Re-emergence of yaws after single mass azithromycin treatment followed by targeted treatment: a longitudinal study

Mitjà, Oriol; Godornes, Charmie; Houinei, Wendy; Kapa, August; Paru, Raymond; Abel, Haina; González-Beiras, Camila; Bieb, Sibauk; Wangi, James; Barry, Alyssa E.; Sanz, Sergi; Bassat, Quique; Lukehart, Sheila A.

doi:10.1016/s0140-6736(18)30204-6

Cited by 73 publications

(88 citation statements)

References 24 publications

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“…Also, our analysis suggests that the persistence of yaws following MDA cannot be attributed purely to a lack of control in a single location nor to reintroduction of yaws at just 1 location. Indeed, our findings are compatible with the fact that many of the cases of yaws that occurred following MDA were in people who were not treated during MDA [24]. Finally, if the observed clustering is due to appreciable inter-village yaws transmission, we suggest that villages may be epidemiologically linked to such a degree that they may not effectively serve as implementation units.…”

Section: Discussionsupporting

confidence: 83%

Spatial-temporal clustering analysis of yaws on Lihir Island, Papua New Guinea to enhance planning and implementation of eradication programs

Mooring

Mitjà

Murray

2018

Preprint

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Section: Discussionsupporting

confidence: 83%

Spatial-temporal clustering analysis of yaws on Lihir Island, Papua New Guinea to enhance planning and implementation of eradication programs

Mooring

Mitjà

Murray

2018

Preprint

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“…The choice of case-control study design could amount to recall bias particularly among the controls. Also, swabs from yaws-like ulcers in some endemic areas have shown infections with Haemophilus ducreyi alone or coinfections with T. pallidum subspecies pertenue and H. ducreyi [9,11,16,17,29]. The prevalence of substandard sanitary and personal hygienic conditions in yaws-endemic communities also facilitates the persistence of H. ducreyi infections in these communities [29].…”

Section: Discussionmentioning

confidence: 99%

“…A major component of the new strategy was the change from the injectable benzathine penicillin to oral azithromycin [7]. The new treatment strategy was piloted in three countries including Ghana [8][9][10] and though the strategy had significant impact on disease burden, it did not achieve elimination targets in high endemic communities [11]. This is a major pointer to further explore the environmental drivers of yaws transmission in highly endemic communities.…”

Section: Introductionmentioning

confidence: 99%

Factors associated with cutaneous ulcers among children in two yaws-endemic districts in Ghana

et al. 2020

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Background: Yaws is a chronic relapsing disease caused by Treponema pallidum subspecies pertunue, which can result in severe disability and deformities. Children below the age of 15 years in resource-poor communities are the most affected. Several non-specific factors facilitate the continuous transmission and resurgence of the disease. Endemic communities in rural Ghana continue to report cases despite the roll out of several intervention strategies in the past years. The objective of this study was to determine the factors associated with cutaneous ulcers among children in two yaws-endemic districts in Ghana. Methods: A community-based unmatched 1:2 case-control study was conducted among children between 1 and 15 years. Data on socio-demographic, environmental and behavioral factors were collected using a structured questionnaire. Active case search and confirmation was done using the Dual Path Platform (DPP) Syphilis Screen and Confirm test kit. Data were analyzed using STATA 15. Logistic regression was done to determine the exposures that were associated with yaws infection at 0.05 significant level. Results: Sixty-two cases and 124 controls were recruited for the study. The adjusted multivariable logistic regression model showed that yaws infection was more likely among individuals who reside in overcrowded compound houses (aOR = 25.42, 95% CI: 6.15-105.09) and with poor handwashing habits (aOR = 6.46, 95% CI: 1.89-22.04). Male (aOR = 4.15, 95% CI: 1.29-13.36) and increasing age (aOR = 5.90, 95% CI: 1.97-17.67) were also associated with yaws infection. Conclusions: Poor personal hygiene, overcrowding and lack of access to improved sanitary facilities are the factors that facilitate the transmission of yaws in the Awutu Senya West and Upper West Akyem districts. Yaws was also more common among males and school-aged children. Improving living conditions, access to good sanitary facilities and encouraging good personal hygiene practices should be core features of eradication programs in endemic communities.

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“…Although subsequent treatment with benzathine benzylpenicillin was used to successfully ring-fence this outbreak, these data highlight the risk of emerging azithromycin resistance threatening yaws eradication efforts. 21 Finally, there is also evidence that non-human primates are also infected with Treponema pallidum subsp pertenue . 22,23 While no evidence currently exists for zoonotic transmission, the existence of a possible animal reservoir highlights the challenges that may emerge during an eradication campaign.…”

Section: Cme: Tropical Medicinementioning

confidence: 99%

Neglected tropical diseases: elimination and eradication

2019

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The term neglected tropical diseases (NTDs) describes a disparate group of diseases which affect populations living in poverty and are important causes of morbidity and mortality worldwide. Global programmes for the control of NTDs benefit large-scale donations made by pharmaceutical companies. A number of NTDs have internationally agreed targets for their control, elimination and eradication. Eradication is defined as the permanent reduction to zero of the worldwide incidence of infection. Elimination is defined as the reduction to zero of the incidence of infection in a specified geographic area. Considerable progress has been made towards elimination and eradication of some NTDs but unexpected new challenges have emerged which threaten the eventual achievement of these goals.

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Re-emergence of yaws after single mass azithromycin treatment followed by targeted treatment: a longitudinal study

Cited by 73 publications

References 24 publications

Spatial-temporal clustering analysis of yaws on Lihir Island, Papua New Guinea to enhance planning and implementation of eradication programs

Spatial-temporal clustering analysis of yaws on Lihir Island, Papua New Guinea to enhance planning and implementation of eradication programs

Factors associated with cutaneous ulcers among children in two yaws-endemic districts in Ghana

Neglected tropical diseases: elimination and eradication

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