[Leprosy surveillance in low-prevalence situations].

The majority of the countries in Latin America have reduced the prevalence of leprosy to less than 1 case for every 10,000 persons. The next step in these countries is to eliminate the disease at the regional and local level, in "pockets" that still have rates higher than 1 per 10,000. Given the demographic transition, the existence of areas with high transmission levels, and the necessity for more sensitive indicators, there is a need to change basic strategies, strengthen surveillance systems, and refocus resources. It is important to revamp efforts through such tactics as identifying priority geographical areas, customizing interventions, improving indicators, and combining passive and active surveillance. This can be done by redesigning surveillance systems to integrate the clinical, laboratory, epidemiological-research, and supply components. The results of the process should provide a minimum set of indicators that make it possible to monitor and evaluate the effectiveness and efficiency of action plans for the postelimination stage.