The Global Leprosy Assessment Index (GLAI): A New Approach for measuring the Severity of Disease in Brazil

Background: In Brazil, the Ministry of Health (MH) monitors leprosy by using 15 indicators. The use of objective parameters is crucial for implementing and evaluating evidence-based public policies. However, an excessive number of variables can make it difficult to define objectives and particularly to verify epidemiological goals. The objective of this paper is to develop the Global Leprosy Assessment Index (GLAI) using data from Brazil.

Methods: This research design uses a principal component analysis model to estimate the GLAI, which combines two important perspectives in the fight against the disease: epidemiological and operational. The data used in the study are at the state level, for the year 2020, and provided by the MH. The GLAI ranges from 0 to 1, with higher values indicating a more severe situation of the disease.

Results: The mean value of the GLAI was 0.67, with a standard deviation of 0.22. Roraima has the highest value, followed by Paraíba with 0.88. On the other hand, Tocantins records the lowest value of the indicator, followed by Mato Grosso with 0.14. The epidemiological and operational indicators have a positive but statistically insignificant correlation (r = 0.25; p-value = 0.20).

Conclusions: The development of evidence-based public policies relies on the availability of valid and reliable indicators. The GLAI presented in this article can be easily reproduced to assist in the monitoring of the disease using disaggregated information. Additionally, the GLAI has the potential to serve as a more robust parameter for evaluating the impact of actions designed to eradicate leprosy in Brazil.