01962nas a2200217   4500000000100000008004100001260002500042653002400067653001400091653001400105653001500119653001100134100001500145700001400160700001700174700001300191245012700204490000800331520139100339022001401730       2026                            d  c08/2026bElsevier BV10aPrimary Health Care10aDiagnosis10aTreatment10aDisability10aBrazil1 aMaciel ICL1 aLages DDS1 aCarvalho APM1 aLana FCF00aPerformance of a Brazilian health care network in leprosy care: Early diagnosis, timely treatment, and disability outcomes0 v2803 a<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>
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