@article{103645,
  keywords = {Primary Health Care, Diagnosis, Treatment, Disability, Brazil},
  author = {Maciel ICL and Lages DDS and Carvalho APM and Lana FCF},
  title = {Performance of a Brazilian health care network in leprosy care: Early diagnosis, timely treatment, and disability outcomes},
  abstract = {<p>Leprosy remains a neglected and transmissible disease and continues to challenge the World Health Organization elimination goals, mainly due to delays in diagnosis and treatment. This analytical cross-sectional study assessed indicators related to the performance of the Health Care Network (HCN) of Minas Gerais, Brazil, in leprosy care using secondary data from 2014 to 2023. The outcomes evaluated were early diagnosis, timely treatment initiation, and disability outcomes. Data were obtained from the Notifiable Diseases Information System (SINAN) and the National Register of Health Establishments (CNES) and analyzed using multivariate logistic regression with a 5% significance level. Among 9,630 cases analyzed for early diagnosis, 55.8% were diagnosed early and 44.2% late. Among 10,402 cases, 63.4% initiated treatment within two days, while 36.6% experienced delays. Regarding disability outcomes, among 6,048 cases evaluated, 8.9% worsened, 73.9% remained unchanged, and 17.3% improved. The results reveal persistent disparities related to gender, ethnicity, education, healthcare level, and geographic region, indicating gaps in equity, service organization, and continuity of care. Strengthening primary health care, decentralizing services, and improving professional training are essential strategies to enhance outcomes and support leprosy elimination efforts.</p>
},
  year = {2026},
  journal = {Acta Tropica},
  volume = {280},
  month = {08/2026},
  publisher = {Elsevier BV},
  issn = {0001-706X},
  doi = {10.1016/j.actatropica.2026.108171},
  language = {ENG},
}