An interrupted time series study of the leprosy case detection in Brazil after the COVID-19 pandemic

COVID-19 pandemics affected several health systems processes, including leprosy care. This study aimed to estimate the impact of the COVID-19 pandemic on the leprosy case detection rate in Brazil from 2017 to 2022. Data was retrieved from Sinan, a Brazilian notification system, and monthly leprosy detection rate in the overall population and in individuals under 15 years of age were the main outcomes. The series was interrupted in February 2020, when the COVID-19 public health emergency was declared in Brazil. The data were analysed via Prais-Winsten regression. Over the 72 months analysed, the COVID-19 pandemic led to an immediate 0.55 reduction (95% CI 0.48-0.62) in the overall leprosy detection rate, with a subsequent monthly increase of 1.01 (95% CI 1.00-1.02). For the population under 15 years of age, the pandemic caused an immediate 0.48 reduction (95% CI 0.40-0.57), followed by a monthly increase of 1.01 (95% CI 1.01-1.02) after the onset of the pandemic. Subnational analysis revealed that most federative units followed the trend for the overall detection rate, but high heterogeneity was observed regarding individuals under 15 years of age. Therefore, it is urgent to target strategies to minimize delayed diagnosis and long-term consequences of leprosy.