HTLV Notifications in Palmas, Tocantins: Epidemiological Analysis, Surveillance Weaknesses, and Comparison With the National Scenario

HTLV remains underreported in Brazil, especially outside endemic areas. This study aims to analyze the epidemiological profile of HTLV notifications in Palmas, Tocantins, describing the clinical and sociodemographic characteristics of cases, the detection pattern, and potential weaknesses of the local surveillance system compared to national parameters. Retrospective descriptive study analyzing HTLV notifications (ICD Z22.6) in Palmas, Tocantins, from 2018 to 2024. Variables assessed included sex, age, education, race/color, pregnancy, place of residence, reporting unit, date, and context of diagnosis. Data were extracted from a standardized database and compared with national reports from Brazil’s Ministry of Health. Cases were identified mostly among adults (21 to 62 years), in both sexes, with a slight predominance of males, and were reported by blood banks, private hospitals, and outpatient clinics. The demographic profile differed from the national scenario: a higher proportion of individuals with higher education and a low prevalence of pregnant women or women of reproductive age. Fields such as race/color, education, and pregnancy were frequently ignored or incomplete, limiting risk stratification. Most diagnoses occurred incidentally during blood donation screening, with sporadic records over the years, indicating the absence of an active case-finding routine, especially among pregnant women, differing from Ministry of Health recommendations for endemic areas. There was no evidence of geographic clusters or seasonal increase. Compared with the national scenario, Palmas showed a lower absolute number of notifications, predominance of diagnosis in young adults, underrepresentation of vulnerable groups, and lack of systematic prenatal screening. Notifications originating from private hospitals suggest unequal access to diagnostic investigation. The HTLV epidemiological pattern in Palmas reveals predominantly passive detection dependent on blood donation screening, poor completion of sociodemographic fields, and underreporting among pregnant women, reflecting weaknesses similar to those found elsewhere in Brazil. The capital’s distinct profile may reflect access-related bias, in addition to deficiencies in training and awareness among public-sector healthcare professionals. Strengthening epidemiological surveillance is recommended, including systematic inclusion of pregnant women and vulnerable groups, as well as team training to expand diagnosis and ensure proper completion of notifications.