{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,3]],"date-time":"2026-06-03T15:11:41Z","timestamp":1780499501506,"version":"3.54.1"},"reference-count":64,"publisher":"American Society of Tropical Medicine and Hygiene","issue":"6","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2026,6,3]]},"abstract":"<jats:title>ABSTRACT.<\/jats:title>\n                  <jats:p>Leprosy remains a neglected tropical disease with active transmission. Predictive models improve understanding of epidemiological trends and support control strategies in endemic contexts. This study analyzed leprosy in Brazil between 2001 and 2024, projecting scenarios through 2034. Data were obtained from the National System of Notifiable Diseases, and population estimates were from the Brazilian Institute of Geography and Statistics. Temporal trends were assessed using segmented regression, and projections were generated with statistical methods and machine learning algorithms. Independent variables included sex, age, educational level, clinical form, operational classification, and bacilloscopy index. Consistent decline was observed in the overall detection rate and among individuals younger than 15 years old, suggesting reduced transmission. The proportion of cases diagnosed with grade 2 disability remained high, indicating late detection. Projections showed a gradual decline in endemicity but no elimination of leprosy as a public health problem by 2030. The random forest model identified male sex, age older than 15 years old, lower educational level, and multibacillary clinical form as the main predictors of new cases. The integration of machine learning improved the accuracy of projections and revealed persistent gaps in early diagnosis, providing evidence for targeted interventions and strengthening active surveillance and timely detection. The findings are relevant not only for Brazil but also, for other endemic countries, such as India and Indonesia, reinforcing the global need for intensified elimination strategies. The study demonstrates the potential of predictive modeling to support leprosy control and broader neglected tropical disease programs.<\/jats:p>","DOI":"10.4269\/ajtmh.25-0588","type":"journal-article","created":{"date-parts":[[2026,5,1]],"date-time":"2026-05-01T12:17:15Z","timestamp":1777637835000},"page":"1069-1077","source":"Crossref","is-referenced-by-count":0,"title":["Temporal Trends and Projections of Leprosy in Brazil: Application of Machine Learning Techniques for Predictive Analysis (2001\u20132034)"],"prefix":"10.4269","volume":"114","author":[{"given":"Simone Oliveira Lucas","family":"Bertoldo","sequence":"first","affiliation":[{"name":"Graduate Program in the Northeast Network for Family Health Training, Federal University of Cear\u00e1, Fortaleza, Brazil;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Fernanda Aguiar","family":"Kucharski","sequence":"additional","affiliation":[{"name":"Graduate Program in the Northeast Network for Family Health Training, Federal University of Cear\u00e1, Fortaleza, Brazil;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jana\u00edna Sab\u00f3ia Aguiar de","family":"Azevedo","sequence":"additional","affiliation":[{"name":"Graduate Program in the Northeast Network for Family Health Training, Federal University of Cear\u00e1, Fortaleza, Brazil;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Paula Sacha Frota","family":"Nogueira","sequence":"additional","affiliation":[{"name":"Department of Nursing, Federal University of Cear\u00e1, Fortaleza, Brazil;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Manuela","family":"de Mendon\u00e7a Figueir\u00eado Coelho","sequence":"additional","affiliation":[{"name":"Graduate Program in the Northeast Network for Family Health Training, Federal University of Cear\u00e1, Fortaleza, Brazil;"},{"name":"Department of Nursing, Federal University of Cear\u00e1, Fortaleza, Brazil;"},{"name":"Graduate Program in Nursing, Graduate Program in the Northeast Network for Family Health Training, Federal University of Cear\u00e1, Fortaleza, Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"2795","reference":[{"issue":"2","key":"b1","series-title":"Indian J Med Res","first-page":"120","article-title":"Leprosy research updates: Shaping the future of global leprosy control","volume":"161","author":"Deps","year":"2025"},{"key":"b2","article-title":"Leprosy (Hansen Disease).","year":"2025"},{"key":"b3","article-title":"Leprosy.","year":"2025"},{"key":"b4","series-title":"BMC Infect Dis","first-page":"320","article-title":"Time trend and identification of risk areas for physical disability in leprosy in Brazil","volume":"25","author":"Matos","year":"2025"},{"key":"b5","series-title":"Front Med (Lausanne)","first-page":"1401685","article-title":"Prevalence of paucibacillary cases of leprosy in Brazil: A 20-year systematic review and meta-analysis","volume":"11","author":"Brito Gon\u00e7alves","year":"2024"},{"key":"b6","series-title":"Epidemiol Serv Saude","first-page":"e20231435","article-title":"Trend in the epidemiological risk of leprosy in the state of Goi\u00e1s-Brazil between 2010 and 2021","volume":"33","author":"Barbosa","year":"2024"},{"issue":"5","key":"b7","series-title":"An Bras Dermatol","first-page":"602","article-title":"Epidemiological characteristics of leprosy from 2000 to 2019 in a state with low endemicity in southern Brazil","volume":"98","author":"Moraes","year":"2023"},{"key":"b8","article-title":"Interruption of Transmission and Elimination of Leprosy\u2014Technical Guidance.","year":"2023"},{"key":"b9","article-title":"What are neglected tropical diseases (NTDs)? [Internet]","year":"2026"},{"key":"b10","article-title":"Leprosy\/Hansen Disease Elimination Dossier.","year":"2021"},{"key":"b11","article-title":"Departamento De Inform\u00e1tica Do SUS (DATASUS).","year":"2025"},{"key":"b12","article-title":"Estimativas Da Popula\u00e7\u00e3o Residente Para os Munic\u00edpios e Unidades Da Federa\u00e7\u00e3o.","year":"2024"},{"key":"b13","article-title":"Global Leprosy (Hansen Disease) Update, 2022: New Paradigm\u2014Control to Elimination.","year":"2023"},{"key":"b14","series-title":"Expediente Sobre a Elimina\u00e7\u00e3o Da Lepra Ou Doen\u00e7a De Hansen","year":"2025"},{"key":"b15","series-title":"Public Health","first-page":"307","article-title":"Leprosy in Brazil: An analysis of the Global Burden of Disease estimates between 1990 and 2019","volume":"236","author":"de Ara\u00fajo","year":"2024"},{"issue":"8","key":"b16","series-title":"PLoS Negl Trop Dis.","first-page":"e0012342","article-title":"Leprosy and lymphatic filariasis-related disability and psychosocial burden in northern Mozambique","volume":"18","author":"van Wijk","year":"2024"},{"issue":"1","key":"b17","series-title":"Lepr Rev","first-page":"59","article-title":"Mental wellbeing among people affected by leprosy in the Terai region, Nepal","volume":"92","author":"van Netten","year":"2021"},{"key":"b18","series-title":"Front Trop Dis","first-page":"808955","article-title":"Mental health, stigma, and neglected tropical diseases: A review and systematic mapping of the evidence","volume":"3","author":"Koschorke","year":"2022"},{"key":"b19","series-title":"Lepr Rev","first-page":"221","article-title":"Impact of COVID-19 on leprosy control: Challenges and opportunities","volume":"93","author":"Rao","year":"2022"},{"issue":"4","key":"b20","series-title":"Trop Med Int Health","first-page":"311","article-title":"Leprosy control in the post-COVID era: Lessons from India","volume":"28","author":"Choudhury","year":"2023"},{"key":"b21","article-title":"Global Health Observatory.","year":"2025"},{"issue":"4","key":"b22","series-title":"Lepr Rev","first-page":"e2024059","article-title":"Challenges of delay in diagnosis and high disability rate among newly diagnosed leprosy patients in Karachi, Pakistan","volume":"95","author":"Murtaza","year":"2024"},{"issue":"1","key":"b23","series-title":"Infect Dis Immun","first-page":"1","article-title":"Leprosy: A disease that has never gone away","volume":"5","author":"Zhao","year":"2025"},{"issue":"1","key":"b24","series-title":"Sci Rep","first-page":"19220","article-title":"Enhancing COVID-19 forecasting precision through the integration of compartmental models, machine learning and variants","volume":"14","author":"Baccega","year":"2024"},{"issue":"1","key":"b25","series-title":"Am Stat","first-page":"37","article-title":"Forecasting at scale","volume":"72","author":"Taylor","year":"2018"},{"issue":"4","key":"b26","series-title":"Stoch Environ Res Risk Assess","first-page":"345","article-title":"Machine 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detection approaches for leprosy diagnosis in varied endemic settings: A comprehensive scoping review","volume":"14","author":"Brown","year":"2024"},{"issue":"6","key":"b31","series-title":"Int J Dermatol","first-page":"1079","article-title":"Unveiling hidden leprosy in underserved populations of the Amazonas state through active case-finding\u2014The Amazon Skin Health Program (2023)","volume":"64","author":"Grana","year":"2025"},{"issue":"4","key":"b32","series-title":"Lepr Rev","first-page":"e2024123","article-title":"The role of Artificial Intelligence (AI) in scientific writing and publishing","volume":"95","author":"Saunderson","year":"2024"},{"issue":"2","key":"b1","series-title":"Indian J Med Res","first-page":"120","article-title":"Leprosy research updates: Shaping the future of global leprosy control","volume":"161","author":"Deps","year":"2025"},{"key":"b2","article-title":"Leprosy (Hansen Disease).","year":"2025"},{"key":"b3","article-title":"Leprosy.","year":"2025"},{"key":"b4","series-title":"BMC Infect Dis","first-page":"320","article-title":"Time trend and identification of risk areas for physical disability in leprosy in Brazil","volume":"25","author":"Matos","year":"2025"},{"key":"b5","series-title":"Front Med (Lausanne)","first-page":"1401685","article-title":"Prevalence of paucibacillary cases of leprosy in Brazil: A 20-year systematic review and meta-analysis","volume":"11","author":"Brito Gon\u00e7alves","year":"2024"},{"key":"b6","series-title":"Epidemiol Serv Saude","first-page":"e20231435","article-title":"Trend in the epidemiological risk of leprosy in the state of Goi\u00e1s-Brazil between 2010 and 2021","volume":"33","author":"Barbosa","year":"2024"},{"issue":"5","key":"b7","series-title":"An Bras Dermatol","first-page":"602","article-title":"Epidemiological characteristics of leprosy from 2000 to 2019 in a state with low endemicity in southern Brazil","volume":"98","author":"Moraes","year":"2023"},{"key":"b8","article-title":"Interruption of Transmission and Elimination of Leprosy\u2014Technical Guidance.","year":"2023"},{"key":"b9","article-title":"What are neglected tropical diseases (NTDs)? [Internet]","year":"2026"},{"key":"b10","article-title":"Leprosy\/Hansen Disease Elimination Dossier.","year":"2021"},{"key":"b11","article-title":"Departamento De Inform\u00e1tica Do SUS (DATASUS).","year":"2025"},{"key":"b12","article-title":"Estimativas Da Popula\u00e7\u00e3o Residente Para os Munic\u00edpios e Unidades Da Federa\u00e7\u00e3o.","year":"2024"},{"key":"b13","article-title":"Global Leprosy (Hansen Disease) Update, 2022: New Paradigm\u2014Control to Elimination.","year":"2023"},{"key":"b14","series-title":"Expediente Sobre a Elimina\u00e7\u00e3o Da Lepra Ou Doen\u00e7a De Hansen","year":"2025"},{"key":"b15","series-title":"Public Health","first-page":"307","article-title":"Leprosy in Brazil: An analysis of the Global Burden of Disease estimates between 1990 and 2019","volume":"236","author":"de Ara\u00fajo","year":"2024"},{"issue":"8","key":"b16","series-title":"PLoS Negl Trop Dis.","first-page":"e0012342","article-title":"Leprosy and lymphatic filariasis-related 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Observatory.","year":"2025"},{"issue":"4","key":"b22","series-title":"Lepr Rev","first-page":"e2024059","article-title":"Challenges of delay in diagnosis and high disability rate among newly diagnosed leprosy patients in Karachi, Pakistan","volume":"95","author":"Murtaza","year":"2024"},{"issue":"1","key":"b23","series-title":"Infect Dis Immun","first-page":"1","article-title":"Leprosy: A disease that has never gone away","volume":"5","author":"Zhao","year":"2025"},{"issue":"1","key":"b24","series-title":"Sci Rep","first-page":"19220","article-title":"Enhancing COVID-19 forecasting precision through the integration of compartmental models, machine learning and variants","volume":"14","author":"Baccega","year":"2024"},{"issue":"1","key":"b25","series-title":"Am Stat","first-page":"37","article-title":"Forecasting at scale","volume":"72","author":"Taylor","year":"2018"},{"issue":"4","key":"b26","series-title":"Stoch Environ Res Risk Assess","first-page":"345","article-title":"Machine learning and automatic ARIMA\/Prophet models-based forecasting of COVID-19: Methodology, evaluation, and case study in SAARC countries","volume":"37","author":"Sardar","year":"2023"},{"key":"b27","series-title":"South East Eur J Public Health","first-page":"829","article-title":"Risk factors for disabilities among leprosy patients: A systematic review","volume":"XXVI","author":"Kurane","year":"2025"},{"key":"b28","series-title":"Front Immunol","first-page":"1198764","article-title":"Biomarkers for early leprosy diagnosis and monitoring: Progress and prospects","volume":"14","author":"Truman","year":"2023"},{"key":"b29","article-title":"Expediente sobre la eliminaci\u00f3n de la lepra o enfermedad de Hansen: Herramienta que acompa\u00f1a a la orientaci\u00f3n t\u00e9cnica sobre la interrupci\u00f3n de la transmisi\u00f3n y la eliminaci\u00f3n de la lepra.","year":"2025"},{"issue":"8","key":"b30","series-title":"Life (Basel)","first-page":"937","article-title":"Exploring active case detection approaches for leprosy diagnosis in varied endemic settings: A comprehensive scoping review","volume":"14","author":"Brown","year":"2024"},{"issue":"6","key":"b31","series-title":"Int J Dermatol","first-page":"1079","article-title":"Unveiling hidden leprosy in underserved populations of the Amazonas state through active case-finding\u2014The Amazon Skin Health Program (2023)","volume":"64","author":"Grana","year":"2025"},{"issue":"4","key":"b32","series-title":"Lepr Rev","first-page":"e2024123","article-title":"The role of Artificial Intelligence (AI) in scientific writing and publishing","volume":"95","author":"Saunderson","year":"2024"}],"container-title":["The American Journal of Tropical Medicine and 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