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Prioritizing surveillance activities for certification of yaws eradication based on a review and model of historical case reporting
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BACKGROUNDt: The World Health Organization
(WHO) has targeted yaws for global eradication. Eradication
requires certification that all countries are yaws-free. While
only 14 Member States currently report cases to WHO, many more
are known to have a history of yaws and some of them may have
ongoing transmission. We reviewed the literature and developed a
model of case reports to identify countries in which passive
surveillance is likely to find and report cases if transmission
is still occurring, with the goal of reducing the number of
countries in which more costly active surveillance will be
required. METHODSt: We reviewed published and
unpublished documents to extract data on the number of yaws
cases reported to WHO or appearing in other literature in any
year between 1945 and 2015. We classified countries as: a)
having interrupted transmission; b) being currently endemic; c)
being previously endemic (current status unknown); or d) having
no history of yaws. We constructed a panel dataset for the years
1945-2015 and ran a regression model to identify factors
associated with some countries not reporting cases during
periods when there was ongoing (and documented) transmission.
For previously endemic countries whose current status is
unknown, we then estimated the probability that countries would
have reported cases if there had in fact been transmission in
the last three years (2013-2015)." - Label: RESULTS content:
Yaws has been reported in 103 of the 237 countries and areas
considered. 14 Member States and 1 territory (Wallis and Futuna
Islands) are currently endemic. 2 countries are believed to have
interrupted transmission. 86 countries and areas are previously
endemic (current status unknown). Reported cases peaked in the
1950s, with 55 countries reporting at least one case in 1950 and
a total of 2.35 million cases reported in 1954. Our regression
model suggests that case reporting during periods of ongoing
transmission is positively associated with socioeconomic
development and, in the short-term, negatively associated with
independence. We estimated that for 66 out of the 86 previously
endemic countries whose current status is unknown, the
probability of reporting cases in the absence of active
surveillance is less than 50%. DISCUSSION:
Countries with a history of yaws need to be prioritized so that
international resources for global yaws eradication may be
deployed efficiently. Heretofore, the focus has been on mass
treatment in countries currently reporting cases. It is also
important to undertake surveillance in the 86 previously endemic
countries for which the current status is unknown. Within this
large and diverse group, we have identified a group of 20
countries with more than a 50% probability of reporting cases in
the absence of active surveillance. For the other 66 countries,
international support for active surveillance will likely be
required.
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FITZPATRICK, Christopher, et al. Prioritizing surveillance activities for certification of yaws
eradication based on a review and model of historical case
reporting. PLoS Neglected Tropical Diseases. 2018. Vol. 12, num. 12, pags. e0006953. ISSN 1935-2735. [consulted: 24 of May of 2026]. Available at: https://hdl.handle.net/2445/134883