Perspectives and challenges of access to early diagnosis of leprosy in Brazilian North and Northeast

Abstract

Leprosy is a neglected tropical disease with a severe impact in Brazil, concentrated in the North and Northeast regions due to social determinants and healthcare voids in Primary Health Care. Given this scenario, this study analyzed the epidemiological profile and temporal trend of the disease in these macro-regions, discussing indicators of late diagnosis and operational quality. An epidemiological, descriptive, and retrospective study was conducted using secondary data from SINAN/DATASUS and IBGE estimates (2015–2025). General Detection Coefficients and proportions of Grade 2 Disability and unevaluated cases were calculated. Results showed 61,488 reported cases in the North and 141,542 in the Northeast. The average General Detection Coefficient classified both areas within the Very High endemicity level (North: 31.4 cases per 100,000 inhab.; Northeast: 22.7 cases per 100,000 inhab.), displaying sharp underreporting during the 2020 pandemic year. The G2D proportion exceeded the 5% control limit in both territories (North: 10.8%; Northeast: 10.3%), validating a pattern of high endemicity for late diagnosis. Additionally, a severe healthcare void was identified in the Northeast, which recorded 10.4% of unevaluated cases, compared to 4.3% in the North. In conclusion, indicators confirm late diagnoses and structural barriers to access in primary care, making it imperative to decentralize services, retain professionals in remote areas, and train local teams.

Key words: Leprosy. Early diagnosis. Healthcare disparities. Primary health care.