Penicillin Therapy of Yaws and Serologic Results

Rein, Charles R.

doi:10.1001/archderm.1948.01520190021004

Cited by 4 publications

(1 citation statement)

References 10 publications

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“…This was unexpected since spirochetes are usually not detectable by DFM in yaws lesions within 8-10 hr of treatment. 9 Even after another course of treatment, one of these children had a recurrent yaws lesions and she and two others had serologic evidence of relapse within the first 12 months of follow-up. All responded to a third course of treatment.…”

Section: Discussionmentioning

confidence: 95%

Failure of penicillin treatment of yaws on Karkar Island, Papua New Guinea.

Backhouse¹,

Hudson²,

Hamilton³

et al. 1998

The American Journal of Tropical Medicine and Hygiene

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The endemic treponematosis yaws remains a significant cause of morbidity in many tropical countries, despite mass treatment campaigns to eradicate it. An outbreak of yaws in Marup village on Karkar Island, Papua New Guinea in 1988 provided an opportunity to monitor the outcome of treatment with penicillin over an extended period. Thirty-nine children with clinical yaws (6% of 632 examined) were monitored clinically and serologically, for nearly two years after mass treatment of all villagers with the World Health Organization recommended dosages of benzathine penicillin. Lesions resolved within one month of treatment in all but four (10%) children, three of whom were initially successfully retreated. Before treatment, the Venereal Disease Research Laboratory (VDRL) test result was reactive in 67% of the children and treponema-specific IgM antibody test results were reactive in 41%. Within six months of treatment, of those reactive, the VDRL titer decreased significantly in 25 (96%) of 26 and IgM antibody test results became negative in 13 (81%) of 16 children. However, by the end of follow-up, 11 (28%) of the 39 children had developed clinical and/or serologic evidence of relapse. In these children, response to further treatment was slow and, in three, evidence of active infection persisted or recurred, despite repeated courses. Exogenous reinfection was unlikely in this isolated community, in which the occurrence of yaws was closely monitored after universal treatment. Treatment failure was most likely to have been due to reduced susceptibility to penicillin of Treponema pallidum subsp. pertenue.

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Section: Discussionmentioning

confidence: 95%