Leprosy in Boa Vista, Roraima: multibacillary infection and grade 2 physical disability as markers of late diagnosis

Abstract

Objective: To analyze factors associated with late diagnosis of leprosy, considering multibacillary classification (MB) and grade 2 physical disability (G2D) at diagnosis as outcomes, in Boa Vista, Roraima, Brazil, 2001–2024. Methods: Analytical cross-sectional epidemiological study using secondary data from the Notifiable Diseases Information System (SINAN). New cases residing in the municipality were included. Binary logistic regression was performed to estimate crude and adjusted odds ratios, considering p<0.05 in the final model. Model performance was evaluated using likelihood ratio test, Nagelkerke pseudo-R², and Hosmer–Lemeshow test. Results: A total of 2,248 cases were reported, of which 1,964 had complete data for analysis. There was predominance of males (59.2%), age ≥15 years (91.5%), and low schooling (59.2%). In the final model for the MB outcome, male sex (OR=1.82), age <15 years (OR=0.59), more than five lesions (OR=343.0), and period 2010–2014 (OR=0.41) remained associated. For the G2D outcome, male sex (OR=1.68) and multibacillary classification (OR=9.32) remained associated. Conclusion: The G2D outcome occurred mainly as a consequence of the MB outcome, indicating late diagnosis. Strengthening early detection in primary health care is essential to reduce preventable disabilities.