{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,6]],"date-time":"2026-10-06T17:54:25Z","timestamp":1791309265417,"version":"4.3.1"},"reference-count":20,"publisher":"American Society of Tropical Medicine and Hygiene","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2026,10,6]]},"abstract":"<jats:title>ABSTRACT.<\/jats:title>\n                  <jats:p>\n                    Leprosy, also known as Hansen\u2019s disease, is a chronic infection caused by\n                    <jats:italic>Mycobacterium leprae<\/jats:italic>\n                    or\n                    <jats:italic>Mycobacterium lepromatosis<\/jats:italic>\n                    . Although global prevalence has decreased, the number of cases each year has plateaued at \u223c200,000. In the United States, sporadic cases continue to occur, primarily in the southern states. A retrospective cohort study was conducted from 1992 to 2024 using the TriNetX Research Network (Cambridge, MA, USA), an international electronic health record network, to characterize the clinical features of leprosy and identify factors predicting hospitalization among individuals diagnosed with the disease. Of 215 patients, 30 (14%) required hospitalization. These hospitalized patients were generally older and had other health conditions. Stepwise logistic regression was used to identify a higher absolute neutrophil count and a higher Charlson Comorbidity Index value as predictors of hospitalization. Most patients were from the United States, and the slight majority of cases were clustered in the southern states. These results provide one of the largest recent descriptions of leprosy, highlighting how leprosy reactions and other health issues may influence outcomes, including hospitalization, and emphasizing the importance of ongoing surveillance of leprosy in the southern United States and other regions.\n                  <\/jats:p>","DOI":"10.4269\/ajtmh.26-0065","type":"journal-article","created":{"date-parts":[[2026,10,6]],"date-time":"2026-10-06T17:38:23Z","timestamp":1791308303000},"source":"Crossref","is-referenced-by-count":0,"title":["Clinical Characteristics and Predictors of Hospitalization of Leprosy in the United States: A Multicenter Network Analysis"],"prefix":"10.4269","author":[{"given":"Samantha","family":"Kaplan","sequence":"first","affiliation":[{"name":"Department of Medicine, Division of Infectious Diseases, University of Colorado Denver, Aurora, Colorado, USA;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Oscar","family":"Bernat","sequence":"additional","affiliation":[{"name":"Department of Medicine, Division of Infectious Diseases, University of Colorado School of Medicine, Aurora, Colorado, USA;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Christian","family":"Olivo-Freites","sequence":"additional","affiliation":[{"name":"Ryan Health, Infectious Diseases, New York, New York, USA;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nelson I.","family":"Agudelo Higuita","sequence":"additional","affiliation":[{"name":"University of Oklahoma Health Campus, Oklahoma City, Oklahoma, USA;"},{"name":"Instituto de Enfermedades Infecciosas y de Parasitolog\u00eda Antonio Vidal, Tegucigalpa, Honduras;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Luis A.","family":"Marcos","sequence":"additional","affiliation":[{"name":"Division of Infectious Diseases, Departments of Medicine, Microbiology and Immunology, Stony Brook University, New York, New York, USA;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Edgar A.","family":"Ram\u00edrez-Garc\u00eda","sequence":"additional","affiliation":[{"name":"Universidad Nacional de la Amazon\u00eda Peruana, Iquitos, Peru;"},{"name":"Department of Infectious and Tropical Diseases, Hospital Regional de Loreto \u201cFelipe Santiago Arriola Iglesias\u201d, Iquitos, Peru;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Martin","family":"Casapia","sequence":"additional","affiliation":[{"name":"Research Department, Asociacion Civil Selva Amazonica, Iquitos, Peru;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Daniel B.","family":"Chastain","sequence":"additional","affiliation":[{"name":"Department of Clinical and Administrative Pharmacy, University of Georgia College of Pharmacy, Augusta, Georgia, USA;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Norman","family":"Beatty","sequence":"additional","affiliation":[{"name":"Division of Infectious Diseases and Global Medicine, University of Florida College of Medicine, Gainesville, Florida, USA;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Amir M.","family":"Mohareb","sequence":"additional","affiliation":[{"name":"Division of Infectious Diseases, Massachusetts General Hospital and Harvard Medical School, Boston, Massachusetts, USA;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Andr\u00e9s F.","family":"Henao-Mart\u00ednez","sequence":"additional","affiliation":[{"name":"Department of Medicine, Division of Infectious Diseases, University of Colorado Denver, Aurora, Colorado, USA;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Charlotte","family":"Avanzi","sequence":"additional","affiliation":[{"name":"Department of Microbiology, Immunology, and Pathology, Colorado State University, Fort Collins, Colorado, USA;"},{"name":"Institute of Evolutionary Medicine, One Health Microbial Evolution Laboratory University of Zurich, Zurich, Switzerland;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"John S.","family":"Spencer","sequence":"additional","affiliation":[{"name":"Department of Microbiology, Immunology, and Pathology, Colorado State University, Fort Collins, Colorado, USA;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Carlos","family":"Franco-Paredes","sequence":"additional","affiliation":[{"name":"Hospital Infantil de M\u00e9xico, Federico G\u00f3mez, Mexico City, Mexico;"},{"name":"Department of Microbiology, Immunology, and Pathology, Colorado State University, Fort Collins, Colorado, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"2795","reference":[{"key":"b1","article-title":"Global Leprosy (Hansen Disease) Update, 2022: New Paradigm \u2013 Control to Elimination.","year":"2022"},{"key":"b2","article-title":"Towards Zero Leprosy. Global Leprosy (Hansen\u2019s Disease) Strategy 2021\u20132030.","year":"2021"},{"issue":"19","key":"b3","series-title":"Int J Environ Res Public Health","first-page":"12155","article-title":"Systematic review of survival analysis in leprosy studies-Including the following outcomes: Relapse, impairment of nerve function, reactions and physical disability","volume":"19","author":"Barbosa","year":"2022"},{"issue":"26","key":"b4","series-title":"N Engl J Med","first-page":"2485","article-title":"Autochthonous leprosy in the United States","volume":"388","author":"Belzer","year":"2023"},{"issue":"12","key":"b5","series-title":"Emerg Infect Dis","first-page":"2127","article-title":"Zoonotic leprosy in the Southeastern United States","volume":"21","author":"Sharma","year":"2015"},{"issue":"3","key":"b6","series-title":"Am J Trop Med Hyg","first-page":"452","article-title":"Five-year experience with type 1 and type 2 reactions in Hansen disease at a US travel clinic","volume":"79","author":"Jacob","year":"2008"},{"issue":"2","key":"b7","series-title":"Open Forum Infect Dis","first-page":"ofw063","article-title":"Delayed diagnosis, leprosy reactions, and nerve injury among individuals with Hansen\u2019s disease seen at a United States clinic","volume":"3","author":"Leon","year":"2016"},{"issue":"5","key":"b8","series-title":"An Bras Dermatol","first-page":"654","article-title":"Leprosy in a university hospital in Southern Brazil","volume":"90","author":"de Lima","year":"2015"},{"issue":"5","key":"b9","series-title":"Life","first-page":"586","article-title":"Comorbidities and complications in people admitted for leprosy in Spain, 1997\u20132021","volume":"14","author":"Figueres-Pesudo","year":"2024"},{"issue":"10","key":"b10","series-title":"JAMA Dermatol","first-page":"1120","article-title":"Risk factors for physical disability in patients with leprosy: A systematic review and meta-analysis","volume":"155","author":"de Paula","year":"2019"},{"issue":"7","key":"b11","series-title":"Emerg Infect Dis","first-page":"1437","article-title":"Environmental exposures relative to locally acquired Hansen disease, United States","volume":"31","author":"Chaney","year":"2025"},{"issue":"10","key":"b12","series-title":"PLoS Negl Trop Dis","first-page":"e0007713","article-title":"Trends of leprosy and multibacillary infection in the state of Georgia since the early 1900s","volume":"13","author":"McCormick","year":"2019"},{"key":"b13","series-title":"J Trop Med","first-page":"8652062","article-title":"Leprosy: A review of epidemiology, clinical diagnosis, and management","volume":"2022","author":"Chen","year":"2022"},{"key":"b14","series-title":"Front Immunol","first-page":"1368460","article-title":"Neutrophilic leukocytosis and erythema nodosum leprosum in leprosy: Insights from a retrospective observational study","volume":"15","author":"Feitosa da Silva Barboza","year":"2024"},{"issue":"2","key":"b15","series-title":"Immunohorizons","first-page":"47","article-title":"Erythema nodosum leprosum neutrophil subset expressing IL-10R1 transmigrates into skin lesions and responds to IL-10","volume":"4","author":"Pacheco","year":"2020"},{"key":"b16","series-title":"Front Immunol","first-page":"1366125","article-title":"Whole blood transcriptomics reveals the enrichment of neutrophil activation pathways during erythema nodosum leprosum reaction","volume":"15","author":"Rosa","year":"2024"},{"issue":"2","key":"b17","series-title":"Heliyon","first-page":"e03369","article-title":"Diagnostic value of neutrophil-to-lymphocyte ratio in patients with leprosy reactions","volume":"6","author":"Gomes","year":"2020"},{"issue":"4","key":"b18","series-title":"J Family Med Prim Care","first-page":"1572","article-title":"Leprosy with comorbidities: A call for strengthening vigilance","volume":"14","author":"Ramasamy","year":"2025"},{"issue":"2","key":"b19","series-title":"Leprosy Rev","first-page":"e2024122","article-title":"Association between psychological comorbidities, leprosy reaction, cortisol and C-reactive protein levels in people on leprosy treatment","volume":"96","author":"Loures","year":"2025"},{"issue":"2","key":"b20","series-title":"Harv Data Sci Rev","article-title":"Data quality in electronic health record research: An approach for validation and quantitative bias analysis for imperfectly ascertained health outcomes via diagnostic codes","volume":"4","author":"Goldstein","year":"2022"}],"container-title":["The American Journal of Tropical Medicine and Hygiene"],"original-title":[],"link":[{"URL":"https:\/\/www.ajtmh.org\/view\/journals\/tpmd\/aop\/article-10.4269-ajtmh.26-0065\/article-10.4269-ajtmh.26-0065.xml","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/www.ajtmh.org\/downloadpdf\/journals\/tpmd\/aop\/article-10.4269-ajtmh.26-0065\/article-10.4269-ajtmh.26-0065.xml","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,10,6]],"date-time":"2026-10-06T17:38:23Z","timestamp":1791308303000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.ajtmh.org\/view\/journals\/tpmd\/aop\/article-10.4269-ajtmh.26-0065\/article-10.4269-ajtmh.26-0065.xml"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,10,6]]},"references-count":20,"URL":"https:\/\/doi.org\/10.4269\/ajtmh.26-0065","relation":{},"ISSN":["0002-9637","1476-1645"],"issn-type":[{"value":"0002-9637","type":"print"},{"value":"1476-1645","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,10,6]]}}}