The Lancet has published a new study led by Oriol Mitjà, first author and researcher at the Barcelona Institute for Global Health (ISGlobal), a centre supported by the “la Caixa” Foundation, which concludes that yaws eradication will require more than a single round of mass drug treatment indicated in the current WHO strategy.
Based on these results, Mitjà will launch in April 2018 a new project in Papua New Guinea with the goal of determining how many mass treatments are required, thereby guiding the WHO on the optimal strategy for yaws elimination.
Image/David Fontseca
Azithromycin resistance is reported for the first time
In 2012, Mitjà’s team established that one single dose of azithromycin was enough to cure yaws. This discovery became the cornerstone of the current WHO strategy of mass drug administration to achieve disease elimination by 2020. However, study published in The Lancet concludes that yaws eradication will require the administration of at least two antibiotic doses per person, spaced by 6-12 month intervals.
The international research team presents results obtained 42 months after a mass drug administration treatment in Lihir Island, Papua New Guinea, where 84% of the population received one single dose of azithromycin. A clinical, serological and molecular follow-up was performed to detect active yaws cases (i.e. ulcers where the presence of the causal agent, Treponema pallidum pertenue, was confirmed by DNA amplification). The results show a steep decline in disease prevalence after 18 months of treatment, but a re-emergence after 24 months and an increase to 0.4% after 42 months. Most cases were individuals that were absent at the time of treatment, although there were also imported cases from other regions.
Non-venereal treponematoses: yaws
“Our study underlines the need to treat every individual living in an endemic zone, in order to cure latent infections. Therefore, yaws could be eliminated with repeated rounds of mass treatments” explains the ISGlobal researcher and physician at the Hospital Clinic of Barcelona.
For the first time, the authors identified five T. p. pertenue infections that were resistant to azithromycin as a result of a mutation identified by laboratory techniques in Seattle, USA. The five children lived in the same village and were relatives or friends, indicating that they were infected by the same resistant strain. They were cured only after a penicillin benzathine injection.
“This study reveals the urgent need to include drug resistance monitoring as part of the WHO yaws eradication strategy” explains ISGlobal General Director Antoni Plasència.
Finding the optimal strategy for yaws elimination
The new 24-month project that Mitjà’s team will launch next April in the province of New Ireland, Papua New Guinea aims to identify how many rounds of mass treatment are necessary to achieve yaws elimination and will reach a total of 50,000 people. The results will help the WHO elaborate action guidelines for the governments of affected countries.
Research is always at least 20 years,behind. Never ever pro active. The same is with TB and it cousin chlamidophela c pneumonia which is rampant all over. More or less people thinking they have Lyme when severe symptoms develop. Yes it takes decades to get very sick but many symptoms thst are always dismissed. The real cause is staph aureus (catalase pos). Lyme is not the cause but a consequence of this e coli origin bacteria. So abx given to farm animals since at least the 60’s are the cause of resistance. Yes it is ok to treat farm animals that we eat but not humans. Actually this can not exist. Most often this bacteria enters through the ear like a swimmer’s ear feeling. Wonder why you see hundreds of ticks on aminals. Same would happen to humans if staying outdoors and no hands. See most persons that see doctors have low body temp and that is indicative of chronic infection. Ticks/mosquitoes and all other insects love the “sweet blood they immit”. Yes it is very contagious, latent , gets activated over and over again. Healthy people get it too.
Yep. more research needed, less gossip column.
Yep. More research needed, less gossip column.