Yaws in Pygmy and Bantu children inhabiting the rural zones of Central Africa

Abstract

Introduction: Yaws, an infectious dermatosis is one of 17 neglected tropical diseases still present in the world despite the efforts aiming at the eradication of the disease undertaken in 2020. It is mainly found in populations living in poor hygiene conditions with a limited access to water and health care facilities. BaAka Pygmies and Bantu people inhabiting the rural areas of the Central African Republic (CAR) are still affected by yaws on a large scale. Aim: To assess the prevalence of yaws in Central Africa, treatment accessibility, and the need for implementing future health programs. Material and methods: Primary school BaAka Pygmy and Bantu children from the Dzanga Sangha region (CAR) were assessed in the context of yaws prevalence in years 2019-2020. The diagnosis was based on the clinical picture of the typical skin lesions and their location. Serologic tests were not performed. Results: Four hundred and ninety-four Pygmies and 235 Bantu children were examined, of whom 38.7% and 43.0%, respectively, presented primary yaws lesions. The mean age of Pygmy and Bantu children with lesions was 9.1 and 9.7 years old, respectively. In both ethnic groups boys predominated. The most common location of yaws lesions were lower legs, ankles, knees and feet. Conclusions: Yaws, like all other neglected tropical diseases, might become a cosmopolitan skin disease transferred from Africa to Europe and North America by tourists travelling to sub-Saharan destinations in Africa and migrants. The knowledge of tropical skin diseases and ability to make a differential diagnosis might become necessary for each dermatologist in the next 10-20 years.