Leprosy is an infectious, neglected, stigmatizing disease that remains prevalent in Brazil. Early diagnosis and continuous treatment are essential to prevent permanent consequences for patients. Transmission occurs mainly in poorly ventilated environments with high population density, requiring prolonged contact with the agent Mycobacterium leprae. During the COVID-19 pandemic, these factors were intensified, while access to health services was impaired. This study provides a comparative analysis of the pandemic’s impacts on key leprosy indicators in Brazil. Descriptive, retrospective epidemiological study using data extracted from DATASUS and IBGE between 2018 and 2024. Incidence rates (cases/100,000 inhabitants), mortality (deaths/10 million), and case fatality (deaths/cases, %) were calculated and grouped into three periods: pre-pandemic (2018–2019), pandemic (2020–2022), and post-pandemic (2023–2024). Percentage variations between periods were evaluated. Data for mortality and case fatality in 2024 were not available at the time of analysis. Mean incidence decreased during the pandemic, from 17.7 to 12.0 cases per 100,000 inhabitants (-32.36%), and increased in the post-pandemic period to 14.0 (17.01%). Mortality decreased by -7.19% between the pre-pandemic and pandemic periods, and by -17.65% between the pandemic and post-pandemic periods. Case fatality increased by 39.47% during the pandemic (from 0.38% to 0.53%), followed by a decrease of -32.08% thereafter. The drop in incidence at the beginning of the pandemic suggests underreporting, possibly related to health service reorganization and reduced care-seeking. Despite increases in subsequent years, levels did not return to pre-pandemic values. The rise in case fatality suggests worsening severity among late-diagnosed cases. These findings reinforce the need to strengthen epidemiological surveillance and access to diagnosis. A limitation of the study is the inability to stratify data by individual or clinical characteristics, restricting more detailed analyses of disease severity determinants.
Batistela et al. (Sun,) studied this question.