Epidemiological Profile of Patients with Leprosy in Northeast of Brazil: An Analysis from 2010 to 2022

Leprosy remains a public health problem in Brazil, which ranks second worldwide in the number of new cases, and the Northeast is the region with the highest endemicity. Objective: This study aims to describe the epidemiological profile of patients diagnosed with leprosy in the state of Paraíba and to identify the factors independently associated with treatment abandonment. Methods: This is a retrospective study of individual records from the Notifiable Diseases Information System (SINAN/DATASUS) for Paraíba, 2010–2022. Prevalence ratios (PRs) with 95% confidence intervals were estimated by Poisson regression with robust variance, crude and adjusted for sex, WHO classification, degree of physical disability at diagnosis and mode of entry. Results: 10,337 cases were analysed; 53.8% were men. Men presented with more advanced disease: multibacillary classification adjusted PR 1.46 (95% CI 1.41–1.51) and grade II physical disability at diagnosis PR 2.10 (95% CI 1.82–2.42). Treatment abandonment occurred in 740 cases (8.8% of the 8438 with a definitive treatment outcome). Male sex was associated with abandonment in the crude analysis (PR 1.16; 95% CI 1.01–1.33) but not after adjustment (PR 1.04; 95% CI 0.90–1.21). Abandonment was independently associated with re-entry into the surveillance system after a previous discharge other than cure (PR 3.33; 95% CI 2.71–4.10), multibacillary classification (PR 1.19; 95% CI 1.01–1.40) and an unassessed degree of physical disability at diagnosis (PR 1.47; 95% CI 1.20–1.80). Conclusions: the male disadvantage in leprosy in Paraíba is concentrated at diagnosis rather than during treatment. Abandonment is concentrated among patients returning after a previous interruption, a small and readily identifiable group that could be targeted by supervised treatment and active follow-up.