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The
Hansen’s
disease
surveillance
form
provides
for
initial
classification
of
the
disease
into
one
of
six
categories
which
correspond
to
the
universal
ICD-9-CM
diagnosis
codes
for
leprosy
(030.0-030.3,
030.8,
and
030.9).
This
method
of
reporting
classification
is
completed
more
consistently
than
other
disease
classification
methods
on
the
Leprosy
Surveillance
Form
in
the
U.S.
The
diagnosis
code
distribution
of
classifications
registered
in
2005
is
shown
in
Table
4a.
The
majority
(131/166,
79%)
of
U.S.
cases
are
coded
as
either
030.0
or
030.1
and
correspond
to
either
lepromatous
(59%)
or
tuberculoid
(20%)
respectively.
Comparing
these
percentages
to
the
ten
year
trend
of
reported
codes
(Table
4b)
shows
no
significant
variation,
and
these
2005
reports
are
in
keeping
with
earlier
observations.
Most
leprologists
prefer
the
Ridley-Jopling
classification
system,
which
includes
both
the
lepromatous
and
tuberculoid
ends
of
the
spectrum
as
well
as
the
associated
borderline-
lepromatous,
borderline-tuberculoid
and
an
indeterminate
classification.
Unfortunately,
Ridley-Jopling
classification
data
is
frequently
omitted
from
the
surveillance
form.
Some
clinicians
may
not
know
the
disease
classification
when
they
report
the
case
and
others
may
be
unaware
of
this
classification
system.
The
reported
Ridley-Jopling
classifications
in
2005,
and
their
ten
year
trends,
are
shown
in
Tables
5a
and
5b
respectively.
Consistent
with
the
diagnosis
code
data
the
majority
(51/105)
of
U.S.
cases
are
classified
a
lepromatous.
The
WHO
assess
cases
only
as
‘Multibacillary’
or
‘Paucibacillary’.
A
category
of
Multibacillary
cases
can
be
created
by
combining
the
Borderline
and
Lepromatous
classes
from
the
ICM-9
codes.
Likewise,
Paucibacillary
cases
can
be
identified
by
grouping
the
remaining
categories.
For
2005,
112
(67.4%)
of
the
reported
cases
are
grouped
as
Multibacillary
and
50
(30.4%)
as
Paucibacillary
according
to
this
classification
scheme
(Tables
6a).
These
data
are
in
keeping
with
the
ten
year
trend
of
reporting
as
summarized
in
Table
6b,
and
illustrated
graphically
for
2005
in
Figure
7
and
for
the
preceding
10
year
period
in
Figure
8.
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