SCOLNIK D, LOVINSKY R, ARONSON L, TOLEDANO K, GLAZIER R, EISENSTADT J, WILCOX L, ROWSELL R, SILVERMAN MS; Interscience Conference on Antimicrobial Agents and Chemotherapy (41st : 2001 : Chicago, Ill.).

Abstr Intersci Conf Antimicrob Agents Chemother Intersci Conf Antimicrob Agents Chemother. 2001 Dec 16-19; 41: abstract no. G-1555.

University of Toronto, Toronto, ON, Canada

Background Yaws has recently been increasing in prevalence in impoverished communities. The WHO/UNICEF protocol requirements of IM Benzanthine Penicillin G, and thus a cold chain to preserve the medication, and the need to treat all infected and uninfected children with an IM injection, may have made previous eradication efforts impractical. Methods In February 1999, 7 villages in rural Guyana were screened for the presence of yaws by a mobile medical team. All cases were confirmed by MHA-TP serology. Yaws was found to be highly endemic, and therefore in Feb 2000 a control program was initiated. All children < 14 years of age in the same 7 villages, were screened. All those with active lesions were treated with oral Penicillin V for 7 days. In Feb 2001 the communities were rescreened and all active cases were treated with oral Penicillin V. A case control study was undertaken in a 1:2 ratio, to identify risk factors for yaws acquisition. Results The prevalence of yaws fell dramatically from 5.2% (52 cases in 1,020 children screened in 2000) to 1.6% (8 cases in 516 children screened in 2001). This represents a 71% drop in prevalence. Odds ratio for the difference=0.28 (95% CI=0.11,0.60) (p=0.0007). 17 children who had been treated in 2000 were available for reassessment in 2001 with 16/17 having had complete resolution of their lesions (94% success rate). The one treatment failure had a co-existent pneumonia, which may have limited the response to treatment. Due to a smaller medical team size, less children were screened in 2001 than in 2000, but demographic factors suggested that the samples were representative of the total population. A larger number of siblings and lack of recent antibiotic use suggested a higher risk of yaws. Conclusions A targeted oral Penicillin-based treatment regimen can dramatically decrease the prevalence of yaws in an endemic community.

Publication Types:

• Meeting Abstracts

Keywords:

• Anti-Bacterial Agents
• Case-Control Studies
• Child
• Guyana
• Hemagglutination Tests
• Humans
• Injections, Intramuscular
• Penicillin G
• Penicillin V
• Penicillins
• Prevalence
• United Nations
• Yaws
• diagnosis
• prevention & control
• therapy

Other ID:

• GWAIDS0030516

UI: 102270153

From Meeting Abstracts