YAWS1. PIAN2. BUBAS3. FRAMBOESIA
Yaws and its relativesare caused by spirochete bacteria
Treponema
• Contagious , non venereal treponemal infection. • No cardiovascular or neurological abnormalities
Yaws is typically found in tropical areas of Africa, South America, and Asia
Between 1950 and 1970, WHO and UNICEF led a campaign to treat people in 46 countries
It worked, but these diseases now receive little attention
Caused by Treponema pertenue . Reservoir of infection – Man Age - It affect children < 15 years [peak
incidence 6-10 years]. Immunity – no natural immunity. Provides
partial immunity to veneral syphilis.
ENVIRONMENTAL FACTORS
• Climate – endemic in warm and humid conditions
• Social factors scanty clothingPoor personal cleanlinessOvercrowdingBad housingLow standard of livingAbsence of soap
MODE OF TRANSMISSION
• Direct contact• Fomites• Vector
INCUBATION PERIOD 3 to 5 weeks
The endemic treponematoses are mainly transmitted by human-to-human contact
CLASSIFICATION
• Primary stage …..lesion at site of inoculation. • Secondary stage ….multiple skin lesion. • Latent stage …..no symptom but skin lesion can
relapse. • Tertiary ….bone , joint & soft tissue deformality
OTHER CASSIFICATION
• Early----: primary & secondary { contagious skin lesion }.
• Late -----: tertiary (not contagious).
CLINICAL PRESENTATION Primary lesion called….. mother yaw.[IP 9-90 days]. 1ry papule---enlarge → papilloma {resolve
spontaneously after 3-6 months }. 2ry may occur near the 1ry or elsewhere on the body
{last for more than 6 months } Macule , papules , nodules ,and hyperkeratotic lesion in
palms & soles { CRAB YAWS } ,lesions may ulcerate. Saber shin due to chronic untreated osteoperiostitis. Pt with late yaws → juxtaarticular nodules → gangosa [
rhinopharyngitis mutilans ]
The first sign of yaws is a primary lesion known as a “mother yaw”
Without treatment, secondary widespread lesions form
After years without treatment, larger problems may develop
Gangosa Saber shin / tibia
INVESTIGATIONS
Diagnosis on clinical findings. Non treponema test:VDRL. Positive in all
stages except early lesions . Dark-field examination ….. + ve . Biopsy.
These diseases can be diagnosed in two ways
Dark field microscopy
Serological Tests
MANAGEMENT
Benzathine penicillin ( penicillin G ) 1.2 million units IM once
Penicillin V for 7-10 days.[ for 1ry , 2ry &latent].Tetracyclin 1-2 g\ day for 7-14 days.[tertiary] Erythromycin [tertiary]. Doxycycline 200mg 1 st ,100 mg\day for 7-14
days.[tertiary].
Benzathine penicillin is the main drug of choice for treatment
CONTROL1. Survey2. Treatment
Total mass treatment ( more than 10% prevalence)Juvenile mass treatment ( 5% to 10 %)selective mass treatment (less than 5 %)
3. Resurvey and treatment ( every 6 to 12 months)4. Surveillance5. Environmental improvement6. Resurgence of yaws7. Evaluation