01796nas a2200373   4500000000100000008004100001260000900042653001100051653001600062653001200078653001100090653002600101653002600127653002600153653002600179653002600205653002600231653002100257653002200278653001100300653001000311653001200321653002400333653001700357653001700374653001700391100001500408700001500423245006800438300001000506490000700516520088500523022001401408       1984                            d  c198410aAfrica10aBCG Vaccine10aClimate10aEurope10aHistory, 15th Century10aHistory, 16th Century10aHistory, 17th Century10aHistory, 18th Century10aHistory, 19th Century10aHistory, 20th Century10aHistory, Ancient10aHistory, Medieval10aHumans10aKenya10aleprosy10aModels, Theoretical10aRural Health10aTuberculosis10aUrbanization1 aHunter J M1 aThomas M O00aHypothesis of leprosy, tuberculosis and urbanization in Africa.  a27-570 v193 a<p>Leprosy today is a problem of global magnitude affecting possibly up to 15 million people. Its rise and fall in medieval Europe is an historically fascinating enigma. Partial cross-immunization by epidemic tuberculosis, reinforced by the growth of cities, has been proposed as a mechanism in leprosy's European disappearance, but evidence is lacking. In the case of Africa in recent decades, analysis of leprosy and tuberculosis rates, and of levels of urbanization, albeit with imperfect data, suggests a possible environmental health for leprosy, the existence of some cross-interference between tuberculosis and the milder, paucibacillary form of leprosy, and a negative correlation between leprosy and urbanization. It is argued that the rise of the city in Africa, acting through a combination of influences, including tuberculosis, is leading to a decline of leprosy.</p>  a0277-9536