Department of Global Health, Institute of Public Health and Nursing Research, University of Bremen, Bremen, Germany.
Marie Adelaide Leprosy Center, Karachi, Pakistan.
PLoS Negl Trop Dis. 2024 Sep 12;18(9):e0012434. doi: 10.1371/journal.pntd.0012434. eCollection 2024 Sep.
Leprosy, caused by Mycobacterium leprae, affects multiple body systems and can lead to preventable disability if untreated. While multidrug therapy (MDT) has been available since 1982, historical evidence suggests that untreated leprosy can resolve spontaneously. Nevertheless, the prevalence of self-healing worldwide, as well as factors determining self-healing, remain unclear.
A systematic review was conducted in 2023 with data from PubMed, Infolep, and Web of Sciences data bases, along with a google search. Data extraction and analysis followed PRISMA guidelines and were summarized in a separate Excel sheet. Included were English-language studies on self-healing in leprosy, regardless the year of publication.
We included six studies spanning from 1938 to 1978 exploring the incidence of self-healing in different countries and continents. Children, paucibacillary (PB) cases, and possibly males showed a higher probability of self-healing with an average healing time of two years.
DISCUSSION/CONCLUSION: Recent research on self-healing in leprosy is scarce and evidence limited. This is primarily due to ethical concerns regarding withholding effective treatment of diagnosed patients, and because of the absence of an agreed definition of self-healing. Nevertheless, self-healing appears to be a plausible phenomenon influenced by geographic and demographic factors, and the type of leprosy. We recommend further research on self-healing in leprosy, as it provides insight into the human immune system and the determinants of this phenomenon. More insight could help adapt clinical practices and public health strategies, thereby contributing to an effective management and control of this disease.
麻风病由麻风分枝杆菌引起，可影响多个身体系统，如果不治疗可导致可预防的残疾。虽然自 1982 年以来已经可以使用多药疗法（MDT），但历史证据表明未经治疗的麻风病可以自行痊愈。然而，全世界未经治疗而自行痊愈的患病率以及决定自行痊愈的因素仍不清楚。
2023 年进行了系统评价，检索了 PubMed、Infolep 和 Web of Sciences 数据库以及谷歌搜索的数据。数据提取和分析遵循 PRISMA 指南，并在单独的 Excel 工作表中进行总结。纳入了英语发表的关于麻风病自行痊愈的研究，无论发表年份如何。
我们纳入了 6 项研究，涵盖了从 1938 年到 1978 年不同国家和大陆的自行痊愈发生率。儿童、少菌型（PB）病例和可能是男性的患者自行痊愈的可能性更高，平均治愈时间为两年。
讨论/结论：最近关于麻风病自行痊愈的研究很少，证据有限。这主要是由于在诊断出的患者中拒绝给予有效治疗存在伦理问题，并且因为缺乏自行痊愈的公认定义。然而，自行痊愈似乎是一种合理的现象，受地理和人口因素以及麻风病的类型影响。我们建议进一步研究麻风病的自行痊愈，因为它可以深入了解人类免疫系统和这种现象的决定因素。更多的了解可以帮助调整临床实践和公共卫生策略，从而有助于有效管理和控制这种疾病。
