Physical Disability at Leprosy Diagnosis: A Comparison Between Maranhão and Santa Catarina

Leprosy is a chronic infectious disease caused by Mycobacterium leprae that affects the skin and peripheral nerves and can affect individuals of any age or sex. Despite control strategies, it remains a serious public health problem due to its disabling potential. To compare the distribution of physical disability grades at the time of leprosy diagnosis between the states of Maranhão and Santa Catarina. Ecological, cross-sectional, descriptive study using secondary data from the DATASUS platform. Notification variables related to physical disability grade at diagnosis were analyzed for the period from 2015 to 2024, with a geographic focus on Maranhão and Santa Catarina. Data were organized in Microsoft Excel and analyzed using Jamovi software through the chi-square test of independence, adopting a 5% significance level. Analysis of physical disability assessment at leprosy diagnosis revealed important differences between Maranhão and Santa Catarina. In Maranhão, 58.2% of cases were diagnosed with grade zero disability, 32.1% with grade I, and 9.7% with grade II. In Santa Catarina, the percentages were 47.2% (grade zero), 36.9% (grade I), and 15.8% (grade II). Although Maranhão had a higher number of cases, the proportion of visible disabilities (grade II) was lower. This scenario may be explained by greater professional familiarity with leprosy, favoring early diagnosis, whereas in Santa Catarina, lower prevalence and disease stigma may delay care-seeking. The chi-square test indicated a statistically significant difference between states (p<0.001). Maranhão has achieved better performance in early leprosy detection, with a higher proportion of cases diagnosed before the development of physical disabilities. Conversely, Santa Catarina shows signs of later diagnosis, with a higher frequency of grade II cases, reflecting possible failures in active surveillance, difficulty accessing health services, or lack of adequate professional training. Regional differences highlight the need for locally adapted strategies focused on active case finding, early diagnosis, and disability prevention.