Assessment of grade 2 disability and the epidemiological profile of individuals affected by leprosy in the state of Goiás, Brazil

Abstract

Introduction: leprosy remains a major public health problem in Brazil, particularly due to delayed diagnosis and associated physical disabilities. Grade 2 disability is a marker of disease severity and reflects failures in early detection. Objective: to confirm grade 2 disability assigned at the time of leprosy diagnosis and to analyze the epidemiological profile of patients in the state of Goiás, Brazil. Methods: this was an observational and descriptive study based on secondary data from the Health Surveillance Superintendence of Goiás, covering the years 2023 and 2024. Patients notified as having grade 2 disability at diagnosis were included. Data were obtained from the Notifiable Diseases Information System, Simplified Neurological Assessment forms, and the Grade 2 Disability Investigation System. Regional Health Departments submitted complementary documentation and photographs of hands, feet, and eyes, which were evaluated by specialists to confirm disability grading. Results: in 2023, 34.5% of cases initially classified as Grade 2 disability were not confirmed after expert review; in 2024, this proportion was 30.0%. Among confirmed cases, there was a predominance of low educational level, male sex, and multibacillary operational classification. Conclusion: the reassessment of grade 2 disability revealed inconsistencies in initial classification, indicating weaknesses in neurological evaluation. Accurate identification of disabilities is essential to improve epidemiological indicators, guide public health policies, and reduce the social and economic burden of leprosy.