In:
PLOS Neglected Tropical Diseases, Public Library of Science (PLoS), Vol. 16, No. 3 ( 2022-3-21), p. e0010197-
Abstract:
In yaws-endemic areas, children with Treponema pallidum subsp . pertenue infection may suffer recurrent episodes due to either reinfection or relapse. However, the possibility of infection with other cutaneous ulcer causative agents and difficulties in interpreting standard laboratory results challenges the estimation of yaws recurrence rates. Methods We estimated the rates of yaws recurrences in the Lihir Island (Papua New Guinea) using two approaches: passive surveillance based on a retrospective screening of electronic medical records of cutaneous ulcers diagnosed using serological testing between 2005 and 2016, and active surveillance conducted during a cross-sectional prevalence study which included PCR analyses of ulcers of all suspected cases of yaws. The risk of recurrent infection was assessed based on data from the passive surveillance analysis and using two Cox regression models (crude and multivariate), stratified by year of index episode. Data gathered from the active surveillance was used to characterize the recurrences and no hypothesis testing was performed. Results The electronic medical records included 6,125 patients (7,889 ulcer episodes) with documented serological results of cutaneous ulcers of which1,486 were diagnosed with yaws. Overall, 1,246/6,125 patients (20.3%) presented more than once with a cutaneous ulcer, and 103/1,486 (6.7%) patients had multiple episodes of yaws. The risk of yaws recurrence significantly increased with age and was higher in patients with ≥3 recurrent episodes. In the active surveillance, we identified 50 individuals with recurrent cutaneous ulcer that had PCR results available for both the index and recurrent episode. Of 12 individuals with T . pallidum in the index ulcer, 8 (66%) had T . pallidum in subsequent assessments, relapse related to macrolide-resistance was identified in two of these cases. Conclusions Our results confirm the need for active follow-up of yaws patients after treatment, particularly children and individuals with a history of recurrence.
Type of Medium:
Online Resource
ISSN:
1935-2735
DOI:
10.1371/journal.pntd.0010197
DOI:
10.1371/journal.pntd.0010197.g001
DOI:
10.1371/journal.pntd.0010197.g002
DOI:
10.1371/journal.pntd.0010197.t001
DOI:
10.1371/journal.pntd.0010197.t002
DOI:
10.1371/journal.pntd.0010197.t003
DOI:
10.1371/journal.pntd.0010197.t004
DOI:
10.1371/journal.pntd.0010197.s001
DOI:
10.1371/journal.pntd.0010197.s002
DOI:
10.1371/journal.pntd.0010197.s003
DOI:
10.1371/journal.pntd.0010197.r001
DOI:
10.1371/journal.pntd.0010197.r002
DOI:
10.1371/journal.pntd.0010197.r003
DOI:
10.1371/journal.pntd.0010197.r004
Language:
English
Publisher:
Public Library of Science (PLoS)
Publication Date:
2022
detail.hit.zdb_id:
2429704-5
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