Rising percentage of new female leprosy cases since 2004

Objectives
We determined the male and female ratio of new leprosy cases detected over 15 years, allowing future exploration of inequalities pertaining to biological sex and social aspects of gender, which negatively impact women.

Methods
We extracted sex-disaggregated data from the annual Weekly Epidemiological Record (WER) Global leprosy situation reports, from 2004 to 2020, to determine the temporal pattern of new cases detected, by gender.

Results
Sex disaggregated leprosy data was only consistently reported in WER papers from 2004. The absolute number of female cases detected has remained static over the last 15 years (80,000–90,000 new cases annually). A 56.2% reduction in the number of male cases was observed from 2004–2019, whereas amongst females the reduction was only 37.5%. The difference in gender-specific reduction in case detection was similar in 5 of 6 WHO regions. There is a clear trend of increasing female percent amongst new cases detected from 2004 onwards; 30.8% of all new cases detected in 2004 were female, rising to 38.9% in 2019.

Conclusions
Sex-disaggregated data reporting at the national and international level needs to remain a priority. Further research is needed to understand why the percentage of new female cases detected amongst all new cases is increasing and the role biological factors play in leprosy transmission.