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Table of Contents   
LETTER TO THE EDITOR  
Year : 2017  |  Volume : 10  |  Issue : 2  |  Page : 475-476
World Health Organization advocates for a two-point strategy to achieve eradication of Yaws from the endemic nations


Department of Community Medicine, Shri Sathya Sai Medical College and Research Institute, Kancheepuram, Tamil Nadu, India

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Date of Web Publication22-Jun-2017
 

How to cite this article:
Shrivastava SR, Shrivastava PS, Ramasamy J. World Health Organization advocates for a two-point strategy to achieve eradication of Yaws from the endemic nations. Ann Trop Med Public Health 2017;10:475-6

How to cite this URL:
Shrivastava SR, Shrivastava PS, Ramasamy J. World Health Organization advocates for a two-point strategy to achieve eradication of Yaws from the endemic nations. Ann Trop Med Public Health [serial online] 2017 [cited 2019 Aug 18];10:475-6. Available from: http://www.atmph.org/text.asp?2017/10/2/475/208702
Dear Sir,

Yaws is a chronic infectious disease resulting because of infection with the Treponema pallidum subspecies pertenue.[1] It has been acknowledged as one of the neglected tropical disease owing to its preponderance to affect financially deprived population groups living in hot, humid, and tropical regions.[1],[2] Major proportions of the infected people are poor and have limited access to the health care services, thereby making them extremely vulnerable to the disease, the associated complications like chronic disfigurement and disability, and social consequences such as sickness absenteeism and reduced productivity.[1],[2]

Of the 88 nations which were initially considered endemic for the disease, only 13 are currently endemic and close to ninety million people are at the risk of acquiring the infection.[1],[2],[3] However, the exact estimates must be higher than the obtained ones owing to the absence of systematic mapping.[4] It has been observed that almost three-fourth of the cases are children <15 years of age, with the presence of overcrowding and poor hygiene augmenting the risk of person-to-person transmission of the disease.[2],[3]

Even though there is no vaccine available to prevent the acquisition of the infection, it is still considered as one of the infections, which are a potential candidate for eradication as there are no extra-human reservoirs.[4],[5],[6]

In fact, based on the discovery that a single dose of azithromycin can totally cure the disease, the World Health Organization (WHO) has set the target to eradicate (viz., absence of new cases for a successive span of 3 years, well-supported by the serological surveys among children) the disease by 2020 from all the endemic nations.[1],[3]

This has been acknowledged as a historical step in ensuring the control of the disease, as for almost six decades, benzathine penicillin was the drug of choice, which had its own limitations (viz., hypersensitivity, cost associated with administration, etc.).[3] The primary strategy envisaged by the WHO is to ensure mass treatment of all eligible members of the community in endemic regions with oral azithromycin (or intramuscular benzathine penicillin, if contraindicated).[1],[5] However, to assess the outcome of it, the treatment has to be combined with active surveillance, bi-annually, to identify and treat all symptomatic/latent cases of the disease.[1],[3],[5]

Nevertheless, issues like ensuring absence of active and latent cases among children <5 years of age, sustaining high levels of political commitment and motivation among the local health workers to work constantly for the disease, shortcomings in the mapping of the disease due to which policy makers are finding it tough to localize the elimination efforts, fostering linkages with different stakeholders and involving them in an evidence-based manner, and ensuring community participation, has been identified as some of the challenges towards achieving the aim of global eradication of the disease.[1],[5] Further, the majority of these hurdles can be addressed, if the systematic mapping of the disease can be achieved in the endemic nations.[3] Simultaneously, the progress of elimination can be evaluated through serologic surveys among 1–5 year aged children.[5],[6] Moreover, the disease can be definitely eradicated, as India and Ecuador have succeeded in interrupting the transmission of the disease.[1],[6]

To conclude, it is the need of the hour to work in collaboration and optimally utilize the benefit offered by the antibiotic and effective strategy to ensure that the yaws disease is globally eradicated by 2020.

Financial support and sponsorship

Nil.

Conflicts of interest

There are no conflicts of interest.

 
   References Top

1.
World Health Organization. Yaws – Fact Sheet; 2016. Available from: http://www.who.int/mediacentre/factsheets/fs316/en/. [Last accessed on 2016 Mar 09].  Back to cited text no. 1
    
2.
Mabey D. Mapping the geographical distribution of yaws. Lancet Glob Health 2015;3:e300-1.  Back to cited text no. 2
[PUBMED]    
3.
Mitjà O, Marks M, Konan DJ, Ayelo G, Gonzalez-Beiras C, Boua B, et al. Global epidemiology of yaws: A systematic review. Lancet Glob Health 2015;3:e324-31.  Back to cited text no. 3
    
4.
Marks M, Mitjà O, Vestergaard LS, Pillay A, Knauf S, Chen CY, et al. Challenges and key research questions for yaws eradication. Lancet Infect Dis 2015;15:1220-5.  Back to cited text no. 4
    
5.
Kazura JW. Yaws eradication – A goal finally within reach. N Engl J Med 2015;372:693-5.  Back to cited text no. 5
    
6.
Narain JP, Jain SK, Bora D, Venkatesh S. Eradicating successfully yaws from India: The strategy & global lessons. Indian J Med Res 2015;141:608-13.  Back to cited text no. 6
[PUBMED]  [Full text]  

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Correspondence Address:
Saurabh RamBihariLal Shrivastava
Department of Community Medicine, 3rd Floor, Shri Sathya Sai Medical College and Research Institute, Ammapettai, Thiruporur–Guduvancherry Main Road, Sembakkam Post, Kancheepuram - 603 108, Tamil Nadu
India
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Source of Support: None, Conflict of Interest: None


DOI: 10.4103/1755-6783.208702

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