Impact of the COVID‐19 pandemic on the diagnosis of new leprosy cases in Northeastern Brazil, 2020

Abstract

This study analyzed the impact of the COVID‐19 pandemic on the detection of new cases of leprosy in the state of Bahia, Brazil. The periods January–September 2019 and January–September 2020 were compared. There was a 44.40% reduction in the diagnosis of leprosy when comparing the two periods (1,705 in 2019 and 948 in 2020). There was a reduction in the number of municipalities with reported cases: 251 municipalities in 2019 and 202 in 2020, expressing a reduction of 24.25%. Considering only the months following the arrival of the virus (April–September), the reduction was 51.10%. An inverse correlation was observed between the number of new cases of leprosy and the cumulative number of cases of COVID‐19 (Spearman's correlation coefficient = −0.840; P < 0.001) and the number of new monthly cases of COVID‐19 (Spearman's correlation coefficient = −0.817; P < 0.001). A slight increase was also observed in the proportion of multibacillary cases in the state (70.38% in 2019 and 72.69% in 2020) as well as in the proportion of individuals with the degree of physical disability not assessed at diagnosis, whose proportion rose from 16.39% in 2019 to 22.53% in 2020. The negative impact of COVID‐19 in tackling leprosy should be seen as a warning sign for health and political authorities.

Impact of the COVID-19 pandemic on the diagnosis of leprosy in Brazil: An ecological and population-based study

“…Interestingly, the number of MB leprosy cases was already remarkably high reported before the pandemic in Brazil. 25 Nonetheless, even after WHO remarks on the diagnosis and treatment of NTDs such as leprosy, the pandemic will probably significantly affect the goals for the control of leprosy and other NTDs, as already previously stated for schistosomiasis. 45 , 46 , 47 Likewise, Barros and colleagues 4 assessed the availability of leprosy services during the COVID-19 pandemic in Bangladesh, India, Mozambique, and Zimbabwe.…”

“…Likewise, previous studies conducted by our group have already demonstrated the negative effect of the pandemic in the diagnosis of hepatitis C, compromising the Brazilian hepatitis C eradication plan by the year 2030. 24 Moreover, the new coronavirus pandemic also has affected the diagnosis of leprosy 23 and tuberculosis 25 in the state of Bahia, located in the Northeast region.…”

“…Late diagnosis of leprosy, high proportions of MB leprosy cases, individuals diagnosed with a physical disability, and a poor treatment rate were already challenges in Brazil before the COVID-19 pandemic. 25 More importantly, the poorest segments of the population live mostly in clusters, especially slums. Social isolation measures lead to longer household contact, which could potentially increase the risk of M. leprae transmission.…”

“…Although % change was initially designed to assess disparities in the mortality rate of different health problems, it has also been used to analyse morbidity rates, as demonstrated in prior studies conducted by our group. 23 , 24 , 25 Considering the expected value and the one observed, it is possible to calculate the increase or reduction in the phenomenon occurrence in time and space. 26 The % change was calculated through the following equation: in which, the number of cases registered in 2020 corresponds to the official data monthly notified by the Brazilian Ministry of Health; and the number of cases expected for 2020 corresponds to the average of cases registered monthly in the five years prior to the pandemic year (2015 to 2019).…”

Impact of the COVID-19 pandemic on hepatitis C diagnosis in Brazil: Is the global hepatitis C elimination strategy at risk?

“…Moreover, due to concern of contracting COVID-19 at health services, patients have delayed seeking medical care when symptoms appear or when they have been exposed to risk factors. As a result of these changes, there have been negative impacts on surveillance programs and detection of new cases of several diseases [ 4 , 10 ].…”