Despite almost 30 years of effective chemotherapy with MDT, the global new case detection rate of leprosy has remained quite constant over the past years.
If this inequality in TB case notification resulted from access to health care, then it may limit the effectiveness of DOTS strategy to attain the global WHO 70% TB case detection rate and 85% treatment success rate aimed at interrupting TB transmission, reducing mortality and preventing emergence of drug resistance [ 5, 31].
In summary, conventional cytogenetic analysis provided a global view but had a lower detection rate and longer turnaround time than other methods.
Although there is a declining trend in the global burden of leprosy, there are 15 countries in Asia and Africa which account for 94% of the global total of the new-case detection rate.
Of note, linear regression of the 2 global expression covariates (see methods) and detection rate metrics (one reflecting all 24,357 transcripts probed by the Illumina HumanRefseq-8 chip and the other reflecting the 14,078 transcripts detected in this brain sample) all showed strong correlation (r2 in excess of 0.5 for all 6 comparisons).
Universal achievement of the global WHO target of 70% case detection rate across different geographical settings with diversity in socio-economic condition will continue to be a challenge.
In 2003 the global TB case-detection rate was only 45%, falling short of the global target of 75% [ 3].
In 2012, the African Region had the lowest average case detection rate for all forms of tuberculosis, at 59%, compared with the global average of 67%.
This campaign has produced a large decline in global prevalence of leprosy over the last 20 years, but despite this, the new case detection rate is still high in many regions [ 1].
Therefore, a global strategy for the development and strengthening of laboratory diagnosis is urgently needed to improve the case detection rate, especially in regions with high prevalence of TB and HIV.
