Temporal trends of leprosy in a Brazilian state capital in Northeast Brazil: epidemiology and analysis by joinpoints, 2001 to 2012.

The objective of this study was to characterize epidemiological and temporal trends of leprosy in the city of Fortaleza, Ceará, Brazil, from 2001 to 2012. A total of 9,658 new cases were reported. Their temporal trend was analyzed by the jointpoint regression model. The overall detection rate showed a declining trend, with annual percent change (APC) of -4.0 and 95% confidence interval (95%CI) -5.6 - -2.3. The detection rate in children under 15 years of age (APC = -1.4; 95%CI -5.4 - 2.8) and the detection rate of disability grade 2 (APC = -0.8; 95%CI -4.5 - 3.1) were stable. The proportion of female patients was descending (APC = -1,5; 95%CI -2.3 - -0.8). The proportion of multibacillary cases from 2005 to 2012 (APC = 1.4; 95%CI 0.6 - 2.3) and among them, lepromatous cases from 2004 to 2012 (APC = 6.0; 95%CI 3.4 - 8.6) were increasing. There was stability in the proportion of cases with grade 1 (APC = 1.4; 95%CI -0.9 - 3.7) and grade 2 disability (APC = 3.7; 95%CI -0.1 - 7.8). Despite the trend towards a reduction in detection, the disease transmission persists in the city. The data also suggest late diagnosis.