Impact of the COVID-19 Pandemic on the Diagnosis of Leprosy in Brazil: An Ecological and Population-Based Study of a Millenary and Still Neglected Disease

Abstract

The pandemic caused by the new coronavirus disease 2019 (COVID-19) has severely impacted global health. Actions to control the transmission of the virus, such as social distancing measures, can impair the diagnosis, treatment, and control of other infections, especially neglected tropical diseases, as leprosy. Herein, we assessed the impact of the COVID-19 pandemic on leprosy diagnosis in Brazil during 2020, by means of an ecological and population-based study, using spatial analysis techniques. The variables assessed were monthly incidence of leprosy in the general population and children under 15 years old, and also multibacillary (MB) leprosy diagnosis. The p-value approach was used to determine if there was an increase or decrease in the number of leprosy cases in 2020, considering the average monthly cases registered in the last five years (2015 to 2019) as the expected number of cases for 2020. In addition, spatial distribution maps were elaborated, considering the p-value of each Brazilian state. The number of cases diagnosed started to fall in March 2020. It was verified a reduction of 11,357 notifications of leprosy cases in Brazil (P-score = -41.4%) in 2020. Likewise, there was a reduction of leprosy notifications in children under 15 years-old (n = -1,036; P-score = -56.82%). Conversely, the diagnosis of MB leprosy increased (P-score = 8.1%). Spatial distribution maps depicted a reduction of up to 100% regarding new leprosy cases, in some states. Taken together, the results reported attest that along with COVID-19 spread there was a reduction in leprosy diagnosis in the general population and children under 15 years-old, and also an increase in MB leprosy cases diagnosed, signaling a serious impact of the pandemic on leprosy control strategies in Brazil.Funding: None to declare. Declaration of Interest: None to declare. Ethical Approval: This study used public-domain aggregate secondary data and identification of the individuals was not possible. For this reason, the individual consent form was dispensed. Thus, the research did not have to go through the Ethics and Research Committee with Human Beings. Nevertheless, the ethical precepts of research involving human beings established by Resolution 466/2012 of the National Health Council and the Declaration of Helsinki were followed.