Leprosy is a chronic infectious disease that affects the skin and peripheral nerves. The multibacillary form, which has higher transmissibility and greater disabling potential compared to the paucibacillary form, has been the most frequent in Brazil, indicating delayed disease detection. Its persistence in the country reflects structural and public health policy failures. This study aimed to analyze the epidemiological profile of leprosy cases in Brazil between 2016 and 2024, focusing on operational classification and its implications for diagnosis in primary health care. An observational, descriptive, retrospective study based on data from the Notifiable Diseases Information System. Leprosy data from Brazil between 2016 and 2024 were collected, classified according to operational form, and sociodemographic variables and clinical aspects were analyzed. During the analyzed period, Brazil reported 275,026 leprosy cases, with predominance of the multibacillary form (223,301; 81.3%) compared to the paucibacillary form (51,427; 18.7%). The multibacillary form was more frequent in men (134,853; 60.4%). Regarding self-declared race/color, most cases occurred among mixed-race individuals (132,443; 59.3%). In terms of education, illiterate individuals and those with incomplete 1st to 4th grade together accounted for 26% (71,349) of all cases. At diagnosis, 96,243 (35%) presented some degree of disability, reflecting the functional risk of the disease. Additionally, 102,240 (45.6%) of multibacillary cases had more than five skin lesions, indicating probable diagnostic delay, while only 48,853 (17.7%) had a single lesion at diagnosis. Regionally, the highest numbers were recorded in the Northeast (87,875; 39.3%). The multibacillary form is the most frequently diagnosed across all age groups in Brazil and represents a marker of detection failure in primary health care, which serves as the entry point to the SUS. Only a small proportion of the population receives clinical confirmation with a single lesion, which may be related to limited knowledge of early leprosy signs among healthcare professionals. Strengthening primary health care is essential to ensure timely identification, recognizing that the disease is closely linked to population vulnerability and remains an important marker of social exclusion.
Ridolfi et al. (Sun,) studied this question.