Secular trends in leprosy burden: Comparative insights from India and Brazil in the last three decades using the Global Burden of Disease study data

The objective of this study is to analyze the changes in leprosy burden in India and Brazil between 1990 and 2019. Using data from the 2019 Global Burden of Disease study, this research evaluated leprosy rates (incidence, prevalence, and DALYs) from 1990 to 2019, in India and Brazil. It investigated age and gender-specific rates in both countries, adjusting for age and providing rates with 95% uncertainty intervals. Additionally, the study illustrated the geographic distribution of prevalence across different states in India. Both India and Brazil have seen reductions in leprosy rates including incidence, prevalence, and DALYs. In India, incidence dropped from 6.04 to 1.81 cases per 100,000 between 1990 and 2019. Prevalence decreased from 73.45 to 20.00 cases per 100,000, and DALYs went down from 4.04 to 1.09 per 100,000 during the same period. In Brazil, incidence declined from 4.76 to 3.48 cases per 100,000, prevalence dropped from 26.13 to 22.20 cases, and DALYs decreased from 1.13 to 1.04 per 100,000 between 1990 and 2019. Leprosy remains a significant health issue in India and Brazil. A multi-center study is essential to grasp the barriers in the existing strategies of their national leprosy eradication programs.