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