PHYSICAL DISABILITIES RESULTING FROM LEPROSY IN INDIGENOUS POPULATIONS OF THE STATE OF TOCANTINS, 2015 TO 2025

Abstract

The study aimed to analyze the epidemiological profile and time trend of physical disabilities resulting from leprosy in indigenous populations of Tocantins, from 2015 to 2025. An ecological and time-series study was conducted using data from SINAN, evaluated by Joinpoint regression. A total of 122 cases were notified, with a predominance of multibacillary forms (85.2%) and significant neural impairment at the time of diagnosis (42.6%), a finding compatible with late detection. Over the entire period, the overall detection rate remained stationary (AAPC = 0.10%), despite showing a decreasing inflection between 2017 and 2025 (APC = -24.78%), a scenario compatible with the persistence of transmission in the villages. Additionally, strong spatial asymmetries were observed in the cumulative incidence for the period, notably in the Médio Norte Araguaia health region (2,160.46 cases per 100,000 inhabitants in the period; annual average of 196.41/100,000 inhabitants). Although there was a statistically significant reduction in initial disability records over the series — which may reflect either earlier detection or operational variations in neurological assessment and reporting —, 24.6% of the patients concluded treatment without a final neurological evaluation, indicating important operational fragilities in follow-up. It is concluded that the high burden of the disease persists, making it urgent to qualify neurological examinations and reinforce active search actions adapted to the geographical and sociocultural challenges of indigenous communities.