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Leprosy Elimination Monitoring (LEM) in Brazil, 2003

in collaboration with the Lauro de Souza Lima Institute (Bauru, São Paulo) & the Alfredo da Mata Foundation (Manaus, Amazonas), January 2004

- Executive Summary
(8 pp, PDF, 484 KB)
- Full-text report
(36 pp, PDF, 2099 KB, with links from Table of Contents to chapters)
- Reports from the Brazilian States

- LEM Guidelines for Monitors (WHO)
- PAHO Leprosy Page
- WHO Leprosy Page:
English  | français

The present publication is a contribution of the Pan American Health Organization/World Health Organization (PAHO/WHO), in conjunction with the Brazilian Ministry of Health, which aims to improve and promote access to nationwide leprosy information.

The reported data resulted from the Leprosy Elimination Monitoring (LEM) exercise undertaken in the 27 Brazilian states during June and August 2003 by technicians from two PAHO/WHO Collaborating Centers in Brazil: Lauro de Souza Lima Institute and Alfredo da Mata Foundation.

LEM exercises are based both on a cross-sectional study carried out at health care facilities selected at random and interviews with patients and health care personnel. LEM is an independent and formal assessment method using standard indicators established by the World Health Organization (WHO). Data collected during these exercises supplements the routine information system, making it possible to obtain detailed information on the performance of health services, quality of health care services offered to leprosy patiens, Multi-drug therapy (MDT) access and coverage at state, regional and municipal levels. These indicators enable us to measure specific aspects of leprosy elimination goals as it provides information that will help managers in the decision-making process and implementation of action plans such as:

• Internal validation of data on prevalence and detection rates (crude and specific).
• Integration of MDT services in the general health care system by means of MDT blister packs supply.
• Widen geographic coverage of MDT services.
• Assessment of the quality of MDT services in accordance with cohort analysis.

The coordination for implementing the exercise and elaborating reports in each state of North and Northeast Regions was under the responsibility of the Alfredo da Mata Foundation; the initiative in the Southeast, South and Central Regions was carried out by the Lauro de Souza Lima Institute.

The elaboration and systematization of indicators fulfill WHO guidelines to provide an understanding of the country's leprosy epidemiological and operational profile. It is hoped that the efforts of every professional involved in this work will contribute mainly to enhance and promote access to diagnosis and treatment services provided for the population so as to reach the goal of eliminating leprosy as a public health problem in Brazil.