{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,8]],"date-time":"2026-07-08T19:12:50Z","timestamp":1783537970396,"version":"3.55.0"},"update-to":[{"DOI":"10.1371\/journal.pntd.0014450","type":"new_version","label":"New version","source":"publisher","updated":{"date-parts":[[2026,7,8]],"date-time":"2026-07-08T00:00:00Z","timestamp":1783468800000}}],"reference-count":28,"publisher":"Public Library of Science (PLoS)","issue":"7","license":[{"start":{"date-parts":[[2026,7,2]],"date-time":"2026-07-02T00:00:00Z","timestamp":1782950400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/100000030","name":"Centers for Disease Control and Prevention","doi-asserted-by":"publisher","award":["GH001353-01"],"award-info":[{"award-number":["GH001353-01"]}],"id":[{"id":"10.13039\/100000030","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["www.plosntds.org"],"crossmark-restriction":false},"short-container-title":["PLoS Negl Trop Dis"],"abstract":"<jats:sec id=\"sec001\">\n                    <jats:title>Introduction<\/jats:title>\n                    <jats:p>\n                      Despite sustained elimination efforts, leprosy transmission persists in Uganda. The World Health Organization\u2019s\n                      <jats:italic>Towards Zero Leprosy<\/jats:italic>\n                      strategy targets zero infections and Grade 2 Disability (G2D) by 2030. Uganda\u2019s National TB and Leprosy Strategic Plan aims to reduce child cases to &lt;3% and G2D to &lt;5%. We assessed temporal trends and spatial distribution of leprosy in Uganda from 2020\u20132024 to evaluate progress toward these targets.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"sec002\">\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>We conducted a descriptive analysis using national surveillance data from the District Health Information System 2 (DHIS2). Newly diagnosed leprosy cases reported between 2020 and 2024 were analyzed by age, sex, clinical type, and disability grade. Incidence was calculated using annual mid-year population estimates from the Uganda Bureau of Statistics. Temporal trends were assessed using the Mann\u2013Kendall test and Sen\u2019s slope estimator. Spatial distribution of incidence, child cases, and G2D proportions was examined using QGIS at the regional and district levels.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"sec003\">\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Between 2020 and 2024, Uganda reported 1,935 new leprosy cases, with an overall incidence of 8.8 per 1,000,000 population. Multibacillary disease accounted for 86% of cases, and 21% presented with Grade 2 Disability (G2D). Children aged \u226415 years comprised 14% of cases, consistently exceeding the national elimination target of 3%. No significant monotonic trend was observed in overall incidence (p\u2009=\u20090.89), child proportion (p\u2009=\u20090.069), or G2D proportion (p\u2009=\u20090.14). Spatial analysis demonstrated persistent concentration of high incidence in the West Nile region, with 9 of 13 districts bearing the highest disease burden. Elevated G2D proportions were observed intermittently in the Teso and Ankole regions.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"sec004\">\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>Leprosy incidence in Uganda remained relatively stable from 2020 to 2024; however, persistently high proportions of multibacillary disease, child cases, and G2D indicate ongoing transmission and delayed diagnosis in specific regions. Targeted interventions, including strengthened contact tracing and active case detection in high-burden areas, are essential to accelerate progress toward national elimination goals.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1371\/journal.pntd.0014450","type":"journal-article","created":{"date-parts":[[2026,7,2]],"date-time":"2026-07-02T18:09:36Z","timestamp":1783015776000},"page":"e0014450","update-policy":"https:\/\/doi.org\/10.1371\/journal.pntd.corrections_policy","source":"Crossref","is-referenced-by-count":0,"title":["Temporal and spatial patterns of Leprosy in Uganda, 2020\u20132024: A nationwide surveillance analysis"],"prefix":"10.1371","volume":"20","author":[{"ORCID":"https:\/\/orcid.org\/0009-0007-9072-5783","authenticated-orcid":true,"given":"Gertrude","family":"Abbo","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1709-9521","authenticated-orcid":true,"given":"Richard","family":"Migisha","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Emmanuel","family":"Mfitundinda","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lilian","family":"Bulage","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Geofrey","family":"Amanya","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alex","family":"Mulindwa","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rose","family":"Kengonzi","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Stavia","family":"Turyahabwe","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Henry","family":"Luzze","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Benon","family":"Kwesiga","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3560-1952","authenticated-orcid":true,"given":"Alex Riolexus","family":"Ario","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"340","published-online":{"date-parts":[[2026,7,2]]},"reference":[{"issue":"8","key":"pntd.0014450.ref001","doi-asserted-by":"crossref","first-page":"467","DOI":"10.1080\/20477724.2022.2057722","article-title":"Global epidemiology of leprosy from 2010 to 2020: A systematic review and meta-analysis of the proportion of sex, type, grade 2 deformity and age","volume":"116","author":"J Yang","year":"2022","journal-title":"Pathog Glob Health"},{"issue":"9","key":"pntd.0014450.ref002","doi-asserted-by":"crossref","DOI":"10.1371\/journal.pntd.0009769","article-title":"Measuring endemicity and burden of leprosy across countries and regions: a systematic review and Delphi survey","volume":"15","author":"DO Ogunsumi","year":"2021","journal-title":"PLoS Negl Trop Dis"},{"issue":"7","key":"pntd.0014450.ref003","doi-asserted-by":"crossref","first-page":"100899","DOI":"10.1016\/j.disamonth.2019.100899","article-title":"Epidemiological aspects of leprosy","volume":"66","author":"G Sarode","year":"2020","journal-title":"Dis Mon"},{"key":"pntd.0014450.ref004","unstructured":"Classification of leprosy. Infolep. [cited 2024 May 23]. https:\/\/www.leprosy-information.org\/resource\/classification-leprosy-11"},{"key":"pntd.0014450.ref005","unstructured":"Challenges beyond elimination in leprosy. The International Journal of Mycobacteriology. [cited 2024 Aug 29]. https:\/\/journals.lww.com\/ijmy\/fulltext\/2017\/06030\/challenges_beyond_elimination_in_leprosy.2.aspx"},{"key":"pntd.0014450.ref006","unstructured":"Leprosy. [cited 2024 May 26]. https:\/\/www.who.int\/news-room\/fact-sheets\/detail\/leprosy"},{"key":"pntd.0014450.ref007","unstructured":"Global leprosy (Hansen disease) update, 2021: moving towards interruption of transmission. [cited 2024 May 23]. https:\/\/www.who.int\/publications-detail-redirect\/who-wer9736-429-450"},{"key":"pntd.0014450.ref008","unstructured":"Spatial distribution and temporal trends of leprosy in Uganda, 2012-2016: a retrospective analysis of public health surveillance data. [cited 2024 May 23]. https:\/\/pubmed.ncbi.nlm.nih.gov\/31783799"},{"key":"pntd.0014450.ref009","unstructured":"National Tuberculosis and Leprosy Control Programme Revised National Strategic Plan 2015\/16 - 2019\/20. 2015. http:\/\/library.health.go.ug\/communicable-disease\/tuberculosis\/national-tuberculosis-and-leprosy-control-programme-revised"},{"key":"pntd.0014450.ref010","unstructured":"Ministry of Health Government of Uganda. National strategic plan for tuberculosis and leprosy control 2020\/21 \u2013 2024\/25. [cited 2024 May 23]. https:\/\/www.health.go.ug\/cause\/national-strategic-plan-for-tuberculosis-and-leprosy-control-2020-21-2024-25"},{"key":"pntd.0014450.ref011","unstructured":"Uganda\u2019s Zero Leprosy Action Plan outlines agenda for disease elimination. Global Partnership for Zero Leprosy. [cited 2025 June 12]. https:\/\/zeroleprosy.org\/ugandas-zero-leprosy-action-plan-outlines-agenda-for-disease-elimination"},{"key":"pntd.0014450.ref012","unstructured":"TB MoH report July 2020 to June 2021. Ministry of Health. 2021. https:\/\/library.health.go.ug\/sites\/default\/files\/resources\/TB%20MoH%20report%20July%202020%20to%20June%202021.pdf"},{"key":"pntd.0014450.ref013","unstructured":"GPZL\u2019s Country Model Webinar. Global Partnership for Zero Leprosy. [cited 2025 June 12]. https:\/\/zeroleprosy.org\/country-model-webinar"},{"key":"pntd.0014450.ref014","unstructured":"NTLP Manual 3rd edition. [cited 2025 Apr 3]. https:\/\/health.go.ug\/sites\/default\/files\/NTLP%20Manual%203rd%20edition_17th%20Aug_final.pdf"},{"key":"pntd.0014450.ref015","unstructured":"National population and housing census 2024 final report volume 1 main. [cited 2026 May 28]. https:\/\/www.ubos.org\/wp-content\/uploads\/2024\/12\/National-Population-and-Housing-Census-2024-Final-Report-Volume-1-Main.pdf"},{"key":"pntd.0014450.ref016","article-title":"Policy review of the CAST campaign in Uganda through the narrative lens: why has it worked?","journal-title":"Discover Public Health"},{"key":"pntd.0014450.ref017","unstructured":"The Zero Leprosy Roadmap. Global Partnership for Zero Leprosy. [cited 2025 June 12]. https:\/\/zeroleprosy.org\/the-zero-leprosy-roadmap"},{"key":"pntd.0014450.ref018","unstructured":"Towards zero leprosy. Global leprosy (Hansen\u2019s Disease) strategy 2021\u20132030. [cited 2025 April 3]. https:\/\/www.who.int\/publications\/i\/item\/9789290228509"},{"issue":"9","key":"pntd.0014450.ref019","doi-asserted-by":"crossref","DOI":"10.1371\/journal.pntd.0010756","article-title":"Delayed detection of leprosy cases: a systematic review of healthcare-related factors","volume":"16","author":"Y Dharmawan","year":"2022","journal-title":"PLoS Negl Trop Dis"},{"key":"pntd.0014450.ref020","unstructured":"Trend of pediatric leprosy in an endemic area in Northeast of Brazil, 2008\u20132018. Enfermedades Infecciosas y Microbiolog\u00eda Cl\u00ednica. [cited 2025 July 8]. https:\/\/www.elsevier.es\/en-revista-enfermedades-infecciosas-microbiologia-clinica-28-articulo-trend-pediatric-leprosy-in-an-S0213005X23001829"},{"issue":"2","key":"pntd.0014450.ref021","doi-asserted-by":"crossref","DOI":"10.1371\/journal.pntd.0011092","article-title":"Leprosy among new child cases in China: epidemiological and clinical analysis from 2011 to 2020","volume":"17","author":"J Peng","year":"2023","journal-title":"PLoS Negl Trop Dis"},{"key":"pntd.0014450.ref022","unstructured":"Gender differentials in the social impact of leprosy. [cited 2025 May 5]. https:\/\/pubmed.ncbi.nlm.nih.gov\/8885612"},{"key":"pntd.0014450.ref023","unstructured":"Global report on neglected tropical diseases 2023. World Health Organization. 2023. https:\/\/www.who.int\/publications\/i\/item\/9789240067295"},{"issue":"12","key":"pntd.0014450.ref024","doi-asserted-by":"crossref","first-page":"1456","DOI":"10.1093\/trstmh\/trab084","article-title":"An assessment of the reported impact of the COVID-19 pandemic on leprosy services using an online survey of practitioners in leprosy referral centres","volume":"115","author":"B de Barros","year":"2021","journal-title":"Trans R Soc Trop Med Hyg"},{"issue":"5","key":"pntd.0014450.ref025","doi-asserted-by":"crossref","DOI":"10.1371\/journal.pntd.0009436","article-title":"Mycobacterium leprae transmission characteristics during the declining stages of leprosy incidence: a systematic review","volume":"15","author":"T Hambridge","year":"2021","journal-title":"PLoS Negl Trop Dis"},{"key":"pntd.0014450.ref026","unstructured":"Revised NTLP-strategic plan (2015-2020). 2017. https:\/\/health.go.ug\/sites\/default\/files\/Revised%20NTLP-Stragetic%20Plan%20%282015-2020%29_25th%20Jul2017%20final.pdf"},{"key":"pntd.0014450.ref027","unstructured":"NTLP Manual 3rd Edition. 2023. [cited 2025 June 24]. https:\/\/health.go.ug\/sites\/default\/files\/NTLP%20Manual%203rd%20edition_17th%20Aug_final.pdf"},{"key":"pntd.0014450.ref028","unstructured":"Uganda Ministry of Health launches the National Coordination Committee for Tuberculosis. OMS | Escrit\u00f3rio Regional para a \u00c1frica. 2025. [cited 2025 June 24]. https:\/\/www.afro.who.int\/news\/uganda-ministry-health-launches-national-coordination-committee-tuberculosis"}],"updated-by":[{"DOI":"10.1371\/journal.pntd.0014450","type":"new_version","label":"New version","source":"publisher","updated":{"date-parts":[[2026,7,8]],"date-time":"2026-07-08T00:00:00Z","timestamp":1783468800000}}],"container-title":["PLOS Neglected Tropical Diseases"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/dx.plos.org\/10.1371\/journal.pntd.0014450","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,7,8]],"date-time":"2026-07-08T17:47:17Z","timestamp":1783532837000},"score":1,"resource":{"primary":{"URL":"https:\/\/dx.plos.org\/10.1371\/journal.pntd.0014450"}},"subtitle":[],"editor":[{"given":"Anil","family":"Fastenau","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"editor"}]}],"short-title":[],"issued":{"date-parts":[[2026,7,2]]},"references-count":28,"journal-issue":{"issue":"7","published-online":{"date-parts":[[2026,7,2]]}},"URL":"https:\/\/doi.org\/10.1371\/journal.pntd.0014450","relation":{},"ISSN":["1935-2735"],"issn-type":[{"value":"1935-2735","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,7,2]]}}}