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    Community-based mass treatment with azithromycin for the elimination of yaws in Ghana-Results of a pilot study.
    PLoS Negl Trop Dis 2018 Mar 22;12(3):e0006303. Epub 2018 Mar 22.
    Center for Global Health, Centers of Disease Control and Prevention, Atlanta, Georgia, United States of America.
    Introduction: The WHO yaws eradication strategy consists of one round of total community treatment (TCT) of single-dose azithromycin with coverage of > 90%.The efficacy of the strategy to reduce the levels on infection has been demonstrated previously in isolated island communities in the Pacific region. We aimed to determine the efficacy of a single round of TCT with azithromycin to achieve a decrease in yaws prevalence in communities that are endemic for yaws and surrounded by other yaws-endemic areas. Read More

    Direct Whole-Genome Sequencing of Cutaneous Strains of Haemophilus ducreyi.
    Emerg Infect Dis 2018 Apr;24(4):786-789
    Haemophilus ducreyi, which causes chancroid, has emerged as a cause of pediatric skin disease. Isolation of H. ducreyi in low-income settings is challenging, limiting phylogenetic investigation. Read More

    Diagnosis and evaluation of causative factors for the presence of endemic treponemal disease in a Japanese sub-tropical island population from the Tokugawa period.
    Int J Paleopathol 2015 Sep 15;10:16-25. Epub 2015 May 15.
    Research Institute for Sustainable Environments and Cultures, Nishikyushu University, Kanzaki 842-8585, Japan.
    We present a description and differential diagnosis of pathological lesions observed on skeletal elements found during surface surveys of the Nagabaka site on Miyako-jima Island, Japan. The Nagabaka site served as a bone depository during the Early Modern period (c. AD 1600-1870). Read More

    Comparative efficacy of low-dose versus standard-dose azithromycin for patients with yaws: a randomised non-inferiority trial in Ghana and Papua New Guinea.
    Lancet Glob Health 2018 Apr 16;6(4):e401-e410. Epub 2018 Feb 16.
    Department of Control of Neglected Tropical Diseases, World Health Organization, Geneva, Switzerland.
    Background: A dose of 30 mg/kg of azithromycin is recommended for treatment of yaws, a disease targeted for global eradication. Treatment with 20 mg/kg of azithromycin is recommended for the elimination of trachoma as a public health problem. In some settings, these diseases are co-endemic. Read More

    Community knowledge, perceptions and attitudes regarding leprosy in rural Cameroon: The case of Ekondotiti and Mbonge health districts in the South-west Region.
    PLoS Negl Trop Dis 2018 Feb 12;12(2):e0006233. Epub 2018 Feb 12.
    Department of Internal Medicine and Specialties, Faculty of Medicine and Biomedical Sciences, The University of Yaounde 1, Yaounde, Cameroon.
    Background: Although leprosy is one of the oldest diseases known to humanity, it remains largely misunderstood. Misconceptions about leprosy lead to stigma towards people with the disease. This study aimed at exploring the knowledge, perceptions and attitudes regarding leprosy in rural Cameroon. Read More

    Re-emergence of yaws after single mass azithromycin treatment followed by targeted treatment: a longitudinal study.
    Lancet 2018 Feb 7. Epub 2018 Feb 7.
    Department of Medicine, University of Washington, Seattle, WA, USA; Department of Global Health, University of Washington, Seattle, WA, USA.
    Background: Yaws is a substantial cause of chronic disfiguring ulcers in children in at least 14 countries in the tropics. WHO's newly adopted strategy for yaws eradication uses a single round of mass azithromycin treatment followed by targeted treatment programmes, and data from pilot studies have shown a short-term significant reduction of yaws. We assessed the long-term efficacy of the WHO strategy for yaws eradication. Read More

    An imperial laboratory: the investigation and treatment of treponematoses in occupied Haiti, 1915-1934.
    Hist Cienc Saude Manguinhos 2017 Oct-Dec;24(4):1089-1106
    PhD Candidat, Newcastle University. School of History, Classics and Archaeology/Newcastle University. NE1 7RU - Newcastle-upon-Tyne - Reino Unido.
    This article examines anti-treponematoses work as part of US occupation public health policy in Haiti, a unique event in the history of international health. Yaws was highly prevalent in Haiti, but occupation doctors initially ignored it because of its close association with syphilis and stigmas attached to sexually transmitted disease. This changed when C. Read More

    Active principles of Tetradenia riparia. IV. Anthelmintic activity of 8(14),15-sandaracopimaradiene-7α,18-diol.
    J Ethnopharmacol 2018 Apr 31;216:229-232. Epub 2018 Jan 31.
    Department of Biology, Animal Physiology and Neurobiology Section, KU Leuven, Naamsestraat 59, box 2465, 3000 Leuven, Belgium.
    Ethnopharmacological Relevance: Tetradenia (T.) riparia (Hochst.) Codd (Lamiaceae), formerly known as Iboza riparia (Hochst. Read More

    Development of a Multilocus Sequence Typing (MLST) scheme for Treponema pallidum subsp. pertenue: Application to yaws in Lihir Island, Papua New Guinea.
    PLoS Negl Trop Dis 2017 12 27;11(12):e0006113. Epub 2017 Dec 27.
    Department of Medicine, University of Washington, Seattle, Washington, United States of America.
    Background: Yaws is a neglected tropical disease, caused by Treponema pallidum subsp. pertenue. The disease causes chronic lesions, primarily in young children living in remote villages in tropical climates. Read More

    Targeted Treatment of Yaws With Household Contact Tracing: How Much do we Miss?
    Am J Epidemiol 2017 Nov 13. Epub 2017 Nov 13.
    Yaws is a disabling bacterial infection primarily found in warm and humid tropical areas. The World Health Organisation strategy mandates an initial round of total community treatment (TCT) with single-dose azithromycin followed either by further TCT or active case finding and treatment of cases and their contacts (the Morges strategy). We wish to investigate the effectiveness of the Morges strategy. Read More

    Patent landscape of neglected tropical diseases: an analysis of worldwide patent families.
    Global Health 2017 Nov 14;13(1):82. Epub 2017 Nov 14.
    Department of Preventive Medicine, Faculty of Public Health, University of Debrecen, Debrecen, Hungary.
    Background: "Neglected Tropical Diseases" (NTDs) affect millions of people in Africa, Asia and South America. The two primary ways of strategic interventions are "preventive chemotherapy and transmission control" (PCT), and "innovative and intensified disease management" (IDM). In the last 5 years, phenomenal progress has been achieved. Read More

    Effectiveness of single-dose azithromycin to treat latent yaws: a longitudinal comparative cohort study.
    Lancet Glob Health 2017 Dec 26;5(12):e1268-e1274. Epub 2017 Oct 26.
    Barcelona Institute for Global Health, Hospital Clinic-University of Barcelona, Barcelona, Spain; Institució Catalana de Recerca i Estudis Avançats (ICREA), Barcelona, Spain; Centro de Investigação em Saúde de Manhiça (CISM), Maputo, Mozambique; Paediatric Infectious Diseases Unit, Paediatric Department, Hospital Sant Joan de Déu Barcelona, Barcelona, Spain.
    Background: Treatment of latent yaws is a crucial component of the WHO yaws eradication strategy to prevent relapse and the resulting transmission to uninfected children. We assessed the effectiveness of single-dose azithromycin to treat patients with latent yaws.

    Methods: This population-based cohort study included children (age <20 years) living on Lihir Island, Papua New Guinea, with high-titre (rapid plasma reagin titre ≥1:8) latent or active yaws, between April, 2013, and May, 2015. Read More

    The cost and cost-effectiveness of rapid testing strategies for yaws diagnosis and surveillance.
    PLoS Negl Trop Dis 2017 Oct 26;11(10):e0005985. Epub 2017 Oct 26.
    Unit of General Epidemiology and Disease Control, Institute of Tropical Medicine, Antwerp, Belgium.
    Background: Yaws is a non-venereal treponemal infection caused by Treponema pallidum subspecies pertenue. The disease is targeted by WHO for eradication by 2020. Rapid diagnostic tests (RDTs) are envisaged for confirmation of clinical cases during treatment campaigns and for certification of the interruption of transmission. Read More

    Diagnostics for Yaws Eradication: Insights From Direct Next-Generation Sequencing of Cutaneous Strains of Treponema pallidum.
    Clin Infect Dis 2018 Mar;66(6):818-824
    Wellcome Trust Sanger Centre, Cambridge, United Kingdom.
    Background: Yaws-like chronic ulcers can be caused by Treponema pallidum subspecies pertenue, Haemophilus ducreyi, or other, still-undefined bacteria. To permit accurate evaluation of yaws elimination efforts, programmatic use of molecular diagnostics is required. The accuracy and sensitivity of current tools remain unclear because our understanding of T. Read More

    Single-Dose Azithromycin for the Treatment of Haemophilus ducreyi Skin Ulcers in Papua New Guinea.
    Clin Infect Dis 2017 Nov;65(12):2085-2090
    Barcelona Institute for Global Health, Hospital Clinic, University of Barcelona, Spain.
    Background: Haemophilus ducreyi (HD) and Treponema pallidum subspecies pertenue (TP) are major causative agents of cutaneous ulcer (CU) in the tropics. Azithromycin is recommended to treat sexually transmitted HD infections and has good in vitro activity against HD strains from both genital and skin ulcers. We investigated the efficacy of oral single-dose azithromycin on HD-CU. Read More

    The cost-effectiveness of an eradication programme in the end game: Evidence from guinea worm disease.
    PLoS Negl Trop Dis 2017 Oct 5;11(10):e0005922. Epub 2017 Oct 5.
    Department of Control of Neglected Tropical Diseases, World Health Organization, Geneva, Switzerland.
    Background: Of the three diseases targeted for eradication by WHO, two are so-called Neglected Tropical Diseases (NTDs)-guinea worm disease (GWD) and yaws. The Guinea Worm Eradication Programme (GWEP) is in its final stages, with only 25 reported in 2016. However, global eradication still requires certification by WHO of the absence of transmission in all countries. Read More

    Complete genome sequences of two strains of Treponema pallidum subsp. pertenue from Ghana, Africa: Identical genome sequences in samples isolated more than 7 years apart.
    PLoS Negl Trop Dis 2017 Sep 8;11(9):e0005894. Epub 2017 Sep 8.
    Department of Biology, Faculty of Medicine, Masaryk University, Kamenice 5, Brno, Czech Republic.
    Background: Treponema pallidum subsp. pertenue (TPE) is the causative agent of yaws, a multi-stage disease, endemic in tropical regions of Africa, Asia, Oceania, and South America. To date, four TPE strains have been completely sequenced including three TPE strains of human origin (Samoa D, CDC-2, and Gauthier) and one TPE strain (Fribourg-Blanc) isolated from a baboon. Read More

    Knowledge, attitudes and practices towards yaws and yaws-like skin disease in Ghana.
    PLoS Negl Trop Dis 2017 Jul 31;11(7):e0005820. Epub 2017 Jul 31.
    School of Public Health, College of Health Sciences, University of Ghana, Legon, Ghana.
    Introduction: Yaws is endemic in Ghana. The World Health Organization (WHO) has launched a new global eradication campaign based on total community mass treatment with azithromycin. Achieving high coverage of mass treatment will be fundamental to the success of this new strategy; coverage is dependent, in part, on appropriate community mobilisation. Read More

    Haemophilus ducreyi DNA is detectable on the skin of asymptomatic children, flies and fomites in villages of Papua New Guinea.
    PLoS Negl Trop Dis 2017 May 10;11(5):e0004958. Epub 2017 May 10.
    Lihir Medical Centre- International SOS, Newcrest Mining, Lihir Island, Papua New Guinea.
    Background: Haemophilus ducreyi and Treponema pallidum subsp. pertenue are major causes of leg ulcers in children in Africa and the Pacific Region. We investigated the presence of DNA (PCR positivity) from these bacteria on asymptomatic people, flies, and household linens in an endemic setting. Read More

    Yaws resurgence in Bankim, Cameroon: The relative effectiveness of different means of detection in rural communities.
    PLoS Negl Trop Dis 2017 May 8;11(5):e0005557. Epub 2017 May 8.
    School of Anthropology, University of Arizona, Tucson, Arizona, United States of America.
    Background: Yaws is an infectious, debilitating and disfiguring disease of poverty that mainly affects children in rural communities in tropical areas. In Cameroon, mass-treatment campaigns carried out in the 1950s reduced yaws to such low levels that it was presumed the disease was eradicated. In 2010, an epidemiological study in Bankim Health District detected 29 cases of yaws. Read More

    Survey of Treponemal Infections in Free-Ranging and Captive Macaques, 1999-2012.
    Emerg Infect Dis 2017 05;23(5):816-819
    Survey results showed treponemal infection among pet macaques in Southeast Asia, a region with a high prevalence of human yaws. This finding, along with studies showing treponemal infection in nonhuman primates in Africa, should encourage a One Health approach to yaws eradication and surveillance activities, possibly including monitoring of nonhuman primates in yaws-endemic regions. Read More

    Human Treponema pallidum 11q/j isolate belongs to subsp. endemicum but contains two loci with a sequence in TP0548 and TP0488 similar to subsp. pertenue and subsp. pallidum, respectively.
    PLoS Negl Trop Dis 2017 Mar 6;11(3):e0005434. Epub 2017 Mar 6.
    Department of Biology, Faculty of Medicine, Masaryk University, Brno, Czech Republic.
    Background: Treponema pallidum subsp. endemicum (TEN) is the causative agent of endemic syphilis (bejel). An unusual human TEN 11q/j isolate was obtained from a syphilis-like primary genital lesion from a patient that returned to France from Pakistan. Read More

    Yaws Osteoperiostitis Treated with Single-Dose Azithromycin.
    Am J Trop Med Hyg 2017 May 13;96(5):1039-1041. Epub 2017 Feb 13.
    Barcelona Institute for Global Health, Hospital Clínic, University of Barcelona, Barcelona, Spain.
    AbstractThe etiologic agent of yaws,subsp., causes a multistage infection transmitted by nonsexual contact with the exudates from active lesions. Bone lesions in the form of osteoperiostitis are common and occur in numerous bones simultaneously in early stages. Read More

    Functional clues from the crystal structure of an orphan periplasmic ligand-binding protein from Treponema pallidum.
    Protein Sci 2017 Apr 23;26(4):847-856. Epub 2017 Mar 23.
    Department of Microbiology, The University of Texas Southwestern Medical Center, Dallas, Texas, 75390.
    The spirochete Treponema pallidum is the causative agent of syphilis, a sexually transmitted infection of major global importance. Other closely related subspecies of Treponema also are the etiological agents of the endemic treponematoses, such as yaws, pinta, and bejel. The inability of T. Read More

    Integrated Mapping of Yaws and Trachoma in the Five Northern-Most Provinces of Vanuatu.
    PLoS Negl Trop Dis 2017 Jan 24;11(1):e0005267. Epub 2017 Jan 24.
    Clinical Research Department, London School of Hygiene & Tropical Medicine, London, United Kingdom.
    Yaws and trachoma are targeted for eradication and elimination as public health problems. In trachoma-endemic populations mass administration of azithromycin can simultaneously treat yaws. We conducted a population-based prevalence survey in the five northernmost provinces of Vanuatu, where trachoma and yaws are suspected to be co-endemic. Read More

    A Single Dose Oral Azithromycin versus Intramuscular Benzathine Penicillin for the Treatment of Yaws-A Randomized Non Inferiority Trial in Ghana.
    PLoS Negl Trop Dis 2017 Jan 10;11(1):e0005154. Epub 2017 Jan 10.
    Department of Epidemiology, School of Public Health, University of Ghana, Legon, Ghana.
    Background: Yaws is a treponemal infection that was almost eradicated fifty years ago; however, the disease has re-emerged in a number of countries including Ghana. A single-dose of intramuscular benzathine penicillin has been the mainstay of treatment for yaws. However, intramuscular injections are painful and pose safety and logistical constraints in the poor areas where yaws occurs. Read More

    Haemophilus ducreyi Cutaneous Ulcer Strains Diverged from Both Class I and Class II Genital Ulcer Strains: Implications for Epidemiological Studies.
    PLoS Negl Trop Dis 2016 Dec 27;10(12):e0005259. Epub 2016 Dec 27.
    Departments of Microbiology and Immunology, Indiana University School of Medicine, Indianapolis, Indiana, United States of America.
    Background: Haemophilus ducreyi has emerged as a major cause of cutaneous ulcers (CU) in yaws-endemic regions of the tropics in the South Pacific, South East Asia and Africa. H. ducreyi was once thought only to cause the genital ulcer (GU) disease chancroid; GU strains belong to 2 distinct classes, class I and class II. Read More

    Mathematical Modeling of Programmatic Requirements for Yaws Eradication.
    Emerg Infect Dis 2017 01;23(1):22-28
    Yaws is targeted for eradication by 2020. The mainstay of the eradication strategy is mass treatment followed by case finding. Modeling has been used to inform programmatic requirements for other neglected tropical diseases and could provide insights into yaws eradication. Read More

    Performance of Syphilis Sentinel Surveillance in the context of endemic Treponematoses: experience from Ghana.
    BMC Infect Dis 2016 Dec 9;16(1):745. Epub 2016 Dec 9.
    London School of Hygiene and Tropical Medicine, London, UK.
    Background: Use of treponemal tests to screen for syphilis (caused by Treponema pallidum pallidum) poses challenges with infection status classification, especially in settings where other treponemal infections are endemic. This study aimed to determine the validity of the syphilis surveillance testing strategy implemented since 2004 using two treponemal tests, and estimate the seroprevalence of active syphilis infection in Ghana where yaws (caused by Treponema pallidum pertenue) is endemic.

    Methods: We retested sera from the 2007 HIV sentinel survey (HSS) using a traditional algorithm, quantitative rapid plasma reagin test followed by qualitative Treponema pallidum haemagglutination assay. Read More

    Benchmarking the Cost per Person of Mass Treatment for Selected Neglected Tropical Diseases: An Approach Based on Literature Review and Meta-regression with Web-Based Software Application.
    PLoS Negl Trop Dis 2016 Dec 5;10(12):e0005037. Epub 2016 Dec 5.
    Department of Control of Neglected Tropical Diseases, World Health Organization, Geneva, Switzerland.
    Background: Advocacy around mass treatment for the elimination of selected Neglected Tropical Diseases (NTDs) has typically put the cost per person treated at less than US$ 0.50. Whilst useful for advocacy, the focus on a single number misrepresents the complexity of delivering "free" donated medicines to about a billion people across the world. Read More

    Community seroprevalence survey for yaws and trachoma in the Western Division of Fiji.
    Trans R Soc Trop Med Hyg 2016 Dec 16;110(10):582-587. Epub 2016 Nov 16.
    Clinical Research Department, Faculty of Infectious and Tropical Diseases, London School of Hygiene & Tropical Medicine, Keppel Street, London WC1E 7HT, UK
    Background: Both yaws and trachoma are endemic in several countries in the Pacific. In co-endemic countries there may be potential synergies between both control programmes.

    Methods: We undertook a cluster randomised trachoma and yaws seroprevalence survey of children in the Western Division of Fiji. Read More

    Opportunities for Integrated Control of Neglected Tropical Diseases That Affect the Skin.
    Trends Parasitol 2016 11 13;32(11):843-854. Epub 2016 Sep 13.
    Centre for International Child Health, University of Melbourne, Melbourne, Australia; Group A Streptococcal Research, Murdoch Childrens Research Institute, Melbourne, Australia.
    Many neglected tropical diseases (NTDs) affect the skin, causing considerable disability, stigma, and exacerbation of poverty. However, there has been relatively little investment into laboratory research, epidemiology, diagnostic tools or management strategies to control tropical skin disease. Integration may advance the control of skin disease across a range of domains, including mapping, diagnosis, clinical management, and community control measures such as mass drug administration. Read More

    The Burden of Leprosy in Cameroon: Fifteen Years into the Post-elimination Era.
    PLoS Negl Trop Dis 2016 Oct 12;10(10):e0005012. Epub 2016 Oct 12.
    Faculty of Medicine and Biomedical Sciences, The University of Yaounde 1, Yaounde, Cameroon.
    Background: Cameroon achieved the elimination target of leprosy in 2000, and has maintained this status ever since. However, a number of health districts in the country continue to report significant numbers of leprosy cases. The aim of this study was to assess the burden of leprosy in Cameroon from 2000 to 2014. Read More

    Denis Burkitt: A legacy of global health.
    J Med Biogr 2016 Sep 28. Epub 2016 Sep 28.
    Faculty of Medicine, University of British Columbia, Vancouver, Canada
    When first described in 1958, Burkitt lymphoma was considered by many to be an African curiosity. However, over the next few decades, over 10,000 publications on Burkitt lymphoma would influence many facets of oncology research including immunology, molecular genetics, chemotherapy, and viral oncology. At the time of discovery, its distribution in equatorial Africa was unique; it was where a child was born and lived, and not what race they were, that conveyed the greatest incidence risk. Read More

    Prevalence of Active and Latent Yaws in the Solomon Islands 18 Months after Azithromycin Mass Drug Administration for Trachoma.
    PLoS Negl Trop Dis 2016 Aug 23;10(8):e0004927. Epub 2016 Aug 23.
    Clinical Research Department, Faculty of Infectious and Tropical Diseases, London School of Hygiene & Tropical Medicine, London, United Kingdom.
    Introduction: Both yaws and trachoma are endemic in the Pacific. Mass treatment with azithromycin is the mainstay of the WHO strategy for both the eradication of yaws and the elimination of trachoma as a public health problem, but the dose recommended for trachoma is lower than that for yaws. In countries where both diseases are endemic, there is a potential for synergy between yaws and trachoma control programs if mass treatment with the lower dose of azithromycin was shown to be effective for the treatment of yaws. Read More

    Recall of symptoms and treatment of syphilis and yaws by healthy blood donors screening positive for syphilis in Kumasi, Ghana.
    Int J Infect Dis 2016 Sep 12;50:72-4. Epub 2016 Aug 12.
    Department of Clinical Immunology, Copenhagen, University Hospital, Copenhagen, Denmark.
    Objective: To describe the recalled medical history, clinical manifestations, and treatment of yaws and syphilis by syphilis seroreactive blood donors in Kumasi, Ghana.

    Methods: Of the blood donors at Komfo Anokye Teaching Hospital, Kumasi, Ghana tested with the syphilis rapid diagnostic test (RDT) and later by rapid plasma reagin (RPR) test, 526 were seroreactive. Four hundred and seventy-one (89. Read More

    Tools for opening new chapters in the book of Treponema pallidum evolutionary history.
    Clin Microbiol Infect 2016 Nov 4;22(11):916-921. Epub 2016 Aug 4.
    Epidemiology of Highly Pathogenic Microorganisms, Germany. Electronic address:
    Treponema pallidum infections causing yaws disease and venereal syphilis are globally widespread in human populations, infecting hundreds of thousands and millions annually respectively; endemic syphilis is much less common, and pinta has not been observed in decades. We discuss controversy surrounding the origin, evolution and history of these pathogens in light of available molecular and anthropological evidence. These bacteria (or close relatives) seem to affect many wild African nonhuman primate (NHP) species, though to date only a single NHP Treponema pallidum genome has been published, hindering detection of spillover events and our understanding of potential wildlife reservoirs. Read More

    Isolation of Treponema DNA from Necrophagous Flies in a Natural Ecosystem.
    EBioMedicine 2016 Sep 28;11:85-90. Epub 2016 Jul 28.
    Department of Medicine, University of Washington, Harborview Medical Center, 325 Ninth Avenue, Seattle, WA 98104, USA.
    Background: Recently, the World Health Organization launched a campaign to eradicate the tropical disease yaws, caused by the bacterium Treponema pallidum subsp. pertenue; however, for decades researchers have questioned whether flies act as a vector for the pathogen that could facilitate transmission.

    Methods: A total of 207 fly specimens were trapped in areas of Africa in which T. Read More

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