Leprosy remains endemic in several regions of Brazil, ranking second worldwide in new annual cases. Ceará has remained among the top positions nationally in incidence over the last four years. In this context, Primary Health Care, through the Family Health Strategy (ESF), has established diagnostic and treatment measures aimed at disease control. This study investigated the impact of ESF actions on leprosy incidence in Sertão dos Inhamuns.

Ecological study with secondary data from 2020 to 2024, involving the municipalities of Tauá, Parambu, and Quiterianópolis. New leprosy cases were obtained from the Notifiable Diseases Information System (SINAN), while ESF coverage data were extracted from the National Registry of Health Establishments (CNES). Based on these data, detection rates per 100,000 inhabitants were calculated using municipal populations from the 2022 Census.

In 2020, Quiterianópolis had 21 ESF teams and, in 2024, this coverage increased to 28 teams for approximately 20,000 inhabitants, representing the highest proportional coverage and recording the lowest leprosy rates in the period, ranging from 0 to 14.8 cases per 100,000 inhabitants. Parambu, in turn, with relatively lower coverage (22 teams in 2024), maintained high rates between 22.3 and 38.2 per 100,000 for four consecutive years. In Tauá, which had 57 teams for about 61,000 inhabitants, an oscillating pattern was observed, with a peak in 2021 (32.7 per 100,000) and a progressive decline to 8.2 in 2024. The data suggest a trend of association between greater ESF coverage and better epidemiological indicators, also considering the expansion of coverage over time.

Thus, data from Sertão dos Inhamuns ‒ especially Tauá, Parambu, and Quiterianópolis ‒ indicate a possible association between ESF coverage expansion and reduced leprosy detection rates, possibly by strengthening prevention actions, active surveillance, and case follow-up, impacting interruption of the transmission chain. In view of these findings, future studies are recommended to deepen analysis of the impact of ESF actions on disease incidence in the municipalities of the region.