MOTA, Janiele Maria Vasconcelos.
Résumé:
Leprosy, an infectious-chronic and stigmatizing disease, is still a public health problem in
Brazil and is considered a neglected disease. In this millennium, after the spread of
polychemotherapy to treat the disease and several international efforts to encourage its
elimination, there was a decrease in the burden of leprosy in the world, however, some countries
persist with a high prevalence. Brazil comprises one of the most endemic countries, deserving
attention of the public managers to elaborate and continuity of programs directed to the
elimination of the disease. In 2016, for this purpose, the guidelines for surveillance and
elimination of leprosy were created by the Ministry of Health, which guided the use of disease
monitoring indicators as a public health problem; and the quality of the services offered. Thus,
the objective was to analyze the progress of the elimination of leprosy as a public health
problem through the indicators of disease monitoring. This is a cross-sectional, retrospective,
descriptive study with a quantitative and documentary approach based on leprosy cases
confirmed and reported in the Information System for Notifiable Diseases from 2001 to 2016
in Brazil. For the description of the investigation, we used the Strengthening the Reporting of
Observational Studies in Epidemiology, and after data collection we performed an analysis of
the indicators of disease monitoring with discussion based on current literature. Among the
results found, endemic parameters showed a tendency to decrease in all regions, except for the
proportion of grade 2 of physical disability among new cases - which is increasing and is higher
in the South and Southeast; decrease in the proportion according to gender, revealing a higher
prevalence in males; and increase in the proportion according to operational classification,
indicating an increase in the percentage of multibacillary cases among the new cases. In
addition, no region reached hyperendemic value, however, only the South registered low
endemia for two of the parameters used. Thus, the reduction of the endemic disease was not
uniform either by the indicator used or by region, and even if there is a tendency to reduce the
endemic disease, it is not possible to predict when it will be considered eliminated. Questions
about the specificity of the indicators have also been raised, and there is no consensus in the
literature on which parameter best defines the endemic, but is often evaluated by the concepts
of prevalence and rate of detection. It is concluded that efforts should be continued to combat
the disease and further studies should be encouraged to evaluate the efficacy and specificity of
each indicator in the elimination of leprosy.
