Mass treatment with single-dose azithromycin for yaws

Area of Science:

• Tropical Medicine
• Infectious Diseases
• Public Health Interventions

Background:

• Yaws eradication is a key global health priority.
• Mass azithromycin treatment is central to the World Health Organization's yaws eradication strategy.
• Empirical data on treatment effectiveness are crucial for global implementation.

Purpose of the Study:

• To evaluate the effectiveness of mass azithromycin treatment for yaws eradication.
• To assess the impact on active and latent yaws prevalence.
• To monitor for macrolide resistance in Treponema pallidum subspecies pertenue.

Main Methods:

• Repeated clinical and serologic surveys for yaws.
• Molecular analyses for macrolide resistance.
• Mass treatment with azithromycin in an endemic island population.
• Primary outcomes: prevalence of active infectious yaws and high-titer latent yaws in children.

Main Results:

• High coverage (82.7%) achieved with mass azithromycin treatment.
• Significant reduction in active yaws prevalence from 2.4% to 0.3%.
• Substantial decrease in high-titer latent yaws in children from 18.3% to 6.5%.
• Mild adverse events (nausea, diarrhea, vomiting) in ~17% of participants.
• No evidence of macrolide resistance emerged.

Conclusions:

• Mass azithromycin treatment rapidly and substantially reduced yaws prevalence.
• Results support the World Health Organization's yaws eradication strategy.
• High-coverage treatment is effective in reducing yaws and is a viable eradication tool.