Hansenologia Internationalis: leprosy and other infectious diseases

Clinical-epidemiological profile of leprosy cases in the states of the Northeast region of Brazil in the period 2018-2022

Marília Dias Bezerra Santos — 2025-02-25

Introduction: one of the challenges in leprosy control in Brazil is the insufficient recognition of the local epidemiological landscape in the analysis of sociodemographic and clinical profiles. Objective: to analyze the clinical-epidemiological profile of leprosy cases in the states of the Northeast region of Brazil from 2018 to
2022. Methods: this ecological study was conducted using data from the Notifiable Diseases Information System and Resident Population data provided by the Department of Information and Informatics of the Unified Health System.
Reported cases of leprosy in Brazil, the Northeast region, and its states during the 2018-2022 period were selected. Results: the Northeast region accounted for the highest number of cases of the disease. Over 50% of the cases occurred in men, individuals of mixed race, and those aged between 20-59 years. A significant decrease in prevalence was observed in 2020, followed by an increase in subsequent years. The states in the region exhibited similar characteristics. Maranhão had the highest absolute number of cases and prevalence. Conclusion: the findings revealed that the clinical-epidemiological profile of the Northeast region is compatible with other endemic regions, highlighting the need to strengthen epidemiological surveillance and promote educational actions targeting vulnerable populations to improve access to early diagnosis and appropriate treatment.

Epidemiological profile of leprosy in the state of Rio Grande do Sul from 2018 to 2022

Amanda Fortes Cavalcante de Oliveira — 2025-02-25

Introduction: leprosy is an infectious and systemic disease caused by the Mycobacterium leprae, characterized by skin and peripheral nerve lesions. It has a heterogeneous distribution throughout the country, raising questions about the factors that could explain the difference between states. Objective: to analyze leprosy cases in the state of Rio Grande do Sul from 2018 to 2022 to understand the contributing factors to the scenario. Methods: cross-sectional descriptive observational study carried out by collecting data from the Notifiable Diseases Information System. Leprosy notifications in the state were analyzed according to the variables: sex, race, education, age group, and clinical form, alongside with the detection rate. Results: during this period, Rio Grande do Sul was the third state with the fewest leprosy cases, with 620 notifications. Most cases occurred in males, aged 60-69 years, with an education level of 5th to 8th grade of elementary school, and self-declared white. The degree of physical disability zero was the most frequent, as was the clinical form, followed by lepromatous leprosy. The basic sanitation indicators still showed deficient conditions, however, those of vaccination coverage with BCG were above the Brazilian average. Discussion: the high incidence of cases among men in Rio Grande do Sul is consistent with the existing literature and does not appear to be related to the demographic characteristics of the state. The predominance of cases in white individuals presents a direct correlation with the ethnic-racial composition of the Rio Grande do Sul population. The level of education data highlights low education as an important characteristic among patients with leprosy. Furthermore, the predominance of multibacillary cases of leprosy suggests that Rio Grande do Sul has an old and predominantly stabilized endemic disease. Conclusion: the state of Rio Grande do Sul does not have the lowest gross number of leprosy cases, however, it does have lower detection rates. Although the research has limitations due to its use of a secondary database, it is clear that implementing health education is essential given the transmission of the disease.

Factors associated with the occurrence of leprosy reactional states in Mato Grosso, Brazil

Vilmeyze Larissa de Arruda — 2025-05-16

Objective: to analyze the factors associated with of leprosy reactional episodes in Mato Grosso, Brazil, from 2011 to 2023. Method: this retrospective cohort study used secondary data from the Notifiable Diseases Information System. Factors associated with reactional episodes were analyzed using binary logistic regression. The final model was adjusted for sociodemographic and clinical variables, with a significance level set at 5%. Odds ratios with 95% confidence intervals were estimated to measure the strength of associations. Results: 5,383 cases of leprosy presenting reactional episodes were recorded. The presence of grade II physical disability (OR: 2.54; 95% CI: 2.24 – 2.89; p ≤ 0.001), multibacillary operational classification (OR: 1.69; 95% CI: 1.46 – 1.95; p ≤ 0.001), and the lepromatous leprosy form (OR: 2.32; 95% CI: 1.90 – 2.83; p ≤ 0.001) were independently associated with the occurrence of reactional episodes. Conclusion: the factors related to leprosy reactions were clinical characteristics linked to the more severe forms of the disease, indicating late diagnosis and treatment. These findings highlight the need for more effective actions to monitor and manage leprosy to improve population health outcomes.

The journey of a woman with erythema nodosum leprosum

Elcie Aparecida Braga Oliveira — 2025-02-26

Introduction: leprosy is a chronic and neglected disease, particularly in Brazil, where challenges for diagnosis are reported. Objective: to report the follow-up of a leprosy disease patient with a complex clinical condition, including severe reactional symptoms such as erythema nodosum lepromatous. Case description: a 28-year-old female patient from Sorocaba in the state of São Paulo, Brazil presented with a history of erythematous nodular lesions since 2015. During care in a private health service, she was treated with topical medications and methotrexate for antiphospholipid antibody syndrome. She reported difficulties scheduling medical appointments and inadequate management at Primary Health Care. In 2019, she was referred to the Policlínica Municipal, where a biopsy of lesions on her left forearm and the dorsum of her foot revealed findings consistent with erythema nodosum. The following year, after a new consultation, she was diagnosed with multibacillary lepromatous leprosy disease, associated with grade 2 physical disability and a type 2 reaction, and multidrug therapy was initiated. By 2021, the patient developed severe symptoms, including nausea, fever, non-ulcerated nodules, generalized body pain, skin patches, lower limb edema, and headaches, significantly impairing her daily activities. She continued multidrug therapy until being referred to the Lauro de Souza Lima Institute in 2022. Despite undergoing home-based treatment, hospitalization was required in 2023. Currently, the patient remains under treatment for reactional episodes, receives no financial support, and is unable to work. Conclusion: leprosy disease is believed to require early detection, proper professional training, and the implementation of effective public policies. The challenges faced by women, often worsened by social stigma, are highlighted, emphasizing the need for integrated, humanized, and multidisciplinary approaches to ensure quality management of this historically neglected disease.