ArticlePLoS neglected tropical diseases2021
Estimating underreporting of leprosy in Brazil using a Bayesian approach.
Article in PLoS neglected tropical diseases, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 16 papers, 2 of them syntheses that pooled it.
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Who cites it
16 citing papers in PubMed, 2 syntheses or guidelines pooled it.
- On the usage of artificial intelligence in leprosy care: A systematic literature review.PLoS computational biology · 2025Pooled it
- Establishing a standard method for analysing case detection delay in leprosy using a Bayesian modelling approach.Infectious diseases of poverty · 2023Pooled it
- Persistent and Emerging High-Risk Clusters of Leprosy Detection in Brazil: A Nationwide Spatiotemporal Analysis, 2001-2023.Tropical medicine & international health : TM & IH · 2026Article
- The Minha Casa Minha Vida social housing programme and leprosy in Brazil: an analysis of the 100 Million Brazilian Cohort (2010-2015).BMC public health · 2025Article
- Evaluating Machine Learning Models for Predicting Late Leprosy Diagnosis by Physical Disability Grade in Brazil (2018-2022).Tropical medicine and infectious disease · 2025Article
- Spatial associations of Hansen's disease and schistosomiasis in endemic regions of Minas Gerais, Brazil.PLoS neglected tropical diseases · 2024Article
- Leprosy.Nature reviews. Disease primers · 2024Review
- Trend in the epidemiological risk of leprosy in the state of Goiás-Brazil between 2010 and 2021.Epidemiologia e servicos de saude : revista do Sistema Unico de Saude do Brasil · 2024Article
- Temporal trends and spatial analysis of leprosy surveillance indicators in the municipalities of the state of Mato Grosso, 2008-2022.Revista da Sociedade Brasileira de Medicina Tropical · 2024Article
- Evaluating active leprosy case identification methods in six districts of Nepal.Infectious diseases of poverty · 2023Article
- Estimating the real burden of gestational syphilis in Brazil, 2007-2018: a Bayesian modeling study.Lancet regional health. Americas · 2023Article
- Effectiveness of population-wide screening and mass drug administration for leprosy control in Kiribati: the COMBINE protocol.BMJ open · 2023Article
- Spatial analysis of the epidemiological risk of leprosy in the municipalities of Minas Gerais.PLoS neglected tropical diseases · 2023Article
- Leprosy prevalence spatial distribution and trend in a health region in Northeast Brazil, 2008-2017: an ecological study.Epidemiologia e servicos de saude : revista do Sistema Unico de Saude do Brasil · 2023Article
- Leprosy and cutaneous leishmaniasis affecting the same individuals: A retrospective cohort analysis in a hyperendemic area in Brazil.PLoS neglected tropical diseases · 2021Article
- Estimating underreporting of leprosy in Brazil using a Bayesian approach.PLoS neglected tropical diseases · 2021Article
Corrections and comments
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Authors and funding
12 authors.
Funding
Abstract
backgroundLeprosy remains concentrated among the poorest communities in low-and middle-income countries and it is one of the primary infectious causes of disability. Although there have been increasing advances in leprosy surveillance worldwide, leprosy underreporting is still common and can hinder decision-making regarding the distribution of financial and health resources and thereby limit the effectiveness of interventions. In this study, we estimated the proportion of unreported cases of leprosy in Brazilian microregions. METHODOLOGY/PRINCIPAL
findingsUsing data collected between 2007 to 2015 from each of the 557 Brazilian microregions, we applied a Bayesian hierarchical model that used the presence of grade 2 leprosy-related physical disabilities as a direct indicator of delayed diagnosis and a proxy for the effectiveness of local leprosy surveillance program. We also analyzed some relevant factors that influence spatial variability in the observed mean incidence rate in the Brazilian microregions, highlighting the importance of socioeconomic factors and how they affect the levels of underreporting. We corrected leprosy incidence rates for each Brazilian microregion and estimated that, on average, 33,252 (9.6%) new leprosy cases went unreported in the country between 2007 to 2015, with this proportion varying from 8.4% to 14.1% across the Brazilian States. CONCLUSIONS/SIGNIFICANCE: The magnitude and distribution of leprosy underreporting were adequately explained by a model using Grade 2 disability as a marker for the ability of the system to detect new missing cases. The percentage of missed cases was significant, and efforts are warranted to improve leprosy case detection. Our estimates in Brazilian microregions can be used to guide effective interventions, efficient resource allocation, and target actions to mitigate transmission.
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