Wednesday, May 28, 2014

Antibiotic Treatment for Yaws – A Plan to Eradicate the Disease

Yaws is an infectious disease that is prevalent among human populations in the tropical regions.  It is a disfiguring ailment that impacts hundreds of thousands of individuals.   There are not many fatalities associated with yaws; however, it produces considerable suffering among those afflicted, especially children.  The primary symptoms include serious skin ulcers especially on the face, back, buttocks and legs.  It has been reported that approximately 100,000 new cases show up every year, of which 75% are children.  Although most suffers heal over time with no chronic side effects, about 10% suffer from erosion of connective tissues including cartilage and bone.

The pathogen responsible for yaws is Treponema pallidum - an organism closely related to the infectious agent that causes syphilis.  However, unlike syphilis, yaws is not sexually transmitted.  Yaws is readily treated by the use of antibiotics.  An attempt was made in 1952 to completely eradicate this disease using benzathine penicillin in over 46 countries.  As a result of this intensive effort, disease incidence had dropped by 95 percent, but by the 1970s, the disease began to return and ultimately reached current levels.

In 2012, a new plan has emerged, sponsored by the World Health Organization (WHO), to eradicate the disease – referred to as the Morges Plan.  The ambitious strategy involved is to use the relatively inexpensive antibiotic azithromycin requiring only one oral dose.  In addition to administering this drug to those individuals infected, the plan is to include at least 90% of the population in the infected areas.  This strategy is designed to treat not only those individuals who are clearly ill but also those with latent infection and who are asymptomatic.

Epidemiologists are hopeful that this scheme might prove successful, but are also aware of the many obstacles that have to be overcome including the magnitude of the administrative task involved, the scope of the project and its cost. 

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