Abstract
Spatial analysis of leprosy case distribution serves as a critical tool for identifying priority areas for intervention, particularly in settings with marked epidemiological heterogeneity. This study aimed to analyze the spatial distribution of new leprosy cases in Pernambuco, Brazil, 2000-2024. This is an ecological study with the municipalities of residence as the units of analysis. The data was extracted from the Notifiable Diseases Information System. The average incidence rates were calculated: general, in children under 15 years of age and with grade 2 physical disability at diagnosis, for four five-year periods. Bayesian smoothing and Moran's global and local autocorrelation statistics were applied. The average rates of overall detection were 29.0/100,000 inhabitants per year (very high); in children under 15 years of age, 10.7/100,000 inhabitants per year (hyperendemic); and grade 2 physical disability, 1.6/100,000 inhabitants per year (low). Spatial analysis showed significant spatial heterogeneity, with clusters of high overall detection rates of leprosy cases, high detection rates among children under 15, and high rates of grade 2 physical disability at diagnosis, mainly in macro-regions I and IV. There is circulation of Mycobacterium leprae across all macro-regions of the state, with evidence of active transmission foci in macro-region III. Therefore, municipalities with a priority for intervention are concentrated in macro-regions I and IV, highlighting the need to strengthen leprosy surveillance and control actions in the state.