Abstract
Objective: To analyze trends of leprosy detection in the general population in the Mesoregions Pará state, Brazil, from 2004 to 2018. Methods: Exploratory ecological study using the Information System for Notifiable Diseases database. Leprosy cases residing in the state of Pará were included. 57,537 case reports were studied, considering the variables: sex, race/skin color, age, education, municipality of residence, year of detection of the disease, classifications by clinical and operational form. Results: The highest proportions of detection were found in the Mesoregions Southwest Paraense (63.76%), Baixo Amazonas (62.94%), Southeast Paraense (60.65%) and Marajó (60.15%). The risk for maintaining the disease transmission was present in the Southeast Paraense Mesoregions (1,476.98/100,000 in hab.) and Southwest Paraense (1,218.42/100,000 in hab.). The dimorphic clinical form predominated, followed by the indeterminate form. The geographic distribution showed that 2/3 of the State had a hyper-endemic area, with high rates, involving the Southeast Paraense Mesoregions (97.58/100 thousand in hab.), Southwest Paraense (83.19/100 thousand in hab.) and Marajó (84,17/100 thousand in hab.). Conclusion: The study of leprosy in Pará state points out a non-homogeneous behavior and unfavorable conditions for control, identifying the urgent need for strategies to make the disease control actions effective.