Leprosy is a chronic infection caused by Mycobacterium leprae, which mainly affects the skin and peripheral nerves. Transmission occurs through close and prolonged contact with sick individuals, via the respiratory route. Without early treatment, it can cause deformities and permanent disabilities. Although curable, leprosy still has high incidence in Brazil. This study analyzes its occurrence to understand persistent transmission and the regional inequalities involved. Ecological study based on data from the Sistema de Informação de Agravos de Notificação (SINAN/DATASUS). Leprosy cases recorded between 2020 and 2025 in Brazil were included. Variables analyzed included year of diagnosis, race/color, sex, age, region, and state. From 2020 to 2025, Brazil recorded a total of 143,437 new leprosy cases, with 2023 having the highest number of notifications (n=30,086). In terms of geographic distribution, the Northeast Region had the most cases (59,348), followed by the Central-West (n=33,455), North (n=23,969), Southeast (n=22,172), and lastly the South Region with the lowest number of cases (n=4,493). By state, Mato Grosso, Maranhão, and Pernambuco were the most affected during the period, with 24,363, 14,981, and 12,530 cases, respectively. In sociodemographic terms, there was predominance of males (n=81,734) compared to females (n=61,698). For race/color, most cases were reported among individuals self-declared as mixed race (parda) (n=85,605), followed by Black individuals (n=18,439). The most affected age group was 40–59 years (n=58,402), followed by 30–39 years (n=19,700). The data show an important public health problem in Brazil, with high incidence in the Northeast and Central-West regions. Persistent active transmission, associated with sociodemographic inequalities, reinforces the need for coordinated surveillance and, especially, early diagnosis. The predominance of cases among males, mixed-race individuals, and those in the economically active age group suggests specific vulnerabilities that should be considered in policymaking. Given the magnitude and distribution of the disease, it is crucial to strengthen regional response strategies, emphasizing equity and access to healthcare services.
Siqueira et al. (Sun,) studied this question.