title: Hansen disease among Micronesian and Marshallese persons living in the United States.
abstract: An increasing proportion of Hansen disease cases in the United States occurs among migrants from the Micronesian region, where leprosy prevalence is high. We abstracted surveillance and clinical records of the National Hansen's Disease Program to determine geographic, demographic, and clinical patterns. Since 2004, 13% of US cases have occurred in this migrant population. Although Hawaii reported the most cases, reports have increased in the central and southern states. Multibacillary disease in men predominates on the US mainland. Of 49 patients for whom clinical data were available, 37 (75%) had leprosy reaction, neuropathy, or other complications; 17 (37%) of 46 completed treatment. Comparison of data from the US mainland with Hawaii and country-of-origin suggests under-detection of cases in pediatric and female patients and with paucibacillary disease in the United States. Increased case finding and management, and avoidance of leprosy-labeled stigma, is needed for this population.
authors.affiliation: Tulane University, New Orleans, Lousiana, USA.
authors.forename: Patricia
authors.initials: P
authors.lastname: Woodall
authors.forename: David
authors.initials: D
authors.lastname: Scollard
authors.forename: Latha
authors.initials: L
authors.lastname: Rajan
mesh_terms: D000293:Adolescent; D000328:Adult; D002648:Child; D002675:Child, Preschool; D003710:Demography; D005260:Female; D006254:Hawaii / Q000453:epidemiology; D006801:Humans; D007917:Leprostatic Agents / Q000008:administration & dosage / Q000627:therapeutic use*; D007918:Leprosy / Q000175:diagnosis / Q000188:drug therapy / Q000208:ethnology* / Q000382:microbiology / Q000473:pathology; D008137:Longitudinal Studies; D008297:Male; D008849:Micronesia / Q000208:ethnology; D009166:Mycobacterium leprae / Q000187:drug effects / Q000502:physiology*; D015995:Prevalence; D014171:Transients and Migrants / Q000706:statistics & numerical data; D014481:United States / Q000453:epidemiology
chemical_list: D007917:Leprostatic Agents