Leprosy is a tropical bacterial disease whose progression is related to difficulty in accessing health services, a latent condition in northeastern Brazil. Early diagnosis can be established by direct bacilloscopy for acid-fast bacilli, with high specificity. Early detection is essential to enable timely treatment and prevent complications; however, accessibility in the Northeast was hindered by the public health emergency during the COVID-19 pandemic. This study aimed to evaluate the impact of the COVID-19 pandemic on the epidemiological situation of leprosy in northeastern Brazilian states. This is a cross-sectional, retrospective, quantitative study based on secondary data from the Notifiable Diseases Information System, tabulated through DATASUS/TABNET. The analyzed data correspond to the number of confirmed leprosy cases and the number of bacilloscopy procedures performed between 2018 and 2023 in northeastern states. A total of 73,716 leprosy cases were recorded in northeastern Brazil between 2018 and 2023. There was a 32% reduction in cases between the 2018–2019 biennium (n=30,171) and 2020–2021 (n=20,509), followed by a 12.3% increase in the 2022–2023 biennium (n=23,036). During the period, Maranhão (26.5%; n=19,544), Pernambuco (21.3%; n=15,714), Bahia (18.3%; n=13,493), and Ceará (13.6%; n=10,031) accounted for most cases. All states showed a decrease in reported cases between 2019 and 2020 (except Rio Grande do Norte, which showed a 3.2% increase) and an increase in 2021. All states recorded fewer cases in the post-pandemic biennium (2022–2023) compared to the pre-pandemic period (2018–2019). Regarding diagnostic methods, bacilloscopy was the most frequently used during the period analyzed (n=290,278) and showed a 22% reduction in the 2020–2021 biennium compared to the previous one, remaining below pre-pandemic levels in the post-pandemic period. The marked reduction in confirmed leprosy cases and bacilloscopy procedures in northeastern states suggests diagnostic failure in the health system during the pandemic. Health policy reformulation and further studies are recommended to assess whether the persistent reduction in detected cases and performed bacilloscopies is associated with chronic underreporting since the pandemic period.
Santos et al. (Sun,) studied this question.