ANSd: A Digital Simplified Neurological Assessment Application to Support Leprosy Care

<title>Abstract</title> <p> <bold>Purpose</bold> : Leprosy (known as Hansen’s disease in Brazil) continues to pose a major public health challenge in several endemic countries. The Simplified Neurological Assessment (from the Portuguese Avalia¸c˜ao Neurol´ogica Simplificada - ANS) is the standard procedure recommended by the Brazilian Ministry of Health to evaluate nerve function in individuals affected by leprosy, and is essential for preventing irreversible disabilities. However, its manual implementation limits data standardization, follow-up, and integration into digital health systems. This study presents the ANSd (Digital Simplified Neurological Assessment, from the Portuguese Avalia¸c˜ao Neurol´ogica Simplificada digital ), a mobile health application designed to support standardized neurological evaluation, improve documentation, and enhance longitudinal monitoring in leprosy care. <bold>Methods</bold> : The development of ANSd application was conducted as action research, applying Soft Systems Methodology (SSM) through iterative learning cycles with the Global Partnership for Zero Leprosy (GPZL) digital health priorities. The process included domain and requirement modeling, data model design, interface design, and software implementation. <bold>Results</bold> : ANSd enables digital recording of sensory and motor testing results, aggregates physical disability grading (from Portuguese, Grau de Incapacidade F´ısica - GIF) and the Eye-Hand-Foot (EHF) score, and stores structured records to support longitudinal patient follow-up. The ANSd application runs entirely offline through an offline-first architecture with encrypted on-device storage, and reproduces the official ANS form as a populated PDF, preserving regulatory compliance while enabling structured data capture. <bold>Conclusion</bold> : By consolidation standardized clinical data in a single digital platform, ANSd strengthens neurological monitoring and supports early detection of nerve impairment in individuals affected by leprosy. The ANSd application aligns with the GPZL’s strategic vision for digital health and offers a scalable solution for improving disability prevention and data-driven decisionmaking in leprosy control programs. Within the Brazilian public healthcare system (from Portuguese Sistema ´ Unico de Sa´ude - SUS), ANSd has the potential to enhance clinical workflows, facilitate integration with national surveillance platforms, and improve the continuity and quality of care for people affected by leprosy. </p>