Study finds new strategy

A NEW study is accelerating progress towards eradicating yaws and reinforcing the knowledge for the elimination of infectious threats.
Yaws is a chronic skin infection characterised by papillomas (non-cancerous lumps) and ulcers. It is caused by the bacterium Treponema pallidum (subspecies pertenue), which belongs to the same group of bacteria that causes venereal syphilis.
The New England Journal of Medicine, the world’s most prestigious journal in biomedical research, included in its latest issue published last Thursday a study led by Dr Lucy John from Papua New Guinea’s National Department of Health (Public Health Division) and Oriol Mitjà from the Germans Trias i Pujol Hospital in Spain.
The study corroborates the greater efficacy of a new strategy for the elimination of yaws compared to that established by the World Health Organisation (WHO).
In 2012, Mitjà and his team, laid the scientific foundations for the WHO to establish the Morges Strategy, aimed at achieving yaws eradication through the implementation of one round of massive administration of azithromycin to people living in areas where cases had been recorded.
However, in 2018 it was found that the WHO strategy was insufficient to stop the transmission of the infection.
The recently published article showed the results of a community-level clinical trial carried out between April 2018 and October 2019 in New Ireland, PNG.
It compares the current WHO strategy (Morges), based on a single round of massive distribution of azithromycin followed by targeted treatment of persistent yaws cases, and an experimental strategy, consistent on three rounds of mass distribution six months apart.
The trial included 57,000 inhabitants of an area with a high prevalence of yaws, randomly assigned to one of the two intervention arms.
The study clearly establishes the benefits of the experimental arm compared to the control.
Eighteen months after the start of the study, the prevalence of yaws was four times lower in the group that received three rounds of azithromycin (0.04 per cent), compared to the group that received a single round (0.16 per cent).
These results outline the steps to be followed to achieve effective eradication of the disease.
The article is signed by 20 researchers from 17 research centres.
Eight authors are Papua New Guinean nationals who have been involved in yaws research conducted in the country since its inception.
Dr John said the WHO roadmap for neglected tropical diseases, launched early last year called for the global eradication of yaws by 2030.