Martins-Melo, Francisco Rogerlândio, Assunção-Ramos, Adriana Valéria, Ramos, Alberto Novaes, Alencar, Carlos Henrique, Montenegro, Renan Magalhães, Wand-Del-Rey de Oliveira, Maria Leide, and Heukelbach, Jorg (2015) Leprosy-related mortality in Brazil: a neglected condition of a neglected disease. Transactions of the Royal Society of Tropical Medicine and Hygiene, 109 (10). pp. 643-652.

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Abstract

Background: Leprosy is a public health problem and a neglected condition of morbidity and mortality in several countries of the world. We analysed time trends and spatiotemporal patterns of leprosy-related mortality in Brazil.

Methods: We performed a nationwide population-based study using secondary mortality data. We included all deaths that occurred in Brazil between 2000 and 2011, in which leprosy was mentioned in any field of death certificates.

Results: Leprosy was identified in 7732/12 491 280 deaths (0.1%). Average annual age-adjusted mortality rate was 0.43 deaths/100 000 inhabitants (95% CI 0.40–0.46). The burden of leprosy deaths was higher among males, elderly, black race/colour and in leprosy-endemic regions. Lepromatous leprosy was the most common clinical form mentioned. Mortality rates showed a significant nationwide decrease over the period (annual percent change [APC]: −2.8%; 95% CI −4.2 to −2.4). We observed decreasing mortality rates in the South, Southeast and Central-West regions, while the rates remained stable in North and Northeast regions. Spatial and spatiotemporal high-risk clusters for leprosy-related deaths were distributed mainly in highly endemic and socio-economically deprived regions.

Conclusions: Leprosy is a neglected cause of death in Brazil since the disease is preventable, and a cost-effective treatment is available. Sustainable control measures should include appropriate management and systematic monitoring of leprosy-related complications, such as severe leprosy reactions and adverse effects to multidrug therapy.

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