{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,26]],"date-time":"2026-06-26T17:54:23Z","timestamp":1782496463658,"version":"3.54.5"},"reference-count":5,"publisher":"Public Library of Science (PLoS)","issue":"6","license":[{"start":{"date-parts":[[2026,6,26]],"date-time":"2026-06-26T00:00:00Z","timestamp":1782432000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["www.plosntds.org"],"crossmark-restriction":false},"short-container-title":["PLoS Negl Trop Dis"],"abstract":"\n Background<\/jats:title>\n Leprosy remains an important cause of disability, even in non-endemic settings. Risk of neuropathy and functional impairment differs across the disease spectrum, yet contemporary U.S. data are limited.<\/jats:p>\n <\/jats:sec>\n \n Objective<\/jats:title>\n To compare disability-related outcomes among patients with lepromatous versus tuberculoid leprosy in a large U.S. electronic health record (EHR) network.<\/jats:p>\n <\/jats:sec>\n \n Methods<\/jats:title>\n Using the TriNetX U.S. Collaborative Research Network (2005\u20132025), patients with lepromatous (ICD-10-CM A30.4-A30.5) and tuberculoid (A30.1-A30.2) leprosy were identified. Disability-related outcomes were defined using ICD-10-CM and CPT codes. Patients with prior disability were excluded to assess incident events. Cohorts were propensity score-matched (1:1) on demographics and comorbidities. Odds ratios (OR) and hazard ratios (HR) with 95% confidence intervals (CI) were calculated.<\/jats:p>\n <\/jats:sec>\n \n Results<\/jats:title>\n A total of 341 lepromatous and 129 tuberculoid patients were identified (median follow-up 1,138 vs 1,021 days). Lepromatous leprosy was associated with higher risk of incident disability-related outcomes (OR 1.89, 95% CI 1.16-3.07). Kaplan-Meier analysis demonstrated lower outcome-free survival in the lepromatous cohort (HR 1.76, 95% CI 1.15-2.71).<\/jats:p>\n <\/jats:sec>\n \n Conclusions<\/jats:title>\n In this U.S.-based cohort, lepromatous leprosy was associated with greater disability-related morbidity compared to tuberculoid leprosy. However, meaningful risk was observed across both subtypes, supporting structured longitudinal follow-up for all patients.<\/jats:p>\n <\/jats:sec>","DOI":"10.1371\/journal.pntd.0014385","type":"journal-article","created":{"date-parts":[[2026,6,26]],"date-time":"2026-06-26T17:35:04Z","timestamp":1782495304000},"page":"e0014385","update-policy":"https:\/\/doi.org\/10.1371\/journal.pntd.corrections_policy","source":"Crossref","is-referenced-by-count":0,"title":["Long-term disability outcomes in Hansen\u2019s disease: A 20-year comparative study of Lepromatous vs. Tuberculoid Leprosy"],"prefix":"10.1371","volume":"20","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-1312-9930","authenticated-orcid":true,"given":"Elaine J.","family":"Ma","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Brandon L.","family":"Adler","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"April W.","family":"Armstrong","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Maria T.","family":"Ochoa","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"340","published-online":{"date-parts":[[2026,6,26]]},"reference":[{"key":"pntd.0014385.ref001","author":"Health Resources and Services Administration (HRSA)","year":"1894"},{"issue":"1","key":"pntd.0014385.ref002","doi-asserted-by":"crossref","first-page":"10374","DOI":"10.1038\/s41598-024-60457-0","article-title":"Neurological features of Hansen disease: a retrospective, multicenter cohort study","volume":"14","author":"X Chen","year":"2024","journal-title":"Sci Rep"},{"issue":"10","key":"pntd.0014385.ref003","doi-asserted-by":"crossref","first-page":"1120","DOI":"10.1001\/jamadermatol.2019.1768","article-title":"Risk Factors for Physical Disability in Patients With Leprosy: A Systematic Review and Meta-analysis","volume":"155","author":"HL de Paula","year":"2019","journal-title":"JAMA Dermatol"},{"issue":"11","key":"pntd.0014385.ref004","doi-asserted-by":"crossref","first-page":"1383","DOI":"10.1111\/j.1365-4632.2011.04935.x","article-title":"A delayed diagnosis of lepromatous leprosy: pitfalls and clues to early recognition","volume":"50","author":"N Kerkeni","year":"2011","journal-title":"Int J Dermatol"},{"issue":"26","key":"pntd.0014385.ref005","doi-asserted-by":"crossref","first-page":"2485","DOI":"10.1056\/NEJMc2302317","article-title":"Autochthonous leprosy in the United States","volume":"388","author":"A Belzer","year":"2023","journal-title":"N Engl J Med"}],"container-title":["PLOS Neglected Tropical Diseases"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/dx.plos.org\/10.1371\/journal.pntd.0014385","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,6,26]],"date-time":"2026-06-26T17:35:05Z","timestamp":1782495305000},"score":1,"resource":{"primary":{"URL":"https:\/\/dx.plos.org\/10.1371\/journal.pntd.0014385"}},"subtitle":[],"editor":[{"given":"Anil","family":"Fastenau","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"editor"}]}],"short-title":[],"issued":{"date-parts":[[2026,6,26]]},"references-count":5,"journal-issue":{"issue":"6","published-online":{"date-parts":[[2026,6,26]]}},"URL":"https:\/\/doi.org\/10.1371\/journal.pntd.0014385","relation":{},"ISSN":["1935-2735"],"issn-type":[{"value":"1935-2735","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,6,26]]}}}