Mass treatment with single-dose azithromycin for yaws

Mitja, Oriol, Houinei, Wendy, Moses, Penias, Kapa, August, Paru, Raymond, Hays, Russell, Lukehart, Sheila, Godornes, Charmine, Bieb, Sibauk Vivaldo, Grice, Tim, Siba, Peter, Mabey, David, Sanz, Sergi, Alonso, Pedro L, Asiedu, Kingsley and Bassat, Quique (2015) Mass treatment with single-dose azithromycin for yaws. New England Journal of Medicine, 372 8: 703-710. doi:10.1056/NEJMoa1408586

Author Mitja, Oriol
Houinei, Wendy
Moses, Penias
Kapa, August
Paru, Raymond
Hays, Russell
Lukehart, Sheila
Godornes, Charmine
Bieb, Sibauk Vivaldo
Grice, Tim
Siba, Peter
Mabey, David
Sanz, Sergi
Alonso, Pedro L
Asiedu, Kingsley
Bassat, Quique
Title Mass treatment with single-dose azithromycin for yaws
Journal name New England Journal of Medicine   Check publisher's open access policy
ISSN 1533-4406
Publication date 2015-02-19
Year available 2015
Sub-type Article (original research)
DOI 10.1056/NEJMoa1408586
Open Access Status
Volume 372
Issue 8
Start page 703
End page 710
Total pages 8
Place of publication Waltham, United States
Publisher Massachussetts Medical Society
Collection year 2016
Formatted abstract
Mass treatment with azithromycin is a central component of the new World Health Organization (WHO) strategy to eradicate yaws. Empirical data on the effectiveness of the strategy are required as a prerequisite for worldwide implementation of the plan.

We performed repeated clinical surveys for active yaws, serologic surveys for latent yaws, and molecular analyses to determine the cause of skin ulcers and identify macrolide-resistant mutations before and 6 and 12 months after mass treatment with azithromycin on a Papua New Guinean island on which yaws was endemic. Primary-outcome indicators were the prevalence of serologically confirmed active infectious yaws in the entire population and the prevalence of latent yaws with high-titer seroreactivity in a subgroup of children 1 to 15 years of age.

At baseline, 13,302 of 16,092 residents (82.7%) received one oral dose of azithromycin. The prevalence of active infectious yaws was reduced from 2.4% before mass treatment to 0.3% at 12 months (difference, 2.1 percentage points; P<0.001). The prevalence of high-titer latent yaws among children was reduced from 18.3% to 6.5% (difference, 11.8 percentage points; P<0.001) with a near-absence of high-titer seroreactivity in children 1 to 5 years of age. Adverse events identified within 1 week after administration of the medication occurred in approximately 17% of the participants, included nausea, diarrhea, and vomiting, and were mild in severity. No evidence of emergence of resistance to macrolides against Treponema pallidum subspecies pertenue was seen.


The prevalence of active and latent yaws infection fell rapidly and substantially 12 months after high-coverage mass treatment with azithromycin, with the reduction perhaps aided by subsequent activities to identify and treat new cases of yaws. Our results support the WHO strategy for the eradication of yaws.
Q-Index Code C1
Q-Index Status Confirmed Code
Institutional Status UQ

Document type: Journal Article
Sub-type: Article (original research)
Collections: Official 2016 Collection
Sustainable Minerals Institute Publications
Version Filter Type
Citation counts: TR Web of Science Citation Count  Cited 18 times in Thomson Reuters Web of Science Article | Citations
Scopus Citation Count Cited 17 times in Scopus Article | Citations
Google Scholar Search Google Scholar
Created: Tue, 03 Mar 2015, 01:08:25 EST by System User on behalf of Scholarly Communication and Digitisation Service