Epidemiological and operational patterns of leprosy in the state of tocantins, 2001-2020: regression by inflection points

Objective: To analyze the trend of epidemiological and operational indicators of leprosy in the state of Tocantins, Brazil, from 2001 to 2020. Methodology: This is a population-based ecological study, with temporal analysis of new leprosy cases based on Poisson regression by inflection points (Joinpoints), using secondary data reported between 2001 and 2020. Results: A total of 24.413 cases were reported. The overall detection coefficient showed four temporal trends. The Médio Norte Araguaia, Cerrado Tocantins Araguaia and Ilha do Bananal regions showed a significant downward trend in the AAPC (3.1%, 4.6% and 5.3%, respectively). Only the Amor Perfeito region showed a significant growth trend of 2.7%. In the evaluation of the Annual Percent Change (APC), the Bico do Papagaio region had a significant increase of 12.1% between 2001 and 2008 and a significant decrease of 10.3% between 2008 and 2020. In the Capim Dourado region, the APC had a significant decrease of 6.3% between 2001 and 2013 and a significant increase of 34.5% between 2013 and 2018. Conclusion: Leprosy remains in high magnitude in Tocantins, indicating active transmission, late diagnosis, heterogeneous trend in case detection in the eight health regions and persistence of hyperendemicity, requiring strengthening of surveillance measures.