02265nas a2200277   4500000000100000008004100001260001200042653001700054653002100071653002700092653001200119100002400131700001700155700001300172700001300185700001200198700001200210700001700222700001500239245013200254856006700386300000900453490000600462520150500468022001401973       2024                            d  bMDPI AG10aEpidemiology10aSpatial analysis10aPrevention and control10aLeprosy1 aHernandez-Bojorge S1 aGardellini T1 aParikh J1 aRupani N1 aJacob B1 aHoare I1 aCalvopiña M1 aIzurieta R00aEcuador Towards Zero Leprosy: A Twenty-Three-Year Retrospective Epidemiologic and Spatiotemporal Analysis of Leprosy in Ecuador  uhttps://www.mdpi.com/2414-6366/9/10/246/pdf?version=1729492198  a1-180 v93 a<jats:p>Ecuador has gone through a significant reduction in new cases from 2000 (106) to 2023 (12), suggesting a trend towards zero leprosy. An ecological spatiotemporal study design was used to describe the epidemiological distribution of the disease in the country during 2000–2023. Leprosy cases registered by the surveillance system of the Ecuadorian Ministry of Public Health were the data utilized for the study. From January 2000 to December 2023, 1539, incidence cases were diagnosed with leprosy in Ecuador. At the time of diagnosis, the median age was 54 years. Most of the cases were males (71.5%). The proportion of incidence cases in subjects over 50 years was 63% and 1.5% in children ≤ 15 years old. The yearly incidence rate ranged from 8.5/1,000,000 population in 2000 to 0.68/1,000,000 population in 2023, remaining within the low-endemic parameter. In total, 35 cantons reported newly detected leprosy cases in the year 2000. By the end of 2023, only eight cantons actively reported cases of leprosy. High-risk clusters for leprosy were detected in the tropical coastal region of Ecuador. The provinces with the highest number of cases during the study period were Guayas (44.8%) and Los Rios (15.7%), with zero cases being found in the Galapagos Islands. Our study is unique in that it documents a retrospective dataset over a two-decade timespan from a South American country that has effectively applied global guidelines for the control and elimination of leprosy.</jats:p>  a2414-6366