02902nas a2200289   4500000000100000008004100001260001600042653001200058653001400070653001500084653003500099653002900134653001100163100001700174700001300191700001100204700001600215700001600231700001400247700001200261245009900273856015300372300001200525490000800537520205300545022001402598       2024                            d  bElsevier BV10aLeprosy10aIncidence10aPrevalence10aDisability-adjusted life years10aGlobal Burden of Disease10aBrazil1 ade Araújo V1 aVeloso G1 aKerr L1 aPescarini J1 aCardoso LDM1 aNaghavi M1 aMalta D00aLeprosy in Brazil: an analysis of the Global Burden of Disease estimates between 1990 and 2019  uhttps://www.sciencedirect.com/science/article/pii/S0033350624003536/pdfft?md5=0431faed07e0a0df623f4d9971bbddd4&pid=1-s2.0-S0033350624003536-main.pdf  a307-3140 v2363 a<p><strong>Objective: </strong>To analyze the occurrence of leprosy in Brazil and its states between 1990 and 2019, according to Global Burden of Disease (GBD) estimates, and its correlation with development status.</p>

<p><strong>Study design:</strong> A descriptive and analytical ecological epidemiological study.</p>

<p><strong>Methods: </strong>Rates of incidence, prevalence, and years lived with disability (YLD) due to leprosy, standardized by age, per 100,000 inhabitants, were analyzed. The trend analysis consisted of the joinpoint regression model and the average annual percentage change. The correlation between the incidence rate and the sociodemographic index (SDI) was investigated (Spearman test) at a 5% significance level. Incidence, prevalence and YLD rates were presented by country's states, sex, and age.</p>

<p><strong>Results: </strong>There was an average percentage decrease of 1.1% per year (P &lt; 0.001) in the incidence rate in the country and, between 1990 and 2019, a decline from 4.8 to 3.5 per 100,000 inhabitants; prevalence from 26.1 to 22.2, and YLD from 1.1 to 1.0. The incidence rate was higher among men and the elderly. Maranhao (7.0 in 1990; 4.2 in 2019), Alagoas (6.6 in 1990; 4.1 in 2019), Acre (6.1 in 1990; ~ 4.0 in 2019), Mato Grosso (5.2 in 1990 and 3.7 in 2019), and Mato Grosso do Sul (4.8 in 1990 and 3.7 in 2019) presented the highest incidence rates. A negative correlation was observed between SDI levels and leprosy incidence rates in 1990 (R ¼ 0.71; P &lt; 0.0001) and 2019 (R ¼ 0.81; P &lt; 0.0001).</p>

<p><strong>Conclusions: </strong>Despite the decrease in the rates of leprosy incidence, prevalence, and YLDs over the analyzed period, Brazil has a long way towards achieving its eradication. The greater burden of the disease in males stands out. The estimated risk of the disease was higher in the states with the lowest SDI levels. Therefore, interventions must consider the heterogeneity of the disease burden geographically and between sociodemographic groups.</p>
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