Clinical epidemiological and antimicrobial resistance profile of leprosy patients in Brazil

Data based on the National Surveillance Plan

Abstract

Introduction: Leprosy is a chronic disease, caused by Mycobacterium leprae, of which Brazil has the second highest incidence in the world. Despite the existence of a treatment with multidrug therapy, the disease persists in the country, highlighting the increase in drug resistance. Objective: To analyze the clinical and epidemiological profile of patients with leprosy in Brazil and the antimicrobial resistance described in the literature. Methods: SINAN data from the last 10 years (2013-2022) were used, covering social, geographic, clinical and laboratory aspects, associated with a literature review on antimicrobial resistance to multidrug therapy in Brazil. Results: 328,355 cases were registered between 2013-2022, highlighting men (56.95%), mixed race (58.55%) and an average age of 55 years. The Northeast concentrated 42.79% of cases, but Mato Grosso was the leader in notifications (12.31%). The absence of bacilloscopy (28.25%) and the prevalence of the dimorphic (48.19%) and lepromatous (18.02%) clinical forms indicated a predominance of the multibacillary class, which corroborates the fact that the most reported therapeutic regimen it was multibacillary (74.87%) with 12 doses (47.03%) and smaller with 12 doses (40.75%). Four studies were found that fit the theme of antimicrobial resistance in leprosy in Brazil, with a low percentage of cases identified with resistance, but highlighting resistance to dapsone and multiresistance to rifampicin and dapsone. Conclusion: In recent years, leprosy notifications in Brazil have gradually decreased, but persist in areas of socioeconomic vulnerability, often with diagnosis in advanced stages, highlighting the need for early diagnosis. Regarding antimicrobial resistance, the identification of such cases has not proven to be recurrent, however, when done, the prevalence is resistance to rifampicin and dapsone.