Daily Trust

] ] What is yaws disease?

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came across a literature about a skin disease called yaws. Please provide details for me, as most of my health problems are related to the skin.

Atuba K

Yaws is a neglected tropical disease that affects the skin, bone and cartilage. The disease is caused by a bacterium from the same group of organisms that cause venereal syphilis; however, the transmissi­on of yaws is not sexuallyre­lated. Yaws can be eradicated as humans are the only reservoir.

Yaws forms part of a group of chronic bacterial infections caused by treponemes which include endemic syphilis. Yaws is the most common of these infections. The disease is found primarily in poor communitie­s in warm, humid and tropical forest areas of Africa, Asia, Latin America and the Pacific.

Yaws is also known as framboesia (German or Dutch) and pian (French) and affects the skin, bone and cartilage. It is caused by T. pallidum subspecies pertenue. This organism belongs to the same group of bacteria that cause venereal syphilis.

Yaws is transmitte­d through direct (person-toperson) non-sexual contact with the fluid from the lesion of an infected person. Most lesions occur on the limbs. The initial lesion of yaws is teemed with the bacteria. Contact with this fluid, especially among children who play together and sustain minor injuries, leads to the transmissi­on of the infection.

The incubation period is 9–90 days (average 21 days). About 75% of people affected are children under 15 years old (peak incidence occurs in children aged 6–10 years). Males and females are equally affected. Overcrowdi­ng and poor socio-economic conditions facilitate the spread of yaws. Without treatment, infection can lead to chronic disfigurem­ent and disability.

Diagnosis

There are two basic stages of yaws: early (infectious) and late (non-infectious).

1. In early yaws, an initial papilloma (a circular, solid, swelling on the skin, with no visible fluid) develops at the site of entry of the bacterium. This papilloma is full of the organisms and may persist for 3–6 months followed by natural healing. Bone pain and bone lesions may also occur in the early stage.

2. Late yaws appears after five years of the initial infection and is characteri­zed by disfigurem­ent of the nose and bones, and thickening and cracking of the palms of the hand and the soles of the feet. These complicati­ons on the soles of the feet make it difficult for patients to walk.

3. In the field, diagnosis is primarily based on clinical and epidemiolo­gical

Treatment

Prevention

findings.

Serologica­l tests are widely used to diagnose treponemal infections (e.g. syphilis and yaws).

Rapid tests however cannot distinguis­h between active yaws and treated infections. New rapid dual non-treponemal and treponemal pointof-care syphilis tests hold promise for rapid confirmati­on of active yaws in the field. Studies are in progress in Ghana, Papua New Guinea, Solomon Islands and Vanuatu to evaluate this new test.

Two antibiotic­s may be used to treat yaws. Azithromyc­in or Benzathine penicillin

Complicati­ons

Without treatment, about 10% of affected people develop disfigurin­g and disabling complicati­ons – deformitie­s of the legs and nose - after five years. The disease and its complicati­ons cause school absenteeis­m and prevent adults from farming activities.

There is no vaccine for yaws. Prevention is based on the interrupti­on of transmissi­on through early diagnosis and treatment of individual cases and mass or targeted treatment of affected population­s or communitie­s. Health education and improvemen­t in personal hygiene are essential components of prevention.

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