The impact of leprosy elimination strategy on an endemic municipality in Rio de Janeiro State, Brazil

Various strategies for eliminating leprosy as a public health problem have evolved in the last 20 years. In some countries, especially highly endemic ones, the WHO target rate for leprosy elimination fell far short. The current study aimed to analyze the impact of different strategies for reducing leprosy prevalence in Duque de Caxias, a highly endemic municipality in Rio de Janeiro State, Brazil. The study observed the evolution of traditional operational indicators for the disease and their trends in the last 14 years. The indicators were calculated using the National Communicable Diseases Database (SINAN). Strategies that focused on decentralization of patient care and/or localized campaigns were associated with earlier case detection, reduction in prevalence, and shorter patient time in the active registry. An increase in the annual detection rate could be related to the existence of hidden prevalence or individuals with asymptomatic infection. New complementary strategies are needed to eliminate the disease in Duque de Caxias.