Unveiling the impact of the COVID-19 pandemic on quality indicators of leprosy services in Brazil: an ecological study

Abstract

Background The COVID-19 pandemic has affected health services around the world. As a result, the control of endemic infectious diseases has been significantly hampered. This study aimed to quantify the impact of the COVID-19 pandemic on quality indicators of leprosy services in Brazil in 2020 and 2021. Methods This is an ecological study with 3 indicators: 1- Proportion of new leprosy cases with degree of physical disability assessed at diagnosis; 2- Proportion of contacts of new cases examined; 3- Proportion of leprosy cured among new cases. To determine the impact, the percentage of variation was used, taking into account the values of the indicators expected for 2020 and 2021, using the average of the last five years, and the values observed in the same years. The impact was quantified as a percentage. Results Brazil's performance in the three indicators analyzed was considered regular (between ≥ 75% and 89.9%), both in the pre-pandemic period and in the first two years. In the assessment of the degree of physical disability, the number of countries with a proportion greater than 90% decreased from 11 (expected value) to 7 (in 2020) and 9 (in 2021). In the evaluation of contacts, four states were expected to achieve the target (> 90%), but only three achieved the indicator in 2020 and one in 2021 (Tocantins). As for the cure rate, four states were expected to achieve values above 90%, but only three did so in 2020 and two in 2021. Conclusion The study showed a negative impact on the quality indicators of leprosy services in Brazil, which was more pronounced in 2021 (for contact examination and cure indicators) than in 2020, making it even more difficult to control the disease in the country.