Clinical-Epidemiological and Spatial Profile by Degree of Physical Disability in Leprosy in the State of Pará, Brazilian Amazon (2013 to 2024): A Cross-Sectional Study
Luiza Raquel Tapajós Figueira *
Postgraduate Program in Parasitic Biology in the Amazon (PPGBPA), University of Pará State (UEPA), Belém, PA, Brazil.
Rebecca Lobato Marinho
Postgraduate Program in Parasitic Biology in the Amazon (PPGBPA), University of Pará State (UEPA), Belém, PA, Brazil.
Marcos Jessé Abrahão Silva
Postgraduate Program in Parasitic Biology in the Amazon (PPGBPA), University of Pará State (UEPA), Belém, PA, Brazil.
Sebastião Kauã de Sousa Bispo
Postgraduate Program in Parasitic Biology in the Amazon (PPGBPA), University of Pará State (UEPA), Belém, PA, Brazil.
Lucas Vinicius Moraes da Silva
Postgraduate Program in Parasitic Biology in the Amazon (PPGBPA), University of Pará State (UEPA), Belém, PA, Brazil.
Thiago Augusto Ferreira dos Anjos
Postgraduate Program in Parasitic Biology in the Amazon (PPGBPA), University of Pará State (UEPA), Belém, PA, Brazil.
Everaldina Cordeiro dos Santos
Postgraduate Program in Parasitic Biology in the Amazon (PPGBPA), University of Pará State (UEPA), Belém, PA, Brazil.
Daniele Melo Sardinha
Postgraduate Program in Parasitic Biology in the Amazon (PPGBPA), University of Pará State (UEPA), Belém, PA, Brazil.
Luana Nepomuceno Gondim Costa Lima
Bacteriology and Mycology Section (SABMI), Evandro Chagas Institute (IEC), Ananindeua, PA, Brazil.
*Author to whom correspondence should be addressed.
Abstract
Background: Leprosy, caused by Mycobacterium leprae, remains a chronic, socially determined infectious disease affecting the skin and peripheral nerves and may cause severe physical disability when diagnosis and treatment are delayed.
Objective: This study analysed the clinical, epidemiological and spatial profile of the degree of physical disability (DPD) at diagnosis and after cure among leprosy cases in the State of Pará, Brazil, between 2013 and 2024.
Methods: A cross-sectional, descriptive and retrospective study was conducted using data from SINAN (National System of Notifiable Diseases). The study population comprised confirmed leprosy cases reported in the municipalities of Pará between 2013 and 2024. Sociodemographic and clinical variables were examined using geoprocessing tools, and frequencies, proportions and prevalence rates were processed with Jamovi 2.6.44 software.
Results: A total of 29,644 cases were reported during the period, indicating a substantial epidemiological burden. Most cases were multibacillary and dimorphic, and 8.8% presented with grade II physical disability at diagnosis. Cases predominated among men aged 36-45 years, mixed-race/brown-skinned individuals, people with low educational attainment and residents of urban areas. Children under 15 years of age accounted for 10% of diagnoses, indicating ongoing transmission. Spatial analysis highlighted municipalities with critical rates, including Inhangapi, Oriximiná, Anajás and Abel Figueiredo. Despite reductions in grades I and II after treatment, 47.1% of patients were not assessed at discharge, indicating weaknesses in post-treatment follow-up.
Conclusion: Leprosy remains highly endemic in Pará and is strongly associated with social vulnerability. Late diagnosis and the occurrence of cases in children under 15 years of age indicate silent transmission, while the number of cases with grade II disability highlights gaps in surveillance, particularly in post-cure assessment. These findings support the need for public policies focused on early detection, continuous monitoring and reduction of regional inequalities.
Keywords: Leprosy, Prevention, Disability, diagnostic, prevalence