Volume 17, Number 6–June 2011
Dispatch
Outcome Predictors in Treatment of Yaws
Oriol Mitjà, Russell Hays, Anthony Ipai, David Gubaila, Francis Lelngei, Martin Kirara, Raymond Paru, and Quique Bassat
Author affiliations: Lihir Medical Centre, Lihir Island, Papua New Guinea (O. Mitjà, R. Hays, A. Ipai, D. Gubaila, F. Lelngei, M. Kirara, R. Paru); and Barcelona Centre for International Health Research, Barcelona, Spain (Q. Bassat)
Suggested citation for this article
Abstract
To estimate failure rates after treatment with benzathine penicillin and to identify determinants of failure that affected outcomes for yaws, we conducted a cohort study of 138 patients; treatment failed in 24 (17.4%). Having low initial titers on Venereal Disease Research Laboratory test and living in a village where yaws baseline incidence was high were associated with increased likelihood of treatment failure.
Yaws is a tropical infection of the skin and bones caused by Treponema pallidum subsp. pertenue and is transmitted by direct, nonsexual contact with infectious lesions (1,2). Although a multinational mass eradication campaign in the 1950s greatly reduced the incidence of this disease (3–5), a resurgence of yaws has occurred in west and Central Africa, Southeast Asia, and the Pacific Islands (6–9). The currently recommended drug therapy for yaws is penicillin G benzathine, administered intramuscularly as a single dose of 1.2 million units (3,5). T. pallidum is a primary human pathogen that has eluded in vitro cultivation (10). Hence, although penicillin treatment failure has been reported for yaws (11), to date penicillin resistance has not been proven. Most serologically defined treatment failures are thought to be caused by either reinfection after treatment or patient-to-patient variation in the rate of decline in nontreponemal test titers after treatment (i.e., >4-fold decrease), rather than by relapse (10). The aim of this study was to estimate failure rates after treatment with benzathine penicillin and to identify determinants of failure that affected the outcome.
full-text:
Outcome Predictors, Yaws | CDC EID
Suggested Citation for this Article
Mitjà O, Hays R, Ipai A, Gubaila D, Lelngei F, Kirara M, et al. Outcome predictors in treatment of yaws. Emerg Infect Dis [serial on the Internet]. 2011 Jun [date cited].
http://www.cdc.gov/EID/content/17/6/1083.htm
DOI: 10.3201/eid1706.101575
Comments to the Authors
Please use the form below to submit correspondence to the authors or contact them at the following address:
Oriol Mitjà, Department of Internal Medicine, Lihir Medical Center, PO Box 34, Lihir Island, New Island Province, Papua, New Guinea; email: oriolmitja@hotmail.com
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