Towards eradication of yaws disease by 2020 using a single dose of azithromycin in mass treatment

Abstract

Background: Yaws is a disfiguring non-venereal treponemal disease, one of the neglected tropical diseases continued to be prevalent in isolated pockets in some of the tropical countries in African, Asia andWestern Pacific Regions of theWorldHealthOrganization (WHO). It is a disease commonly seen amongmarginalized poor section of the most neglected population. More than 50% of the cases occur in children. Generally, it is said “yaws begins where the road ends”. Between 1952 and 1964, the WHO and the UNICEF embarked on global treponema control campaigns to administer a single dose long-acting benzathine penicillin to all yaws cases and their contacts. About 50millionpeoplewere treated in46endemic countries during the campaign. As a result, the burden the disease reduced by more than 95 percent from 50million to 2.5 million. Subsequently, yaws lost its priority in the light of emerging other priority disease control programmers and the goal of eradication was not reached. MethodsM 12 countries of them reported new yaws cases 56 223 (2008) and 47 800 (2012) (WHO 2012). Encouraged by the recent evidence of efficacy of a single oral dose of azithromycin in curing yaws disease in Papua New Guinea and Ghana, WHO recommended single dose azithromycin-based treatment strategy (Morges strategy 2012). Initially, a single dose of azithromycin to entire yaws endemic community followed by targeted treatment of cases and contacts. Conclusion: Yaws endemic countries met in Geneva, Switzerland in 2012 and 2013 and drafted operational guidelines to implement the new treatment strategy. Ghana, Papua New Guinea, Solomon Islands and Vanuatu implemented pilot projects to gain more experience in 2013. World Health Assembly resolution in 2013 included yaws for eradication by 2020.