Towards elimination of yaws in Papua New Guinea

ABSTRACT

@#Yaws is a chronic infectious disease caused by Treponema pallidum subsp. pertenue, which causes disease of the skin, bones and joints and is spread by skin-to-skin contact. Most cases are seen in young children living in rural remote communities in coastal areas. A major campaign to eradicate yaws between 1953 and 1958, by mass treatment of affected communities with long-acting, injectable penicillin, reduced the number of cases by 95% in Papua New Guinea (PNG), but yaws has reappeared in recent years. In the period 2008- 2015 PNG reported >25,000 cases per year, and the country is currently home to about 40% of all the cases of yaws in the world. In 2012, one oral dose of azithromycin was shown to be as effective as intramuscular penicillin in the treatment of the disease, and the World Health Organization launched a new initiative to eradicate yaws by 2020. The new treatment policy recommends mass azithromycin treatment of the entire population in endemic areas. Continued vigilance for the development of macrolide resistance in T. pallidum ssp. pertenue will be important as the drug is introduced into public health practice.