LEPROSY-RELATED MORTALITY IN BRAZIL: BURDEN AND TEMPORAL TRENDS, 2000-2011

Introduction and Objective Leprosy is a public health problem and a neglected condition of morbidity and mortality in several countries of the world. The objective of the present study was to analyze time trends and burden of leprosy-related mortality in Brazil. Methods We performed a nationwide population-based study using mortality data obtained from the Brazilian Mortality Information System. We included all deaths from 2000 to 2011 in which leprosy was mentioned on death certificates as an underlying or associated cause. We calculated crude and age-adjusted mortality rates by sex, age group, race/color, and place of residence. Trends over time were assessed using joinpoint regression. Result and Conclusions 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, with a stable trend in North and Northeast regions. Despite the reduced mortality, leprosy is still a neglected cause of death in Brazil, with regional differences. Leprosy is a preventable disease, and a cost-effective treatment is available, especially in the context of primary health care. Sustainable control measures should include appropriate management and systematic monitoring of leprosy-related complications, such as leprosy reactions and adverse effects to multidrug therapy.