02008nas a2200241   4500000000100000008004100001260001300042653001100055653002100066653001800087653001100105653001200116653002400128653001500152100001200167700001200179245006300191300001100254490000700265050001500272520146500287022001401752       2007                            d  c2007 May10aBrazil10aEndemic Diseases10aHealth policy10aHumans10aleprosy10aModels, Statistical10aPrevalence1 aPenna M1 aPenna G00aTrend of case detection and leprosy elimination in Brazil.  a647-500 v12  aPENNA 20073 a<p>Only six countries did not meet the leprosy elimination target during 2005, amongst them Brazil. In 2006, the Brazilian Ministry of Health announced a reduction of the detection rate of 24% or 10 900 cases from 2004 to 2005. A negative binomial parabolic regression model was adjusted to the detection rate historical series from 1980 to 2004, in order to predict the 2005 detection rate and its 95% confidence interval. This analysis showed that the number of new leprosy cases for 2005 could not be predicted from the previous behaviour of the data what calls for an epidemiological or operational explanation hypothesis. The hypothesis that this drop in detected case number is due to operational change, as a reduction in diagnosis or a modification in the reporting routine, is more likely. Recent change in prevalence case definition turned the prevalence ratio a function of only one variable, the detection rate, as the duration of the diagnosed disease became fixed. In the early nineties, based on epidemiological data evaluation, the BMoH recognized the impossibility of reaching the elimination goal, but it committed to seek leprosy control. This position changed after some years. Leprosy Elimination is a strategy supported by the national and international public opinion. As a one for all recipe, it may cause unwanted effects for it is not flexible enough to deal with different epidemiological behaviours and public health traditions.</p>  a1360-2276