Leprosy in Brazilian counties bordering Paraguay: Mato Grosso do Sul State, 2001-2011

[[[ Background: ]]] In Mato Grosso do Sul state, Brazil, the dry border shared with Paraguay is a territory marked by facilities in the flow of goods, services and people, bringing difficulties for surveillance of communicable diseases. [[[ Purpose: ]]] The purpose of this study is to characterise leprosy epidemiologically in dry border municipalities of Mato Grosso do Sul in Brazil with contiguous urban areas with neighbouring Paraguayan counties, in the period 2001-2011. [[[ Methods: ]]] This is an exploratory descriptive investigation that includes the four dry border municipalities of Mato Grosso do Sul (Coronel Sapucaia, Paranhos, Ponta Porã, and Sete Quedas) in Brazil whose urban areas are contiguous with Paraguay. Data comprised the period 2001-2011. [[[ Results: ]]] The rates of leprosy detection and prevalence oscillated along the study period, increasing in the last 2 years investigated. The detection rate was 3.3/10,000 in 2011, up from 1.7/10,000 in 2009. Prevalence was 5.3/10,000 in 2011, up from 2.5/10,000 in 2009. The Virchowian disease form was predominant in 8 of the 11 years investigated. Most patients were male, with limited formal education (44.2% with less than 4 years of study). [[[ Conclusion: ]]] In the border of Brazil, most (greater than 70%) of the cases detected were classified as multibacillary. The higher coefficient found in Brazilian municipalities was the Virchowian clinical form, which can influence the operational classification in multibacillary. The predominance of the Virchowian clinical form, larger number of patients in rural areas and children under 15 years of age provides new information on the manifestations of the disease in the border territories. The study revealed that municipalities with contiguous cross-border urban areas with Paraguay have unique epidemiological features that need to be addressed by policies focusing leprosy as a public health priority.