Autor/a:
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Mitjà Villar, Oriol; Marks, Michael; Konan, Diby J. P.; Ayelo, Gilbert; González-Beiras, Camila; Boua, Bernard; Houinei, Wendy; Kobara, Yiragnima; Tabah, Earnest N.; Nsiire, Agana; Obvala, Damas; Taleo, Fasihah; Djupuri, Rita; Zaixing, Zhang; Utzinger, Jürg; Vestergaard, Lasse S.; Bassat Orellana, Quique; Asiedu, Kingsley
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Abstract:
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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 We aimed to synthesise published and unpublished work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recently completed unpublished studies from the WHO yaws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unpublished studies met the inclusion criteria.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. |