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Secular trends of new leprosy cases diagnosed in Brazil during 1987-2006.

OBJECTIVE
To analyze trends in occurrence of new leprosy cases in Brazil in the light of changes in public health policy during the period 1987-2006.


MATERIAL AND METHODS
Study of secular trends in New case detection rate (NCDR), viz. for leprosy in Brazil between 1987 and 2006. A linear trend was used to analyze separately the detection rate during the two decades 1987-1996 and 1997-2006. The cut-off point was the year with the peak detection rate in 1997. To analyze the potential increase in accessibility to diagnosis and treatment, a comparison was made between the proportion of cases diagnosed within the health services and municipalities over a 20-year period, split into four 5-year intervals.


RESULTS
The variation of the NCDR between 1987 and 2006 more than doubled between 1987 and 1997, decreased from 1997 to 2000, increased up to 2003 and then dropped considerably between 2004 and 2006. The number of facilities providing health services for the 5-year periods showed a marked increase-more than doubling between the second and third and between the third and fourth periods. The number and therapeutic services are indications that Brazil is perhaps making considerable progress towards eliminating leprosy as a public health problem.