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Global epidemiology of yaws: a systematic review

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BACKGROUND: To achieve yaws eradication, the use of the new WHO
                strategy of initial mass treatment with azithromycin and
                surveillance twice a year needs to be extended everywhere the
                disease occurs. However, the geographic scope of the disease is
                unknown. We aimed to synthesise published and unpublished work
                to update the reported number of people with yaws at national
                and subnational levels and to estimate at-risk populations.
                METHODS: We searched PubMed and WHO databases to identify
                published data for prevalence of active and latent yaws from Jan
                1, 1990, to Dec 31, 2014. We also searched for ongoing or
                recently completed unpublished studies from the WHO yaws
                surveillance network. We estimated yaws prevalence (and 95%
                CIs). We collected yaws incidence data from official national
                surveillance programmes at the first administrative level from
                Jan 1, 2010, to Dec 31, 2013, and we used total population data
                at the second administrative level to estimate the size of
                at-risk populations. FINDINGS: We identified 103 records, of
                which 23 published articles describing 27 studies and four
                unpublished studies met the inclusion criteria. Prevalence of
                active disease ranged from 0.31% to 14.54% in yaws-endemic
                areas, and prevalence of latent yaws ranged from 2.45% to
                31.05%. During 2010-13, 256 343 yaws cases were reported to WHO
                from 13 endemic countries, all of which are low-income and
                middle-income countries. 215 308 (84%) of 256 343 cases reported
                to WHO were from three countries-Papua New Guinea, Solomon
                Islands, and Ghana. We estimated that, in 2012, over 89 million
                people were living in yaws-endemic districts. INTERPRETATION:
                Papua New Guinea, Solomon Islands, and Ghana should be the focus
                of initial efforts at implementing the WHO yaws eradication
                strategy. Community-based mapping and active surveillance must
                accompany the implementation of yaws eradication activities.
                FUNDING: None.

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Articles publicats en revistes (ISGlobal)

# metadata.dc.title[].value
Global epidemiology of yaws: a systematic review