[Infectious nature of leprosy, by Juan de Azúa]. / Contagiosidad de la lepra, por Juan de Azúa.

In this article by Juan de Azua, published in the second issue of Actas Dermosifiliográficas in 1909, the author reports his experience in 139 patients, most of them from Hospital San Juan de Dios, Madrid,Spain, and states he is sure that leprosy is a contagious disease. He discusses the factors related to contagion,which occurs in a closed and family environment, emphasizing socioeconomic factors such as hygiene and promiscuity. He considers direct contact to be important, though also recognizing indirect contact through drinks and food; he totally rejects a hereditary mechanism. Epidemiologically, he draws attention to the higher prevalence of the disease in Andalusia, though not forgetting "La Lepra de Ultramar [leprosy from distant lands]"-32 cases in Spaniards in Cuba and the Philippines. He believes isolation in hospitals or special sanatoriums, such as San Juan de Dios or San Lázaro in Santiago, Granada, and Seville, to be the best prophylaxis, and he considers it would be appropriate to create "Hospitals for poor lepers".

Factors contributing to the decline of leprosy in Spain in the second half of the twentieth century.

BACKGROUND: Leprosy is a chronic infectious disease that is considered to be declining, though it still remains prevalent in many parts of the world. A study was made to explore the health and socioeconomic factors that most influenced the trend of the disease in a typical Mediterranean country. MATERIALS AND METHODS: An ecological study was conducted, investigating possible social, economic and health factors related to the evolution of leprosy incidence. The time period considered was 50 years--the second half of the twentieth century in Spain. RESULTS: The variables showing the strongest correlation to evolution of the incidence of the disease were employment, the number of physicians, and the gross domestic product (GDP), with negative coefficients--while tuberculosis showed a positive coefficient. However, the GDP showed the highest coefficient (0.5). The model that best explained the evolution of leprosy over the last 50 years comprised a 6-year lag period between the socioeconomic factors and the incidence of leprosy--explaining 57% of the data obtained. The annual decrease in leprosy incidence was 1.6%. CONCLUSIONS: Socioeconomic development, assessed in terms of the GDP, was the most important factor in explaining the evolution of leprosy incidence.