Leprosy-Related Disability Among Traced Persons Previously Diagnosed with Leprosy in Togo in the 2010–2024 Period: A National Cross-Sectional Assessment

Leprosy can cause long-term impairments, particularly when diagnosis is delayed or disability prevention and rehabilitation services are insufficient. In Togo, little is known about disability among persons previously treated for leprosy. This study estimated the burden of leprosy-related disability at follow-up among persons diagnosed with leprosy in Togo between 2010 and 2024 and explored associated factors. We conducted a national cross-sectional assessment using retrospective identification of persons diagnosed with leprosy between 1 January 2010, and 31 December 2024. Participants were identified through the confidential national neglected tropical diseases program database and traced through routine health-system channels. After informed consent, participants were interviewed and clinically examined. Disability was graded according to WHO criteria. Logistic regression was used to explore factors associated with disability at follow-up. Of 1197 registered persons, 527 were traced and 522 participated. The median age at diagnosis was 53 years (IQR 39–65), 460 (88.1%) had multibacillary leprosy, and 413 (79.1%) had been detected passively. At follow-up, 314 participants had leprosy-related disability, corresponding to a prevalence of 60.2% (95% CI 55.7–64.3) among traced and participating individuals. Grade 2 disability was present in 286 participants (54.8%, 95% CI 50.4–59.1). Feet were the most frequently affected site, followed by hands and eyes. Disability at follow-up was associated with age, multibacillary disease, treatment interruption, beliefs about illness origin, and use of non-medical providers. This national assessment found a high cumulative burden of leprosy-related disability, particularly grade 2 disability, among traced persons previously diagnosed with leprosy in Togo. As disability at follow-up may reflect impairments present at diagnosis, progression during treatment, or later complications, findings should not be interpreted as incidence of post-treatment disability or causal risk factors. It is necessary to strengthen early case detection, confidential follow-up, self-care, ulcer prevention, rehabilitation referral, and psychosocial support.