04341nas a2200385   4500000000100000008004100001260001000042653001900052653001200071653001300083653001800096653002100114653001800135653001300153653000900166653001100175653001100186653002200197100001600219700001600235700001600251700001700267700002400284700001800308700002300326700001900349700001600368700001700384245011500401856005200516300001100568490000700579520335500586022001403941       2024                            d  bLepra10aGeneral Energy10aLeprosy10aCovid-1910aVulnerability10amental wellbeing10aMental Health10aPandemic10aNTDs10aBrazil10acrisis10aContact screening1 ada Rocha AM1 ade Souza EA1 aFerreira AF1 aFerreira NNL1 ada Silva dos Reis A1 ade Andrade AR1 ade Almeida Silva R1 aSchoenmakers A1 aRamos Jr AN1 ada Silva JAM00aThe impact of COVID-19 on persons affected by leprosy and leprosy control in the North and Northeast of Brazil  uhttps://leprosyreview.org/article/95/1/20-23076  a97-1120 v953 a<p><strong>Introduction &amp; Aim:&nbsp;</strong>Brazil, ranking second globally in newly detected leprosy (Hansen's disease) patients, has encountered obstacles in advancing leprosy control amidst the Covid-19 pandemic, particularly in more vulnerable regions. This study aims to characterize the psychosocial as well as health status and needs of individuals affected by leprosy during the Covid-19 pandemic in the North and Northeast regions of Brazil.</p>

<p><strong>Method:&nbsp;</strong>This is a descriptive cross-sectional study examining the health status and needs of persons affected by leprosy during the Covid-19 pandemic throughout the years 2019 and 2020. Adults receiving multidrug therapy (MDT) who were registered in the National System of Notifiable Diseases during this period and lived in the North and Northeast regions of Brazil were included. After obtaining consent, data collection involved conducting telephone surveys. Referrals to additional care were provided to study participants in need. Data collected were entered into REDCap, with subsequent data extracted using TabWin® software from the Department of Informatics of the Brazilian Unified Health System. We conducted a descriptive analysis of sociodemographic, clinical-epidemiological, and psychosocial variables using STATA. Logistic regression analysis was used to estimate the odds ratio (OR) with 95% confidence intervals (95% CI).</p>

<p><strong>Results:&nbsp;</strong>The study included 346 persons affected by leprosy who were receiving leprosy treatment. Interruption of MDT occurred in 31.8%, among these patients, 22.5% reported that the interruption had a relationship with the pandemic. Of the included participants, 35.3% reported that their household contacts were not screened for leprosy, although 14.2% recognized skin lesions with loss of sensitivity in their contacts. When assessing mental wellbeing, sadness was reported by 32.4%, fear by 35.3%, sleep deprivation by 34.7%, and depression by 9.8% of the participants. We observed an association between loss of income and sadness (OR 1.61; 95%CI 1.02–2.54;&nbsp;p-value 0.040) and reported depression (OR 2.35; 95%CI 1.11–4.98;&nbsp;p-value 0.026). Social distancing had an additional financial impact on 32.3% of persons affected by leprosy in this study.</p>

<p><strong>Discussion &amp; Conclusion:&nbsp;</strong>The pandemic had significant economic, social, and health impacts on the lives of persons affected by leprosy, further complicating leprosy control efforts. Medication availability, medical and psychological patient follow-up, as well as contact screening, were hindered during the pandemic, making the control of leprosy even more challenging. Recognizing the weaknesses of the leprosy control program is crucial for enhancing services both presently and in preparation for future crises like pandemics. Brazil could enhance leprosy control services by implementing novel disease control strategies, including additional prevention measures for contacts. In addition to the necessary improvements needed at the clinical health system level, addressing social vulnerability and enhancing individual mental wellbeing are urgent priorities. This could be achieved through initiatives such as offering counseling and establishing peer-support groups.&nbsp;</p>
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