Introduction

Leprosy remains a major neglected tropical disease and a persistent public health challenge in endemic regions. Brazil accounts for a substantial proportion of global cases, reflecting ongoing transmission and structural inequalities that affect early detection and disease control. Understanding national epidemiological and clinical patterns is essential for guiding public health strategies.

Methods

A nationwide ecological study was conducted using secondary data from the Brazilian Notifiable Diseases Information System (SINAN), accessed through the DATASUS platform. All confirmed leprosy cases reported between 2001 and 2025 were included. Variables analyzed comprised sex, age group, geographic region, operational classification, and clinical form. Descriptive epidemiological analyses were performed using absolute and relative frequencies.

Results

During the study period, 998,774 cases of leprosy were reported in Brazil. A slight predominance among males was observed (56.0%). Most cases occurred in individuals aged 15 years or older (93.5%), while 6.5% were detected in children under 15 years, indicating continued transmission. The Northeast region accounted for the largest proportion of cases (40.2%), followed by the North (20.0%) and Central-West (18.4%) regions, demonstrating marked regional disparities. Multibacillary disease represented 65.7% of cases, suggesting late diagnosis and sustained transmission chains. The dimorphic clinical form was the most frequently reported presentation (40.0%).

Conclusions

Leprosy remains widely distributed across Brazil and disproportionately affects highly endemic regions. The predominance of multibacillary disease and the persistence of cases among children reinforce the need to strengthen early diagnosis, active case detection, and public health surveillance in endemic settings.