Perfil epidemiológico e desigualdades na distribuição da hanseníase em Goiás (2014-2023)

Abstract

Introduction: Leprosy remains a neglected disease with a high public health impact in Brazil, with the state of Goiás ranking 7th among federative units with the highest disease burden in the country. Objective: To analyze the epidemiological profile, temporal trend, distribution inequalities, and the correlation with Family Health Strategy (FHS) coverage in Goiás between 2014 and 2023. Methods: A retrospective and analytical epidemiological study based on secondary data from SINAN, IBGE, and CNES/DATASUS. Results and Discussion: A total of 13,235 new cases were reported during the period. The incidence rate showed a decline (from 29.33 to 11.68/100,000 inhabitants); however, the data suggest an artificial reduction masked by underreporting during the COVID-19 pandemic. The epidemiological profile is characterized by late diagnosis, with 73.52% of cases being multibacillary forms (borderline and lepromatous), and by the maintenance of active transmission, indicated by 3.5% of cases in children under 15 years old. Males presented a higher risk (RR 1.50), and a statistically significant overrepresentation was observed in Pardo (mixed-race), Black, Indigenous, and Asian populations. Spatial distribution was markedly heterogeneous, with hyperendemic regions (North and Rio Vermelho), and a healthcare paradox was noted where regions with higher incidence have the best FHS coverage, suggesting potential underreporting and therapeutic evasion. Conclusion: Leprosy control in Goiás requires not only the expansion of the healthcare network but also technical qualification of teams for early suspicion, active surveillance, and strategic integration to mitigate a disease that persists as a relevant public health problem in the state.