Indicators, spatial distribution, and hidden endemicity of Hansen’s disease: descriptive study, Piauí, 2018–2022

Abstract

Abstract Objective To analyze epidemiological and operational indicators and the hidden endemicity of Hansen’s disease in Piauí from 2018 to 2022. Methods A descriptive study with spatial analysis, using data provided by the State Health Department of Piauí. The variables analyzed included the detection rate of new cases in individuals under 15 years of age, the proportion of new cases presenting grade 2 physical disability at diagnosis, and the percentage of contacts of new cases who were evaluated. Indicators were presented as absolute frequencies per municipality, with percentage variation calculated. Thematic maps were created, and the hidden prevalence of Hansen’s disease in the state was estimated. Results A total of 3,789 new cases were identified. Based on hidden prevalence, an estimated 1,265 cases went undiagnosed during the period. In 2018, 27 municipalities were considered hyperendemic regarding detection in individuals under 15 years, decreasing to 11 by the end of the series. The distribution of new cases with grade 2 disability at diagnosis was predominantly classified as “low” throughout the period, ranging from 143 to 178 municipalities. The proportion of contacts examined for new cases in the “poor” status increased the number of municipalities by 28.8% during the period. Conclusion Hansen’s disease remains hyperendemic in the state, with high detection rates in individuals under 15 years, a substantial proportion of cases with grade 2 physical disability at diagnosis, and weaknesses in surveillance and control actions. The high estimated number of hidden cases underscores the need for strategies to expand early detection and strengthen Primary Health Care.