Leprosy, a chronic disease caused by Mycobacterium leprae, continues to be a significant public health challenge in Brazil, which has a high rate of new cases and late diagnoses. This study investigates the relationship between Primary Health Care (PHC) and Family Health Strategy (FHS) coverage and leprosy detection in Minas Gerais, a state marked by heterogeneity in the distribution of the disease. This observational and ecological study analyzed data from 2010 to 2020, which were obtained from the Notifiable Diseases Information System (SINAN) and the EGESTOR-AB portal. Using statistical methods, such as Pearson’s correlation and Prais–Winsten Linear Regression, trends and associations between coverage variables and leprosy indicators were assessed. This study found that PHC and FHS coverage expansion in Minas Gerais was not directly associated with a uniform reduction in late leprosy diagnosis. The findings indicate that the expansion of PHC and the FHS has not been accompanied by a homogeneous reduction in late diagnoses. It is therefore recommended that active surveillance actions be strengthened, that teams be continuously trained, and that strategies recommended by the WHO be integrated.

Background/Objectives: Leprosy remains a global public health challenge, especially in hyperendemic areas, where spatial, socioeconomic and serological factors influence its persistence. In this study, an integrative review was carried out to analyze the relationship between these factors and the prevalence of Mycobacterium leprae infection, as well as the risk of falling ill. Methods: The integrative search was conducted in the BVS (Medline and LILACS) and Scopus databases, including studies published between 2010 and 2024; PRISMA was followed. Results: The findings indicate that spatial analysis, using geographic information systems, is essential for identifying transmission clusters and targeting control strategies. Poor socioeconomic conditions, such as low income and inadequate sanitation, significantly increase the risk of infection. In addition, serology, especially the detection of Anti-PGL-1 antibodies, has proved to be a promising tool for tracking subclinical infections and improving epidemiological surveillance. However, the integration of spatial, social and serological factors is still limited in the literature. Conclusions: We conclude that multidisciplinary approaches, combining spatial, socioeconomic and serological factors, are fundamental to optimizing control strategies and reducing leprosy transmission in vulnerable populations.

Background: Leprosy control remains challenging in Brazil and has been aggravated by the COVID-19 pandemic. Objective: To analyze the impact of the COVID-19 pandemic on the epidemiological scenario of leprosy through the detection rate of new cases, the risk of illness, and the hidden prevalence of leprosy according to high-risk micro-region in Minas Gerais, Brazil. Methods: An ecological study conducted in the health micro-regions of Minas Gerais, using data on new leprosy cases diagnosed between 2015 and 2023. The annual detection rate of new cases, the risk of illness index and the hidden prevalence of leprosy were evaluated. The time trend was evaluated by calculating the annual percentage change (APC) of the detection rate, based on segmented linear regression, considered significant when it showed p < 0.05. Results: The state of Minas Gerais showed a significant negative annual increase between 2015 and 2020 (APC = −7.91; 95%CI −21.76–−1.72), and in 2020 it showed an inflection point, with an annual increase of 9.91 in the period from 2020 to 2023. When evaluating the hidden prevalence of leprosy in Minas Gerais, we observed a reduction in the estimates’ average from 2015–2019 (2.78) to 2020–2023 (2.00). The state as a whole showed an upward trend in the risk of illness, with the average index varying from 0.28 (medium risk) to 0.55 (high risk). Conclusions: The pandemic has had a considerable and heterogeneous impact on the detection of new cases, as well as on the risk of becoming ill and the hidden prevalence of leprosy, with repercussions for the control of the endemic in populations. There is a need to implement public health policies that prioritize the early identification of cases and ensure that vulnerable populations are monitored.

Objetivo: Descrever a ocorrência da sífilis em gestantes entre 2011 e 2021 em um município da Região Metropolitana de Belo Horizonte, Minas Gerais. Metodologia: Estudo transversal descritivo com dados obtidos das fichas de notificação de sífilis gestacional no Sistema de Informação de Agravos de Notificação e plataformas DATASUS e Instituto Brasileiro de Geografia e Estatística. Os dados foram planilhados no Microsoft® Excel, com posterior análise descritiva. Resultados: O município estudado teve taxas superiores às do estado e do país a partir de 2015, atingindo 29,3% em 2020. Em 2018, o número de casos novos de sífilis congênita também aumentou. Os casos ocorreram principalmente em gestantes entre 20 e 29 anos (58,4%), e naquelas que se autodeclararam pardas (62,2%). As vulnerabilidades incluem diagnóstico tardio e tratamento inadequado dos parceiros. Conclusão: É necessário um pré-natal mais qualificado, com diagnóstico precoce e tratamento oportuno para as gestantes e seus parceiros, além de reforçar a vigilância epidemiológica. ABSTRACT Objective: To describe the occurrence and epidemiological profile of syphilis in pregnant women between 2011 and 2021 in a municipality in Metropolitan Region of Belo Horizonte, Minas Gerais. Methodology: A descriptive cross-sectional study with data obtained from Sistema de Informação de Agravos de Notificação gestational syphilis notification forms and the DATASUS and Instituto Brasileiro de Geografia e Estatística platforms. The data was analyzed using Microsoft® Excel, with posterior description analysis.. Results: The municipality studied had higher rates than the state and the country from 2015 onwards, reaching 29.3% in 2020. In 2018, the number of new cases of congenital syphilis also increased. The cases occurred specially in pregnant women aged between 20 and 29 (58,4%), and who were identified as brown (62,2%). Vulnerabilities include late diagnosis and inadequate treatment of partners. Conclusion: More qualified prenatal care is needed, with early diagnosis and timely treatment for pregnant women and their partners, as well as strengthening epidemiological surveillance.

Objetivo: Analisar a ocorrência de incapacidade física em hanseníase segundo níveis de atenção à saúde no período de 2012 a 2021 em Minas Gerais. Metodologia: Estudo ecológico transversal, realizado com 6.524 casos. Variáveis dependentes: grau de incapacidade física no diagnóstico e na alta. Variáveis independentes: nível de atenção no momento da notificação e da alta. Foi realizado teste Mc Nemar e Teste Qui-quadrado de Pearson considerando como significante um p-valor ≤ 0,05. Resultados: Embora a maioria dos casos tenham sido diagnosticados com grau de incapacidade zero (59,5%), um número expressivo apresentou grau de incapacidade um (28,2%), nos três níveis de assistência (p<0,001). O aumento no percentual de casos com grau incapacidade física zero foi mais relevante no nível de atenção primária (12%) (p<0,001). Conclusão: O elevado número de casos diagnosticados nos serviços especializados e com incapacidades físicas já instalada sugere a necessidade de investimentos no fortalecimento da atenção primária à saúde para garantia de um atendimento integral e resolutivo, com foco no diagnóstico precoce e na redução das incapacidades físicas relacionadas à hanseníase. ABSTRACT Objective: Analyzing the occurrence of physical disability in leprosy according to levels of health care from 2012 to 2021 in Minas Gerais. Methodology: A cross-sectional ecological study conducted with 6,524 cases. Dependent variables: degree of physical disability at diagnosis and at discharge. Independent variables: level of care at the time of notification and discharge. McNemar test and Pearson's chi-square test were performed considering a p-value ≤ 0.05 as significant. Results: Although most cases were diagnosed with degree of disability zero (59.5%), a significant number presented degrees of disability one (28.2%), at the three levels of care (p<0.001). The increase in the percentage of cases with degree of physical disability zero was more relevant at the primary care level (12%) (p<0.001). Conclusion: The high number of cases diagnosed in specialized services and with physical disabilities already present suggests the need for investments in strengthening primary health care to guarantee comprehensive and effective care with a focus on early diagnosis and reducing physical disabilities related to leprosy.