The COVID-19 pandemic drastically impacted various health services globally, and leprosy care in Brazil was no exception. A recent study has found that the pandemic significantly disrupted the detection rate of leprosy cases from 2017 to 2022, underscoring the ongoing challenges in combating this age-old disease.
Leprosy, caused by the bacteria Mycobacterium leprae, affects the skin, nerves, and mucous membranes, and can lead to severe disabilities if left untreated. Despite advances with multidrug therapy (MDT), Brazil currently ranks second globally in reported leprosy cases, with a troubling incidence among children. In 2023 alone, 22,773 new cases were confirmed in the country, with 958 occurring in individuals under 15 years of age.
The study utilized data from the Brazilian notification system, known as Sinan, analyzing leprosy case detection rates before and after the COVID-19 public health emergency was declared in February 2020. Researchers implemented interrupted time series analysis, revealing significant drops in case detection rates with a subsequent slow recovery.
Before the pandemic, Brazil had an average detection of 2,321 leprosy cases per month, translating to 1.1 cases per 100,000 individuals. However, after COVID-19 hit, detection plummeted to 1,520 monthly cases (0.7 per 100,000). The immediate effect caused a 0.55 reduction in the detection rate (95% CI 0.48–0.62), though a gradual monthly increase of 1.01 (95% CI 1.00–1.02) was noted post-pandemic.
For children under the age of 15, the impact was similarly pronounced, with a 0.48 reduction (95% CI 0.40–0.57) seen initially, compared to just 66 monthly cases (0.2 cases per 100,000) detected after the pandemic began. Nonetheless, a subsequent monthly rise of 1.01 (95% CI 1.01–1.02) was observed.
This decline in leprosy detection is particularly concerning, flagging the urgency for targeted strategies to mitigate delayed diagnoses. The pandemic led to the hindrance of routine health services, leaving the healthcare system to struggle with the dual challenge of combating COVID-19 while managing other communicable diseases like leprosy.
Brazil’s response to this pressing issue includes initiatives like the Healthy Brazil Program (Brasil Saudável). Launched in February 2024, this program aims to eradicate socially determined diseases, including leprosy, as public health emergencies. By improving access to health services and enhancing disease control efforts, the program hopes to reverse the trend of declining leprosy detection rates.
Despite increasing awareness of leprosy, the lingering consequences of the pandemic emphasize the need for a revitalization of healthcare practices. The study's results highlight not only the immediate impact of the pandemic but also the critical importance of early detection and treatment for effectively managing leprosy and preventing long-term disabilities in affected populations.
In summary, while Brazil has seen a slow resurgence in case detection post-COVID, the risk of an increased leprosy burden remains high, particularly among vulnerable populations. Continued efforts to strengthen public health systems and promote proactive leprosy screening are essential to prevent further deterioration of the situation. The importance of resolving the impact of the pandemic on neglected tropical diseases like leprosy cannot be overstated; only through targeted interventions can we ensure that those affected receive timely care and support.
