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

Rafiq Nii Attoh Okine,Bismark Sarfo,Cynthia Kwakye-Maclean,Richard M Adanu,Francis Adjei Osei

doi:10.1186/s40249-020-00641-2

Abstract

BackgroundYaws 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.MethodsA 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.ResultsSixty-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.ConclusionsPoor 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.

Highlights

Yaws is a chronic relapsing disease caused by Treponema pallidum subspecies pertunue, which can result in severe disability and deformities
Yaws is one of the three non-venereal treponemal diseases that is considered as a neglected tropical disease (NTD) [1]
Study design The study was a community-based unmatched 1:2 casecontrol study conducted in the Upper West Akyem and Awutu Senya West districts in the Eastern and Western Regions of Ghana respectively

Summary

Introduction

Yaws is a chronic relapsing disease caused by Treponema pallidum subspecies pertunue, which can result in severe disability and deformities. 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. The disease is caused by Treponema pallidum subspecies pertenue. It is a highly contagious disease which has a (2020) 9:26 destructive lesions of bones and cartilages and results in severe deformities and disability [4]. Despite concerted efforts and strategies to eradicate yaws, the disease is still endemic in at least fourteen countries [1]. Eighty-four (84) percent of the cases were from Ghana, Papua New Guinea and Solomon Island [2]

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