Introduction: Leprosy-associated disability is a critical indicator for delay in leprosy diagnosis, perpetuating the ongoing transmission of infection in the community. Initially categorised as the proportion of grade 2 disability (G2D) amongst new leprosy cases, the global G2D rate per 1,000,000 population was introduced in 2009 by the World Health Organization (WHO) as an alternative metric for documenting the disability indicator. The G2D rate indicator considers only population size and not leprosy endemicity in each region, leading the authors to hypothesise that the two disability indicators may potentially yield conflicting information.
Methodology: The Weekly Epidemiological Records (WER), produced annually by the WHO, detailing the previous years’ leprosy situation were analysed between 2004 and 2022. Data was extracted (and calculated where not recorded) on G2D proportion and G2D rate per 1,000,000 population for each WHO region and the global total.
Results: The WHO regions, Africa and Americas, present contradictory and inconsistent information when comparing the G2D rate and G2D proportion. Both WHO regions show an increasing G2D proportion from 2004 to 2022 whilst simultaneously showing a decreasing G2D rate per 1,000,000 population.
Conclusion: The authors believe that relying on the G2D rate indicator alone is inadequate for assessing the complete burden of leprosy-associated disability. It is imperative to integrate this indicator with other metrics to gain a complete understanding of the actual leprosy-associated disability situation. This approach is essential for guiding the planning and direction of future control efforts.
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