The burden of leprosy in Cameroon: fifteen years into the post-elimination era

Cameroon achieved the elimination target of leprosy in 2000, and has maintained this status ever since. However, a number of health districts in the country continue to report significant numbers of leprosy cases. The aim of this study was to assess the burden of leprosy in Cameroon from 2000 to 2014.; We obtained and analysed using the new leprosy burden concept of analysis, leprosy surveillance data collected between 2000 and 2014 from the National Leprosy Control Programme.; Cameroon achieved leprosy elimination in 2000, registering a prevalence rate of 0.94/10,000 population. The prevalence rate dropped further to reach 0.20/10,000 population (78% reduction) in 2014. Similarly, the new case detection rate dropped from 4.88/100,000 population in 2000 to 1.46/100,000 population (85.3% reduction) in 2014. All 10 regions of the country achieved leprosy elimination between 2000 and 2014; however, 10 health districts were still to do so by 2014. The number of high-leprosy-burden regions decreased from 8 in 2000 to 1 in 2014. Seven and two regions were respectively medium and low-burdened at the end of 2014. At the health districts level, 18 remained at the high-leprosy-burdened level in 2014.; The leprosy prevalence and detection rates as well as the overall leprosy burden in Cameroon have dropped significantly between 2000 and 2014. However, a good number of health districts remain high-leprosy-burdened. The National Leprosy Control Programme should focus efforts on these health districts in the next coming years in order to further reduce the burden of leprosy in the country

Trends in the leprosy point prevalence rate and NCDR from 2000–2014.

<p>The point prevalence rate declined from 0.94/10,000 in 2000 to 0.20/10,000 population in 2014 (P<0.001) accounting for a 78% reduction. Similarly the annual NCDR declined from 4.88/100.000 population in 2000 to 1.46/100.000 population in 2014 (P = 0.018) accounting for an 85.3% reduction. However, two peaks in annual NCDR were noticed in 2002 and 2006 with annual NCDR of 9.96/100,000 and 4.29/100,000 population respectively.</p

5-year trend in selected leprosy elimination indicators by region from 2000 to 2014.

<p>5-year trend in selected leprosy elimination indicators by region from 2000 to 2014.</p

Health Districts which remained hyper endemic for leprosy at the end of 2014.

<p>Health Districts which remained hyper endemic for leprosy at the end of 2014.</p

Trends in the leprosy point prevalence rate and NCDR from 2000–2014.

<p>The point prevalence rate declined from 0.94/10,000 in 2000 to 0.20/10,000 population in 2014 (P<0.001) accounting for a 78% reduction. Similarly the annual NCDR declined from 4.88/100.000 population in 2000 to 1.46/100.000 population in 2014 (P = 0.018) accounting for an 85.3% reduction. However, two peaks in annual NCDR were noticed in 2002 and 2006 with annual NCDR of 9.96/100,000 and 4.29/100,000 population respectively.</p

Five-year-interval trend in leprosy burden map of Cameroon by region from 2000 to 2014.

<p>In 2000, 8 out of 10 regions in Cameroon were high-leprosy-burdened and one medium-burdened. By 2005 this number decreased to 6 and then to 5 in 2010, and further to 1 in 2014.</p

Five-year-interval trend in leprosy burden map of Cameroon by health district from 2000 to 2014.

<p>The number of high-leprosy-burdened districts dropped from 68 in 2000 to 18 in 2014. During the same period, the number of medium-burdened districts also witnessed a drop from 31 to 20. The reduction in the number of both high and medium-burdened health districts was gained by low-leprosy-burdened districts that rose from 82 in 2000 to 143 in 2014.</p

Trends in the number of leprosy endemic regions and health districts in Cameroon from 2000 to 2014.

<p>Panel A shows the trend in the number of regions of Cameroon, out of a total of 10 regions, with a point prevalence rate per 10,000 population of more than 1. Panel B shows the trend in the number of HDs of Cameroon, out of a total of 181 HDs, with a point prevalence rate per 10,000 population of more than 1. At the end of 2014, leprosy elimination was achieved in all 10 regions; and is still to be achieved in 10 HDs.</p