","author":"World Health Organization","year":"2016"},{"key":"pntd.0010719.ref010","doi-asserted-by":"crossref","first-page":"e0009201","DOI":"10.1371\/journal.pntd.0009201","article-title":"Towards the elimination of leprosy in Yunnan, China: a time-series analysis of surveillance data","volume":"15","author":"TJ Shui","year":"2021","journal-title":"PLoS Negl Trop Dis"},{"key":"pntd.0010719.ref011","doi-asserted-by":"crossref","first-page":"27","DOI":"10.1097\/JD9.0000000000000065","article-title":"Epidemiological characteristics of leprosy in China, 2018","volume":"3","author":"L Wang","year":"2020","journal-title":"Int J Dermatol Venereol"},{"key":"pntd.0010719.ref012","doi-asserted-by":"crossref","first-page":"e20180540","DOI":"10.1590\/0037-8682-0540-2018","article-title":"Physical disabilities due to leprosy in Alagoas State, Northeast Brazil: a temporal and spatial modeling","volume":"52","author":"CDF Souza","year":"2019","journal-title":"Rev Soc Bras Med Trop"},{"key":"pntd.0010719.ref013","first-page":"405","article-title":"Global leprosy update, 2015: time for action, accountability and inclusion","volume":"91","author":"World Health Organization","year":"2016","journal-title":"Wkly Epidemiol Rec"},{"key":"pntd.0010719.ref014","doi-asserted-by":"crossref","first-page":"7812","DOI":"10.1038\/s41598-018-26085-1","article-title":"Coexistence of nerve enlargement and neuratrophy detected by ultrasonography in leprosy patients","volume":"8","author":"X Chen","year":"2018","journal-title":"Sci Rep"},{"key":"pntd.0010719.ref015","doi-asserted-by":"crossref","first-page":"e0009913","DOI":"10.1371\/journal.pntd.0009913","article-title":"Presenting symptoms of leprosy at diagnosis: clinical evidence from a cross-sectional, population-based study","volume":"15","author":"X Chen","year":"2021","journal-title":"PLoS Negl Trop Dis"},{"key":"pntd.0010719.ref016","doi-asserted-by":"crossref","first-page":"993","DOI":"10.1590\/S0104-11692008000600009","article-title":"Physical disabilities resulting from Hansen\u2019s disease in Vale do Jequitinhonha\/state of Minas Gerais, Brazil","volume":"16","author":"FC Lana","year":"2008","journal-title":"Rev Lat Am Enfermagem"},{"key":"pntd.0010719.ref017","first-page":"43","article-title":"The extent of leprosy-related disabilities in Istanbul Leprosy Hospital, Turkey","volume":"68","author":"T Cakiner","year":"1997","journal-title":"Lepr Rev"},{"key":"pntd.0010719.ref018","doi-asserted-by":"crossref","first-page":"e0006645","DOI":"10.1371\/journal.pntd.0006645","article-title":"Grade 2 disabilities in leprosy patients from Brazil: need for follow-up after completion of multidrug therapy","volume":"12","author":"MT Raposo","year":"2018","journal-title":"PLoS Negl Trop Dis"},{"key":"pntd.0010719.ref019","first-page":"421","article-title":"Weekly epidemiological record. Global leprosy (Hansen disease) update, 2020: impact of COVID-19 on the global leprosy control","volume":"96","author":"World Health Organization","year":"2021","journal-title":"Wkly Epidemiol Rec"}],"container-title":["PLOS Neglected Tropical Diseases"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/dx.plos.org\/10.1371\/journal.pntd.0010719","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2022,10,11]],"date-time":"2022-10-11T13:22:45Z","timestamp":1665494565000},"score":1,"resource":{"primary":{"URL":"https:\/\/dx.plos.org\/10.1371\/journal.pntd.0010719"}},"subtitle":[],"editor":[{"given":"Carlos","family":"Franco-Paredes","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"editor"}]}],"short-title":[],"issued":{"date-parts":[[2022,10,11]]},"references-count":19,"journal-issue":{"issue":"10","published-online":{"date-parts":[[2022,10,11]]}},"URL":"https:\/\/doi.org\/10.1371\/journal.pntd.0010719","relation":{},"ISSN":["1935-2735"],"issn-type":[{"value":"1935-2735","type":"electronic"}],"subject":[],"published":{"date-parts":[[2022,10,11]]}}}