Clinical outcome of skin yaws lesions after treatment with benzathinebenzylpenicillin in a pygmy population in Lobaye, Central African Republic

Abstract

BackgroundYaws is a bacterial skin and bone infectious disease caused by Treponema pallidum pertenue. It is endemic, particularly among pygmies in Central African Republic. To assess the clinical cure rate after treatment with benzathinepenicillin in this population, we conducted a cohort survey of 243 patients in the Lobaye region.Findings and conclusionThe rate of healing of lesions after 5 months was 95.9%. This relatively satisfactory level of therapeutic response implies that yaws could be controlled in the Central African Republic. Thus, reinforcement of the management of new cases and of contacts is suggested.

Epidemiology of yaws: an update

“…Recent evidence of surveys indicate that the underlying prevalence of T. pallidum infection in the communities of southwest Central African Republic (Lobaye and Sangha) may be very high with 11% (95% CI: 10.2–12.8) of schoolchildren with yaws skin lesions and 85% (95% CI: 82.5–88.1) prevalence of reactive serology (active and latent) (B Boua, personal communication, March 2013). This region, close to the borders of the Democratic Republic of the Congo and the Republic of the Congo, is also inhabited by indigenous populations 15. Previous serological surveys performed in 1978 in the same areas showed that 78%–86% of children had sera positive for Treponema , suggesting massive endemicity of T. pallidum pertenue infection 16,17.…”

“…Data from WHO,2 Global Health Observatory Data Repository: Yaws,8 Coldiron et al,14 Manirakiza et al,15 Edorh et al,21 Akogun et al,23 Backhouse et al,28 Mitjà et al,31 de Noray et al36 Abbreviations: CI, confidence interval; NA, not applicable; ND, no data.…”

Mapping the Epidemiology of Yaws in the Solomon Islands: A Cluster Randomized Survey

“…Tertiary yaws causes disfiguring lesions of the face but neurological and cardiovascular manifestations (which can appear in advanced syphilis) are not thought to occur. A major campaign in the 1950s was responsible for a significant reduction in the prevalence of disease worldwide, but following the dismantling of vertical control programs, the number of cases subsequently rebounded, and yaws now represents a significant public health problem in Africa, South-East Asia, and the Pacific 6–10…”

Yaws essentials: What health professionals should know about yaws

“…It causes a chronic relapsing nonvenereal treponematoses, characterized by highly contagious primary and secondary cutaneous lesions, and noncontagious tertiary destructive lesions of the bones [19]. Mass campaigns carried out in yaws endemic areas since the 1950's gave arise to the possibility of eradication, however, resurgence of yaws has been reported due to curtailment of control activities, which has allowed the reservoir of untreated cases to grow unchecked [12]. Yaws presents new challenges such as unknown epidemiological situation, poor awareness and knowledge among healthcare workers, and attenuated clinical forms of the disease [10].…”

“…Regional lymphadenopathy and arthralgia may occur; [4] The secondary stage develops after 1 to 24 months from disease onset [8]. During the secondary stage, multiple lesions called "daughter yaws" develop as smaller skin papillomas, which are widespread [12]. Hyperkeratosis, cracking and secondary infections may also develop at the soles [7].…”