02675nas a2200397   4500000000100000008004100001260001300042653001500055653001000070653000900080653002200089653001000111653002100121653002600142653002100168653001100189653001400200653001100214653002000225653001200245653001600257653001500273653003000288653002200318653003000340100001200370700001500382700001700397245010800414856007600522300001000598490000700608050001500615520163300630022001402263       2008                            d  c2008 Feb10aAdolescent10aAdult10aAged10aAged, 80 and over10aChild10aChild, Preschool10aDisability Evaluation10aDisabled Persons10aHumans10aIncidence10aInfant10aInfant, Newborn10aleprosy10aMiddle Aged10aPrevalence10aSeverity of Illness Index10aSurvival Analysis10aWorld Health Organization1 aMeima A1 aVan Veen N1 aRichardus JH00aFuture prevalence of WHO grade 2 impairment in relation to incidence trends in leprosy: an exploration.  uhttp://onlinelibrary.wiley.com/doi/10.1111/j.1365-3156.2007.01996.x/pdf  a241-60 v13  aMEIMA 20083 a<p><b>OBJECTIVES: </b>To explore the relationship between leprosy incidence trends and the future prevalence of World Health Organization (WHO) grade 2 impairment caused by leprosy.</p><p><b>METHODS: </b>Three scenarios were defined to estimate incidences and prevalences of leprosy impairment beyond 2000, assuming 6%, 12% and 18% annual declines in case detection rate respectively, and 6% impairment among new patients. Case detection data from 1985 to 2000 were used for projecting leprosy incidences up to 2020. To estimate future prevalences of WHO grade 2 impairment, the survival of existing and new impaired individuals was calculated.</p><p><b>RESULTS: </b>In the 6% scenario, 410 000 new patients will be detected in 2010 and 250 000 in 2020. The number of people living with WHO grade 2 impairment in these years will be 1.3 and 1.1 million, respectively. The 12% scenario predicts that 210 000 new patients will be detected in 2010 and 70 000 in 2020. The grade 2 prevalences will be 1.2 and 0.9 million, respectively. In the 18% scenario, the incidence will be 110 000 in 2010 and 20 000 in 2020, and the grade 2 prevalences will be 1.1 and 0.8 million, respectively.</p><p><b>CONCLUSIONS: </b>Declines in numbers of people living with grade 2 impairment lag behind trends in leprosy incidence. The prevalence of people with grade 2 decreases much slower than leprosy incidence and case detection in all three scenarios. This implies that a substantial number of people will live with impairment and will need support, training in self-care and other prevention of disability interventions in the next decades.</p>  a1365-3156