Disappearance of leprosy from Norway: an exploration of critical factors using an epidemiological modelling approach
Disappearance of leprosy from Norway: an exploration of critical factors using an epidemiological modelling approach
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DOI：
10.1093/ije/31.5.991
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发表时间：
2002-10-01
影响因子：
7.7
通讯作者：
Habbema, JDF
中科院分区：
文献类型：
--
作者：
Meima, A;Irgens, LM;Habbema, JDF
背景到世纪中期，麻风病在挪威已成为一个严重的公共卫生问题。到1920年，新病例很少发生。本研究的目的是解释从挪威的麻风disappearance.Methods从挪威国家麻风病登记处和人口普查的数据消失。患者数据包括出生年份、发病、登记、住院、死亡和移民。挪威的数据进行了分析，使用流行病学模型的疾病传播和control.Results的时间趋势，在挪威的麻风新病例检测可以充分再现。随着时间的推移，新病例检测向年龄较大的转变是由于假设感染者可能有很长的潜伏期。这一下降不能完全用挪威隔离病人的政策来解释：还必须假定传播的自动减少反映了生活条件等方面的改善。隔离政策的估计贡献的下降，在新的病例检测很大程度上取决于假设建立的传染性在潜伏期和减弱的传播机会，由于快速传播到密切contacts.Conclusion隔离中断传播的影响仍然不确定。这种不确定性也适用于主要依赖化疗治疗的当代麻风病控制。需要进一步研究以确定麻风病干预措施对传播的影响。
Background By the middle of the 19th century, leprosy was a serious public health problem in Norway. By 1920, new cases only rarely occurred. This study aims to explain the disappearance of leprosy from Norway.Methods Data from the National Leprosy Registry of Norway and population censuses were used. The patient data include year of birth, onset of disease, registration, hospital admission, death, and emigration. The Norwegian data were analysed using epidemiological models of disease transmission and control.Results The time trend in leprosy new case detection in Norway can be reproduced adequately. The shift in new case detection towards older ages which occurred over time is accounted for by assuming that infected individuals may have a very long incubation period. The decline cannot be explained fully by the Norwegian policy of isolation of patients: an autonomous decrease in transmission, reflecting improvements in for instance living conditions, must also be assumed. The estimated contribution of the isolation policy to the decline in new case detection very much depends on assumptions made on build-up of contagiousness during the incubation period and waning of transmission opportunities due to rapid transmission to close contacts.Conclusion The impact of isolation on interruption of transmission remains uncertain. This uncertainty also applies to contemporary leprosy control that mainly relies on chemotherapy treatment. Further research is needed to establish the impact of leprosy interventions on transmission.