GEOGRAPHIC DISTRIBUTION OF LEPROSY HOSPITALIZATIONS IN BRAZIL: AN ECOLOGICAL ANALYSIS

Leprosy is a neglected disease that remains a major public health challenge in Brazil, with a substantial impact on socially vulnerable populations. Despite advances in diagnosis and treatment, advanced-stage cases still lead to hospitalizations and deaths. Understanding the regional distribution of these outcomes may reveal disparities in access to health services, contributing to the planning of more equitable interventions. This study aimed to analyze patterns of hospitalizations and in-hospital deaths due to leprosy in Brazil. Observational, ecological, retrospective study based on secondary data from the SUS Hospital Information System (SIH/SUS), extracted from DATASUS. All individuals hospitalized for leprosy (ICD-10: A30) and its sequelae in Brazil between 2020 and 2024 were included. Variables analyzed included total number of hospitalizations, number of in-hospital deaths, and mortality rate, stratified by geographic macroregion (North, Northeast, Southeast, South, and Central-West). Data were organized into frequency tables, and mortality rate was calculated as the ratio between deaths and hospitalizations, expressed as a percentage. The Chi-Square test (χ²) was applied to evaluate the association between deaths and region, with a 5% significance level (p<0.05). A total of 15,792 leprosy-related hospitalizations were analyzed between 2020 and 2024, with 321 deaths recorded, resulting in an overall mortality rate of 2.03%. The Northeast had the highest number of hospitalizations (6,036), followed by the Southeast (2,915), South (2,748), North (2,122), and Central-West (1,971). The highest mortality rates were observed in the South (2.84%) and Northeast (2.42%), while the lowest occurred in the Central-West (0.91%) and North (1.32%). The chi-square test indicated a statistically significant association between region and in-hospital deaths (χ²=31.27; p<0.001), suggesting regional inequality in leprosy-related outcomes. Findings reveal regional inequality in leprosy-related hospital outcomes in Brazil, with higher mortality in the South and Northeast. The statistical association between the distribution of deaths and macroregions points to potential differences in access to early diagnosis and quality of care.