Leprosy in the Vale do Itajaí Santa Catarina, Brazil (2004–2024): epidemiological profile and proposal of an operational indicator for hidden endemic surveillance
DOI:
https://doi.org/10.17058/reci.v16i.20966Keywords:
Leprosy, Mycobacterium leprae, Epidemiological Surveillance, Contact Tracing, Health Service IndicatorsAbstract
Background and Objectives: Leprosy remains endemic in Brazil, the country with the second-highest number of cases worldwide. In low-endemic regions, underreporting and predominantly passive surveillance hinder the identification of the true disease burden. This study aimed to characterize the epidemiological profile of leprosy in the Vale do Itajaí region, Santa Catarina, Brazil, from 2004 to 2024, and to propose an operational indicator — the Active Case Finding Detection Rate among Contacts (ACF-DRC) — to assess early detection capacity by surveillance services. Methods: Descriptive ecological study using secondary data from the Notifiable Diseases Information System (SINAN), covering 42 municipalities. Sociodemographic, clinical, and operational variables were analyzed using absolute and relative frequencies. Results: A total of 426 cases were recorded, of which 330 (77.5%) were new cases. There was a predominance of males (n=254; 59.6%), White race (n=334; 78.4%), age group 40–49 years (n=106; 24.9%), and incomplete primary education. The multibacillary operational class accounted for 299 (70.2%) cases, and the lepromatous form for 160 (37.6%). Grade 2 physical disability at diagnosis was identified in 25 (6.3%) of those evaluated. Detection through contact examination occurred in only 8 (1.9%) cases. The ACF-DRC calculated for the Médio Vale was 1.11%, classified as poor. Conclusion: The findings indicate late diagnosis, predominantly passive surveillance, and a probable hidden endemic. The ACF-DRC is a proposal that may assist surveillance evaluation in low-endemic areas, requiring validation in future studies.
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Copyright (c) 2026 Vitória Bortolotto Vieira, Franciani Rodrigues da Rocha, Bruno Vitiritti Ferreira Zanardo, João Luis Beber, Maria Eduarda Oliveira Baschera, Emanuelle Cristiny Monte dos Santos, Laura Schroeder Medeiros da Silva

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