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Impact of community mass treatment with azithromycin for trachoma elimination on the prevalence of yaws.

Abstract

BACKGROUND: Community mass treatment with 30mg/kg azithromycin is central to the new WHO strategy for eradicating yaws. Both yaws and trachoma- which is earmarked for elimination by 2020 using a strategy that includes mass treatment with 20mg/kg azithromycin-are endemic in the Pacific, raising the possibility of an integrated approach to disease control. Community mass treatment with azithromycin for trachoma elimination was conducted in the Solomon Islands in 2014.

METHODS: We conducted a study to assess the impact of mass treatment with 20mg/kg azithromycin on yaws. We examined children aged 5-14 years and took blood and lesion samples for yaws diagnosis.

RESULTS: We recruited 897 children, 6 months after mass treatment. There were no cases of active yaws. Serological evidence of current infection was found in 3.6% (95% CI= 2.5-5.0%). This differed significantly between individuals who had and had not received azithromycin (2.8% vs 6.5%, p=0.015); the prevalence of positive serology in 5-14 year-olds had been 21.7% (95% CI=14.6%-30.9%) 6 months prior to mass treatment. Not receiving azithromycin was associated with an odds of 3.9 for infection (p=0.001). National figures showed a 57% reduction in reported cases of yaws following mass treatment.

DISCUSSION: Following a single round of treatment we did not identify any cases of active yaws in a previously endemic population. We found a significant reduction in latent infection. Our data support expansion of the WHO eradication strategy and suggest an integrated approach to the control of yaws and trachoma in the Pacific may be viable.

More information

Type
Journal Article
Author
Marks M
Vahi V
Sokana O
Chi K
Puiahi E
Kilua G
Pillay A
Dalipanda T
Bottomley C
Solomon AW
Mabey DC W
Year of Publication
2015
Journal
PLoS neglected tropical diseases
Volume
9
Issue
8
Number of Pages
e0003988
Language
eng
ISSN Number
1935-2735
DOI
10.1371/journal.pntd.0003988
Alternate Journal
PLoS Negl Trop Dis
Publication Language
eng