Yaws is a chronic and disfiguring bacterial infection caused by Treponema pallidum subsp. pertenue.
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name: Yaws
creation_date: '2026-01-26T15:56:41Z'
updated_date: '2026-04-11T00:45:07Z'
category: Infectious Disease
description: >-
Yaws is a chronic and disfiguring bacterial infection caused by Treponema
pallidum subsp. pertenue.
disease_term:
term:
id: MONDO:0006019
label: yaws
preferred_term: Yaws
parents:
- Bacterial Infection
- Neglected tropical disease
infectious_agent:
- name: Treponema pallidum subsp. pertenue
infectious_agent_term:
preferred_term: Treponema pallidum subsp. pertenue
term:
id: NCBITaxon:168
label: Treponema pallidum subsp. pertenue
description: Spirochete that causes yaws.
evidence:
- reference: PMID:40036381
reference_title: "Yaws - A Review of Clinical Features, Diagnosis and Treatment."
supports: SUPPORT
snippet: "Yaws, a neglected tropical disease caused by Treponema pallidum subsp. pertenue, primarily affects children in impoverished rural areas."
explanation: The abstract identifies T. pallidum subsp. pertenue as the cause of yaws.
transmission:
- name: Direct skin contact
description: Transmitted through direct skin contact with infected individuals.
evidence:
- reference: PMID:40036381
reference_title: "Yaws - A Review of Clinical Features, Diagnosis and Treatment."
supports: SUPPORT
snippet: "It is spread through direct skin contact."
explanation: The abstract states yaws is spread through direct skin contact.
phenotypes:
- name: Skin ulcer
category: Dermatologic
frequency: COMMON
phenotype_term:
preferred_term: Skin ulcer
term:
id: HP:0200042
label: Skin ulcer
evidence:
- reference: PMID:40036381
reference_title: "Yaws - A Review of Clinical Features, Diagnosis and Treatment."
supports: SUPPORT
snippet: "In the primary stage, patients develop a, usually painless, papilloma or ulcer, often on the lower extremities, which is highly contagious."
explanation: The abstract describes ulcer formation in primary yaws.
treatments:
- name: Azithromycin therapy
description: Oral azithromycin is preferred for treatment.
treatment_term:
preferred_term: Pharmacotherapy
term:
id: NCIT:C15986
label: Pharmacotherapy
evidence:
- reference: PMID:40036381
reference_title: "Yaws - A Review of Clinical Features, Diagnosis and Treatment."
supports: SUPPORT
snippet: "Though yaws can be treated with benzathine penicillin, oral azithromycin has become the preferred treatment due to its ease of administration."
explanation: The abstract notes oral azithromycin as the preferred treatment.
references:
- reference: DOI:10.1101/2024.10.27.24316187
title: 'The Effect of Repeated Mass Drug Administration on the Transmission of Yaws: A Genomic Epidemiology Study'
found_in:
- Yaws-deep-research-falcon.md
findings:
- statement: Yaws, a neglected tropical disease caused by Treponema pallidum subspecies pertenue , has evaded eradication, in part due to a high proportion of asymptomatic cases.
supporting_text: Yaws, a neglected tropical disease caused by Treponema pallidum subspecies pertenue , has evaded eradication, in part due to a high proportion of asymptomatic cases.
evidence:
- reference: DOI:10.1101/2024.10.27.24316187
reference_title: 'The Effect of Repeated Mass Drug Administration on the Transmission of Yaws: A Genomic Epidemiology Study'
supports: SUPPORT
evidence_source: HUMAN_CLINICAL
snippet: Yaws, a neglected tropical disease caused by Treponema pallidum subspecies pertenue , has evaded eradication, in part due to a high proportion of asymptomatic cases.
explanation: Deep research cited this publication as relevant literature for Yaws.
- reference: DOI:10.1101/2024.11.07.24316738
title: 'The Morges Strategy for Yaws Eradication: the First Largescale Total Community Treatment with Azithromycin Against Yaws in the Congo-Basin, using a Novel Model'
found_in:
- Yaws-deep-research-falcon.md
findings:
- statement: Yaws is targeted for eradication by 2030.
supporting_text: Yaws is targeted for eradication by 2030.
evidence:
- reference: DOI:10.1101/2024.11.07.24316738
reference_title: 'The Morges Strategy for Yaws Eradication: the First Largescale Total Community Treatment with Azithromycin Against Yaws in the Congo-Basin, using a Novel Model'
supports: SUPPORT
evidence_source: HUMAN_CLINICAL
snippet: Yaws is targeted for eradication by 2030.
explanation: Deep research cited this publication as relevant literature for Yaws.
- reference: DOI:10.1371/journal.pntd.0011602
title: The genomes of the yaws bacterium, Treponema pallidum subsp. pertenue, of nonhuman primate and human origin are not genomically distinct
found_in:
- Yaws-deep-research-falcon.md
findings:
- statement: Treponema pallidumsubsp.pertenue(TPE) is the causative agent of human yaws.
supporting_text: Treponema pallidumsubsp.pertenue(TPE) is the causative agent of human yaws.
evidence:
- reference: DOI:10.1371/journal.pntd.0011602
reference_title: The genomes of the yaws bacterium, Treponema pallidum subsp. pertenue, of nonhuman primate and human origin are not genomically distinct
supports: SUPPORT
evidence_source: HUMAN_CLINICAL
snippet: Treponema pallidumsubsp.pertenue(TPE) is the causative agent of human yaws.
explanation: Deep research cited this publication as relevant literature for Yaws.
- reference: DOI:10.1371/journal.pntd.0011831
title: 'Low genetic diversity of Treponema pallidum ssp. pertenue (TPE) isolated from patients’ ulcers in Namatanai District of Papua New Guinea: Local human population is infected by three TPE genotypes'
found_in:
- Yaws-deep-research-falcon.md
findings:
- statement: Yaws is an endemic disease caused by Treponema pallidum subsp. pertenue (TPE) that primarily affects children in rural regions of the tropics.
supporting_text: Yaws is an endemic disease caused by Treponema pallidum subsp. pertenue (TPE) that primarily affects children in rural regions of the tropics.
evidence:
- reference: DOI:10.1371/journal.pntd.0011831
reference_title: 'Low genetic diversity of Treponema pallidum ssp. pertenue (TPE) isolated from patients’ ulcers in Namatanai District of Papua New Guinea: Local human population is infected by three TPE genotypes'
supports: SUPPORT
evidence_source: HUMAN_CLINICAL
snippet: Yaws is an endemic disease caused by Treponema pallidum subsp. pertenue (TPE) that primarily affects children in rural regions of the tropics.
explanation: Deep research cited this publication as relevant literature for Yaws.
- reference: DOI:10.1371/journal.pntd.0012224
title: Knowledge, attitudes and practices towards yaws in endemic areas of Ghana, Cameroon and Côte d’Ivoire
found_in:
- Yaws-deep-research-falcon.md
findings:
- statement: Knowledge, attitudes and practices towards yaws in endemic areas of Ghana, Cameroon and Côte d’Ivoire
supporting_text: Yaws, caused by Treponema pallidum ssp. pertenue, remains a significant public health concern in tropical regions of West Africa and the South Pacific, primarily affecting children in remote areas with limited access to hygiene and sanitation.
evidence:
- reference: DOI:10.1371/journal.pntd.0012224
reference_title: Knowledge, attitudes and practices towards yaws in endemic areas of Ghana, Cameroon and Côte d’Ivoire
supports: SUPPORT
evidence_source: HUMAN_CLINICAL
snippet: Yaws, caused by Treponema pallidum ssp. pertenue, remains a significant public health concern in tropical regions of West Africa and the South Pacific, primarily affecting children in remote areas with limited access to hygiene and sanitation.
explanation: Deep research cited this publication as relevant literature for Yaws.
- reference: DOI:10.1371/journal.pntd.0012899
title: Guidance for conducting and evaluating serological surveys to assess interruption of yaws transmission in the context of an eradication target
found_in:
- Yaws-deep-research-falcon.md
findings:
- statement: Guidance for conducting and evaluating serological surveys to assess interruption of yaws transmission in the context of an eradication target
supporting_text: This document provides a summary of guidance developed for national programmes on conducting serosurveys to assess yaws transmission status, with the objective of confirming yaws seroprevalence below 1% at each of three serosurveys over a period of 3–10 years after reporting the last case of active yaws in a region.
evidence:
- reference: DOI:10.1371/journal.pntd.0012899
reference_title: Guidance for conducting and evaluating serological surveys to assess interruption of yaws transmission in the context of an eradication target
supports: SUPPORT
evidence_source: OTHER
snippet: This document provides a summary of guidance developed for national programmes on conducting serosurveys to assess yaws transmission status, with the objective of confirming yaws seroprevalence below 1% at each of three serosurveys over a period of 3–10 years after reporting the last case of active yaws in a region.
explanation: Deep research cited this publication as relevant literature for Yaws.
- reference: DOI:10.1371/journal.pone.0295088
title: Prevalence of yaws and syphilis in the Ashanti region of Ghana and occurrence of H. ducreyi, herpes simplex virus 1 and herpes simplex virus 2 in skin lesions associated with treponematoses
found_in:
- Yaws-deep-research-falcon.md
findings:
- statement: Yaws affects children in tropical regions, while syphilis primarily affects sexually active adults worldwide.
supporting_text: Yaws affects children in tropical regions, while syphilis primarily affects sexually active adults worldwide.
evidence:
- reference: DOI:10.1371/journal.pone.0295088
reference_title: Prevalence of yaws and syphilis in the Ashanti region of Ghana and occurrence of H. ducreyi, herpes simplex virus 1 and herpes simplex virus 2 in skin lesions associated with treponematoses
supports: SUPPORT
evidence_source: HUMAN_CLINICAL
snippet: Yaws affects children in tropical regions, while syphilis primarily affects sexually active adults worldwide.
explanation: Deep research cited this publication as relevant literature for Yaws.
- reference: DOI:10.3390/diseases13010014
title: 'Yaws in Africa: Past, Present and Future'
found_in:
- Yaws-deep-research-falcon.md
findings:
- statement: Yaws is an infectious, neglected tropical disease that affects the skin of many children and adolescents who live in poor, rural, low-income communities in humid, tropical areas of Africa, Southeast Asia, and the Pacific Islands.
supporting_text: Yaws is an infectious, neglected tropical disease that affects the skin of many children and adolescents who live in poor, rural, low-income communities in humid, tropical areas of Africa, Southeast Asia, and the Pacific Islands.
evidence:
- reference: DOI:10.3390/diseases13010014
reference_title: 'Yaws in Africa: Past, Present and Future'
supports: SUPPORT
evidence_source: HUMAN_CLINICAL
snippet: Yaws is an infectious, neglected tropical disease that affects the skin of many children and adolescents who live in poor, rural, low-income communities in humid, tropical areas of Africa, Southeast Asia, and the Pacific Islands.
explanation: Deep research cited this publication as relevant literature for Yaws.
- reference: DOI:10.3855/jidc.17753
title: Comparison of the standard Q syphilis antibody rapid diagnostic test to gold standards for yaws detection in children
found_in:
- Yaws-deep-research-falcon.md
findings:
- statement: Yaws remains a public health problem in Indonesia, and it is the largest contributor to Yaws cases in Southeast Asia.
supporting_text: Yaws remains a public health problem in Indonesia, and it is the largest contributor to Yaws cases in Southeast Asia.
evidence:
- reference: DOI:10.3855/jidc.17753
reference_title: Comparison of the standard Q syphilis antibody rapid diagnostic test to gold standards for yaws detection in children
supports: SUPPORT
evidence_source: HUMAN_CLINICAL
snippet: Yaws remains a public health problem in Indonesia, and it is the largest contributor to Yaws cases in Southeast Asia.
explanation: Deep research cited this publication as relevant literature for Yaws.
Yaws is a neglected tropical disease and endemic treponematosis caused by the spirochete Treponema pallidum subsp. pertenue (TPE). It is clinically characterized by early contagious skin lesions and, in a subset of untreated infections, late destructive disease affecting cartilage and bone. (tabah2024themorgesstrategy pages 1-5, barton2024theeffectof pages 1-3)
Direct abstract support (examples): - “Yaws… remains a significant public health concern… primarily affecting children in remote areas with limited access to hygiene and sanitation.” (Beiras et al., published 2024-06-20; https://doi.org/10.1371/journal.pntd.0012224) (beiras2024knowledgeattitudesand pages 1-2) - “Yaws is targeted for eradication by 2030.” (Tabah et al., posted 2024-11; https://doi.org/10.1101/2024.11.07.24316738) (tabah2024themorgesstrategy pages 1-5)
In the retrieved full-text corpus for this run, formal ICD-10/ICD-11 codes, MeSH IDs, Orphanet IDs, and MONDO IDs were not explicitly stated; therefore, they cannot be reliably asserted here without introducing uncited information. (boaitey2024prevalenceofyaws pages 1-2, beiras2024knowledgeattitudesand pages 1-2)
The information in this report is derived from aggregated disease-level resources (reviews, implementation reports, genomic epidemiology studies) and population-based studies rather than individual EHR-only observations. (barton2024theeffectof pages 1-3, tabah2024themorgesstrategy pages 1-5)
Infectious agent (primary cause): - Treponema pallidum subsp. pertenue (TPE). (barton2024theeffectof pages 1-3, janeckova2023thegenomesof pages 1-2)
Transmission mechanism (proximal cause): - Non-venereal, largely via direct skin-to-skin contact with exudate from infectious lesions/ulcers. (tabah2024themorgesstrategy pages 1-5, beiras2024knowledgeattitudesand pages 1-2)
Evidence in the retrieved sources emphasizes contextual risk: - Tropical settings with limited access to hygiene/sanitation and remote communities. (beiras2024knowledgeattitudesand pages 1-2) - Overcrowding and poor personal/environmental hygiene facilitating spread. (tabah2024themorgesstrategy pages 1-5) - Age: majority of cases occur in children <15 years (e.g., “75% of new cases in those aged below 15 years”). (barton2024theeffectof pages 1-3)
The retrieved corpus does not provide genetic protective variants or quantified environmental protective factors for yaws; prevention appears dominated by interruption of transmission via MDA/TCT and surveillance rather than host-genetic protection. (tabah2024themorgesstrategy pages 1-5)
No direct gene–environment interaction evidence (human host genetics interacting with exposure) was present in the retrieved texts. (barton2024theeffectof pages 1-3)
Staging (with timing): - Incubation: 10–90 days (mean ~3 weeks) before primary lesions. (irawan2024comparisonofthe pages 1-2) - Primary lesions: often heal in ~3–6 months (but may become latent). (barton2024theeffectof pages 1-3, irawan2024comparisonofthe pages 1-2) - Secondary disease: disseminated lesions; can occur up to ~2 years after primary lesion onset; may involve systemic symptoms and infectious exudative lesions. (irawan2024comparisonofthe pages 1-2) - Latent stage: seroreactive without symptoms. (irawan2024comparisonofthe pages 1-2) - Tertiary: described as non-infectious, occurring in ~10% within 5–10 years with tissue damage and persistent bone deformities. (irawan2024comparisonofthe pages 1-2)
Skin and bone involvement: contemporary sources frame yaws as affecting “mainly… the skin and bones” and describe late destructive bone lesions. (irawan2024comparisonofthe pages 1-2, barton2024theeffectof pages 1-3)
A 2024 Ghana study illustrates frequent alternative etiologies in clinically similar lesions: - In yaws-like lesions (n=110), multiplex PCR found 9.1% Haemophilus ducreyi, 1.8% HSV-1, and 0.9% T. pallidum. (Boaitey et al., published 2024-05-22; https://doi.org/10.1371/journal.pone.0295088) (boaitey2024prevalenceofyaws pages 1-2) - In syphilis-like lesions (n=46), 28.3% HSV-2 was detected. (boaitey2024prevalenceofyaws pages 1-2)
This supports a key operational concept: syndromic “skin ulcer” programs must consider non-treponemal pathogens to avoid over-attribution to yaws and to ensure appropriate antivirals (for HSV) where relevant. (boaitey2024prevalenceofyaws pages 1-2)
Based on described phenotypes: - Skin ulcer: HP:0001056 - Skin papule: HP:0000980 - Hyperkeratosis (palms/soles): HP:0000962 (or palmoplantar keratoderma HP:0000982) - Osteitis / periostitis / bone pain (bone involvement noted across clinical descriptions): HP:0002754 (osteitis), HP:0002716 (periostitis), HP:0002653 (bone pain) - Lymphadenopathy (secondary stage described): HP:0002716 is periostitis; for lymphadenopathy use HP:0002716? (avoid mislabel); suggested: HP:0002716 is incorrect; instead HP:0002716 lymphadenopathy is not correct; therefore no HPO ID is asserted here.
(These are ontology suggestions to aid knowledge-base mapping; the retrieved texts did not provide explicit ontology IDs.) (irawan2024comparisonofthe pages 1-2)
Not applicable as a primary genetic disease: yaws is infectious. No human germline causal genes/variants were provided in retrieved sources. (barton2024theeffectof pages 1-3)
Low genetic diversity and typing in Papua New Guinea (PNG): - 1,081 ulcer swabs collected during an MDA study; 302/1,081 (28.5%) TPE PCR-positive; 255/302 (84.4%) fully typed by MLST. (medappa2024lowgeneticdiversitya pages 1-2) - Low diversity with three genotypes (JE11, SE22, TE13). (medappa2024lowgeneticdiversitya pages 1-2)
Whole-genome sequencing during repeated MDA trial: - WGS on 263 swabs recovered 222 good-quality TPE genomes; identified 29 fine-scale sub-lineages, with differential elimination/persistence across study arms. (barton2024theeffectof pages 1-3)
Macrolide (azithromycin) resistance is associated with 23S rRNA mutations: - In the repeated-MDA genomic epidemiology study, “Repeated rounds of MDA… led to emergence and spread of azithromycin resistance to three children.” (Barton et al., posted 2024-10; https://doi.org/10.1101/2024.10.27.24316187) (barton2024theeffectof pages 1-3) - A 2018–2019 PNG cluster-randomized trial summary in the same preprint notes “three epidemiologically linked cases harbouring the 23S rRNA A2058G” mutation. (barton2024theeffectof pages 1-3) - In the PNG typing study, an A2058G mutation was found in three JE11 isolates. (medappa2024lowgeneticdiversitya pages 1-2)
Additional genomic signals under selection during MDA: - Persistent sub-lineages with nonsynonymous mutations in penicillin-binding proteins were observed in the repeated-MDA study. (barton2024theeffectof pages 1-3)
The retrieved evidence frames yaws as associated with poverty-linked environmental conditions (limited hygiene/sanitation, overcrowding) rather than specific toxins or lifestyle exposures. (tabah2024themorgesstrategy pages 1-5, beiras2024knowledgeattitudesand pages 1-2)
1) Exposure to lesion exudate via skin-to-skin contact leads to inoculation with TPE. (tabah2024themorgesstrategy pages 1-5) 2) Primary infection manifests as early skin lesions; a portion resolves or becomes latent. (irawan2024comparisonofthe pages 1-2) 3) Secondary dissemination affects skin and bones; late tertiary disease can produce destructive bone lesions and deformities in a subset of untreated cases. (barton2024theeffectof pages 1-3, irawan2024comparisonofthe pages 1-2) 4) Programmatically, asymptomatic/latent infection contributes to persistence and re-emergence after MDA, consistent with genomic evidence that re-emergence is largely local and driven by pre-existing sub-lineages. (barton2024theeffectof pages 1-3)
The retrieved sources do not provide mechanistic pathway-level data (e.g., cytokine signatures). For knowledge-base mapping, plausible GO terms consistent with infectious skin/bone pathology include: - GO:0006954 inflammatory response - GO:0009615 response to virus (for HSV differential in ulcers) - GO:0007155 cell adhesion / GO:0006955 immune response (broad)
These are suggestions only; explicit molecular pathway profiling was not present in the retrieved texts. (boaitey2024prevalenceofyaws pages 1-2)
Not directly provided. For mapping inflammatory skin lesions and ulcer exudate, candidate CL terms may include: - CL:0000623 neutrophil - CL:0000542 lymphocyte - CL:0000235 macrophage
(Again, suggestions only; not explicitly measured in sources.) (irawan2024comparisonofthe pages 1-2)
Not explicitly provided in sources; included as mapping suggestions. (tabah2024themorgesstrategy pages 1-5)
The retrieved corpus for this run does not include a GBD-style global incidence estimate specific to 2023–2024; a modeling burden estimate in a 2024 preprint states: “Without an eradication campaign, yaws would cause an estimated 1·6 million disability-adjusted life years from 2015-2050.” (barton2024theeffectof pages 1-3)
Standard Q Syphilis Ab RDT in children with suspected yaws (Indonesia; 2024): - Study population: 195 children aged 2–15 years; 116 clinically suspected, 13 serologically positive. (irawan2024comparisonofthe pages 1-2) - Performance: vs TPHA sensitivity 93.3% and specificity 99.4%; vs RPR sensitivity 100% and specificity 98.4%. (irawan2024comparisonofthe pages 1-2) - Abstract conclusion: “Standard Q Syphilis Ab RDT examination can be used as a screening test… RPR is still required to confirm the diagnosis of yaws.” (Irawan et al., doi:10.3855/jidc.17753; accepted 2023-11-29; published 2024-11 issue) (irawan2024comparisonofthe pages 1-2)
The Ghana study shows that multiplex PCR can identify alternative etiologies in yaws-like ulcers (notably H. ducreyi and HSV), a major practical issue for elimination programs relying on clinical case finding. (boaitey2024prevalenceofyaws pages 1-2)
No host genetic testing is indicated; pathogen sequencing and MLST/WGS are the main “omics” tools described. (medappa2024lowgeneticdiversitya pages 1-2, barton2024theeffectof pages 1-3)
The retrieved evidence set does not provide modern case-fatality rates; yaws is principally morbidity-causing rather than acutely fatal in the texts retrieved. (barton2024theeffectof pages 1-3)
Morges strategy / TCT and coverage targets: - The KAP study notes that a “cornerstone” is achieving “population treatment coverage of over 90%.” (beiras2024knowledgeattitudesand pages 1-2)
Large-scale Congo-Basin TCT implementation (2024 preprint): - Target population 1,530,014 across 17 districts; first-round coverage 95.21% overall; second-round Cameroon coverage 95.73%; active yaws prevalence decreased from 6.5% to 0.4% overall. (tabah2024themorgesstrategy pages 1-5) - Abstract support: “A novel TCT model was successfully implemented at largescale… The prevalence of active yaws dropped remarkably… however complete interruption of yaws transmission was not achieved.” (Tabah et al., 2024-11; https://doi.org/10.1101/2024.11.07.24316738) (tabah2024themorgesstrategy pages 1-5)
Repeated MDA vs targeted treatment (PNG; 2024 genomic epidemiology preprint): - In a 56,676-person cluster randomized trial context, active cases reduced three-fold in control arm vs 11-fold in experimental arm at 18 months (summary in text). (barton2024theeffectof pages 1-3) - Tradeoff: repeated MDA increased selection pressure and was associated with emergence/spread of azithromycin resistance in 3 children. (barton2024theeffectof pages 1-3)
(These are mapping suggestions; MAXO IDs were not present in the retrieved texts.) (tabah2024themorgesstrategy pages 1-5)
Evidence emphasizes population-level chemoprevention/interrupting transmission via TCT/MDA with high coverage, followed by surveillance and targeted treatment. - In Congo-Basin implementation, TCT was followed by “post-campaign active surveillance, treatment of yaws cases and their contacts.” (tabah2024themorgesstrategy pages 1-5)
KAP study data show persistent misconceptions about transmission (e.g., low correct identification of person-to-person transmission), supporting the need for culturally tailored education. - Only 11.9% (Ghana) and 20.7% (Côte d’Ivoire) correctly identified contact with an infected person as a mode of transmission; 42.6% in Cameroon. (beiras2024knowledgeattitudesand pages 1-2)
A 2023 PLOS Neglected Tropical Diseases genomic study directly addresses the long-standing “no animal reservoir” assumption: - Abstract conclusion: “Our data show that NHPs are infected with strains that are not only similar to the strains infecting humans but are genomically indistinguishable from them.” (Janečková et al., published 2023-09-13; https://doi.org/10.1371/journal.pntd.0011602) (janeckova2023thegenomesof pages 1-2) - The study sequenced/finished genomes from 10 NHP-origin isolates and found “no consistent differences between human and NHP TPE genomes,” recommending continued surveillance in areas with naturally infected NHPs even if yaws is eliminated in humans. (janeckova2023thegenomesof pages 1-2, janeckova2023thegenomesof pages 9-10)
This constitutes a major contemporary complication for eradication: elimination in humans may not equal biological eradication if an untreated wildlife reservoir persists. (janeckova2023thegenomesof pages 1-2)
No dedicated experimental model organism systems were described in the retrieved texts for this run beyond naturally infected nonhuman primates being recognized as hosts/reservoirs and genomic comparators. (janeckova2023thegenomesof pages 1-2)
1) Implementation effectiveness is high but elimination is fragile. Large-scale TCT can reach WHO-recommended coverage thresholds (>90%) and drive large prevalence reductions (e.g., 6.5%→0.4% active yaws), but may still fail to fully interrupt transmission, supporting recommendations for multiple rounds and sustained surveillance. (tabah2024themorgesstrategy pages 1-5)
2) Repeated MDA improves suppression but increases resistance risk. Genomic epidemiology indicates greater suppression (11-fold vs 3-fold reduction in active cases at 18 months in one trial context) but also documents emergence/spread of macrolide resistance (23S rRNA A2058G/A2059G) in a small number of children, highlighting the need for resistance surveillance integrated into programs. (barton2024theeffectof pages 1-3)
3) Diagnostics must explicitly address ulcer syndrome heterogeneity. The Ghana PCR study demonstrates that yaws-like ulcers frequently have non-treponemal etiologies (H. ducreyi, HSV), meaning that reliance on clinical diagnosis alone can overestimate yaws and misdirect treatment (especially for HSV, which does not respond to antibiotics). (boaitey2024prevalenceofyaws pages 1-2)
4) The reservoir question is no longer hypothetical. Finished genomes provide strong evidence that NHP strains are genomically indistinguishable from human strains, which supports a potential animal reservoir and implies that “eradication” verification must incorporate ecological surveillance in relevant geographies. (janeckova2023thegenomesof pages 1-2, janeckova2023thegenomesof pages 9-10)
References
(barton2024theeffectof pages 1-3): Amber Barton, Petra Pospíšilová, Camila G Beiras, Lucy N. John, Wendy Houinei, Lorenzo Giacani, David Šmajs, Michael Marks, Oriol Mitjà, Mathew A Beale, and Nicholas R Thomson. The effect of repeated mass drug administration on the transmission of yaws: a genomic epidemiology study. MedRxiv, Oct 2024. URL: https://doi.org/10.1101/2024.10.27.24316187, doi:10.1101/2024.10.27.24316187. This article has 0 citations.
(beiras2024knowledgeattitudesand pages 1-2): Camila González Beiras, Adingra Tano Kouadio, Becca Louise Handley, Daniel Arhinful, Serges Tchatchouang, Ahouansou Stanislas Sonagnon Houndji, Eric Tettey Nartey, Dolphine Osei Sarpong, Gely Menguena, Philippe Ndzomo, Laud Anthony Basing, Kouadio Aboh Hugues, Ivy Brago Amanor, Mohammed Bakheit, Emelie Landmann, Patrick Awondo, Claudia Müller, Tania Crucitti, Nadine Borst, Lisa Becherer, Simone Lüert, Sieghard Frischmann, Aboubacar Sylla, Mireille S. Kouamé-Sina, Emma Michèle Harding-Esch, Sascha Knauf, Oriol Mitjà, Sara Eyangoh, Kennedy Kwasi Addo, Solange Ngazoa Kakou, and Michael Marks. Knowledge, attitudes and practices towards yaws in endemic areas of ghana, cameroon and côte d’ivoire. PLOS Neglected Tropical Diseases, 18:e0012224, Jun 2024. URL: https://doi.org/10.1371/journal.pntd.0012224, doi:10.1371/journal.pntd.0012224. This article has 1 citations and is from a domain leading peer-reviewed journal.
(tabah2024themorgesstrategy pages 1-5): Earnest Njih Tabah, Alphonse Um Boock, Chefor Alain Djam, Gilius Axel Aloumba, Boua Bernard, Nzoyem Colin Tsago, Irine Ngani Nformi, Loic Douanla Pagning, Elisaberth Baran-A-Bidias, Christian Elvis Kouayep-Watat, Smith Afanji, Ebai George, Marielle Patty Ngassa, Bonaventure Savadogo, Serges Tchatchouang, Valerie Donkeng, Yves Thierry Barogui, Sara Eyangoh, and Kingsley Bampoe Asiedu. The morges strategy for yaws eradication: the first largescale total community treatment with azithromycin against yaws in the congo-basin, using a novel model. MedRxiv, Nov 2024. URL: https://doi.org/10.1101/2024.11.07.24316738, doi:10.1101/2024.11.07.24316738. This article has 1 citations.
(medappa2024lowgeneticdiversitya pages 1-2): M Medappa, P Pospíšilová, and MPM Madruga. Low genetic diversity of treponema pallidum ssp. pertenue (tpe) isolated from patients' ulcers in namatanai district of papua new guinea: local human population …. Unknown journal, 2024.
(janeckova2023thegenomesof pages 1-2): Klára Janečková, Christian Roos, Pavla Fedrová, Nikola Tom, Darina Čejková, Simone Lueert, Julius D. Keyyu, Idrissa S. Chuma, Sascha Knauf, and David Šmajs. The genomes of the yaws bacterium, treponema pallidum subsp. pertenue, of nonhuman primate and human origin are not genomically distinct. PLOS Neglected Tropical Diseases, 17:e0011602, Sep 2023. URL: https://doi.org/10.1371/journal.pntd.0011602, doi:10.1371/journal.pntd.0011602. This article has 15 citations and is from a domain leading peer-reviewed journal.
(vicar2025yawsinafrica pages 1-2): Ezekiel K. Vicar, Shirley V. Simpson, Gloria I. Mensah, Kennedy K. Addo, and Eric S. Donkor. Yaws in africa: past, present and future. Diseases, 13:14, Jan 2025. URL: https://doi.org/10.3390/diseases13010014, doi:10.3390/diseases13010014. This article has 2 citations.
(vicar2025yawsinafrica pages 2-4): Ezekiel K. Vicar, Shirley V. Simpson, Gloria I. Mensah, Kennedy K. Addo, and Eric S. Donkor. Yaws in africa: past, present and future. Diseases, 13:14, Jan 2025. URL: https://doi.org/10.3390/diseases13010014, doi:10.3390/diseases13010014. This article has 2 citations.
(irawan2024comparisonofthe pages 1-2): Yudo Irawan, Astuti Giantini, and Nevi Yasnova. Comparison of the standard q syphilis antibody rapid diagnostic test to gold standards for yaws detection in children. Journal of infection in developing countries, 18 11:1734-1738, Nov 2024. URL: https://doi.org/10.3855/jidc.17753, doi:10.3855/jidc.17753. This article has 1 citations.
(vicar2025yawsinafrica pages 7-8): Ezekiel K. Vicar, Shirley V. Simpson, Gloria I. Mensah, Kennedy K. Addo, and Eric S. Donkor. Yaws in africa: past, present and future. Diseases, 13:14, Jan 2025. URL: https://doi.org/10.3390/diseases13010014, doi:10.3390/diseases13010014. This article has 2 citations.
(boaitey2024prevalenceofyaws pages 7-8): Yaw Agyekum Boaitey, Alex Owusu-Ofori, Amarachukwu Anyogu, Farhang Aghakhanian, Natasha Arora, Jonathan B. Parr, Philipp P. Bosshard, Saki Raheem, and Pascale Gerbault. Prevalence of yaws and syphilis in the ashanti region of ghana and occurrence of h. ducreyi, herpes simplex virus 1 and herpes simplex virus 2 in skin lesions associated with treponematoses. PLOS ONE, 19:e0295088, May 2024. URL: https://doi.org/10.1371/journal.pone.0295088, doi:10.1371/journal.pone.0295088. This article has 7 citations and is from a peer-reviewed journal.
(boaitey2024prevalenceofyaws pages 2-4): Yaw Agyekum Boaitey, Alex Owusu-Ofori, Amarachukwu Anyogu, Farhang Aghakhanian, Natasha Arora, Jonathan B. Parr, Philipp P. Bosshard, Saki Raheem, and Pascale Gerbault. Prevalence of yaws and syphilis in the ashanti region of ghana and occurrence of h. ducreyi, herpes simplex virus 1 and herpes simplex virus 2 in skin lesions associated with treponematoses. PLOS ONE, 19:e0295088, May 2024. URL: https://doi.org/10.1371/journal.pone.0295088, doi:10.1371/journal.pone.0295088. This article has 7 citations and is from a peer-reviewed journal.
(boaitey2024prevalenceofyaws pages 1-2): Yaw Agyekum Boaitey, Alex Owusu-Ofori, Amarachukwu Anyogu, Farhang Aghakhanian, Natasha Arora, Jonathan B. Parr, Philipp P. Bosshard, Saki Raheem, and Pascale Gerbault. Prevalence of yaws and syphilis in the ashanti region of ghana and occurrence of h. ducreyi, herpes simplex virus 1 and herpes simplex virus 2 in skin lesions associated with treponematoses. PLOS ONE, 19:e0295088, May 2024. URL: https://doi.org/10.1371/journal.pone.0295088, doi:10.1371/journal.pone.0295088. This article has 7 citations and is from a peer-reviewed journal.
(boaitey2024prevalenceofyaws pages 10-11): Yaw Agyekum Boaitey, Alex Owusu-Ofori, Amarachukwu Anyogu, Farhang Aghakhanian, Natasha Arora, Jonathan B. Parr, Philipp P. Bosshard, Saki Raheem, and Pascale Gerbault. Prevalence of yaws and syphilis in the ashanti region of ghana and occurrence of h. ducreyi, herpes simplex virus 1 and herpes simplex virus 2 in skin lesions associated with treponematoses. PLOS ONE, 19:e0295088, May 2024. URL: https://doi.org/10.1371/journal.pone.0295088, doi:10.1371/journal.pone.0295088. This article has 7 citations and is from a peer-reviewed journal.
(barton2024theeffectof pages 12-14): Amber Barton, Petra Pospíšilová, Camila G Beiras, Lucy N. John, Wendy Houinei, Lorenzo Giacani, David Šmajs, Michael Marks, Oriol Mitjà, Mathew A Beale, and Nicholas R Thomson. The effect of repeated mass drug administration on the transmission of yaws: a genomic epidemiology study. MedRxiv, Oct 2024. URL: https://doi.org/10.1101/2024.10.27.24316187, doi:10.1101/2024.10.27.24316187. This article has 0 citations.
(vicar2025yawsinafrica pages 11-11): Ezekiel K. Vicar, Shirley V. Simpson, Gloria I. Mensah, Kennedy K. Addo, and Eric S. Donkor. Yaws in africa: past, present and future. Diseases, 13:14, Jan 2025. URL: https://doi.org/10.3390/diseases13010014, doi:10.3390/diseases13010014. This article has 2 citations.
(janeckova2023thegenomesof pages 9-10): Klára Janečková, Christian Roos, Pavla Fedrová, Nikola Tom, Darina Čejková, Simone Lueert, Julius D. Keyyu, Idrissa S. Chuma, Sascha Knauf, and David Šmajs. The genomes of the yaws bacterium, treponema pallidum subsp. pertenue, of nonhuman primate and human origin are not genomically distinct. PLOS Neglected Tropical Diseases, 17:e0011602, Sep 2023. URL: https://doi.org/10.1371/journal.pntd.0011602, doi:10.1371/journal.pntd.0011602. This article has 15 citations and is from a domain leading peer-reviewed journal.
(beiras2024knowledgeattitudesand pages 8-9): Camila González Beiras, Adingra Tano Kouadio, Becca Louise Handley, Daniel Arhinful, Serges Tchatchouang, Ahouansou Stanislas Sonagnon Houndji, Eric Tettey Nartey, Dolphine Osei Sarpong, Gely Menguena, Philippe Ndzomo, Laud Anthony Basing, Kouadio Aboh Hugues, Ivy Brago Amanor, Mohammed Bakheit, Emelie Landmann, Patrick Awondo, Claudia Müller, Tania Crucitti, Nadine Borst, Lisa Becherer, Simone Lüert, Sieghard Frischmann, Aboubacar Sylla, Mireille S. Kouamé-Sina, Emma Michèle Harding-Esch, Sascha Knauf, Oriol Mitjà, Sara Eyangoh, Kennedy Kwasi Addo, Solange Ngazoa Kakou, and Michael Marks. Knowledge, attitudes and practices towards yaws in endemic areas of ghana, cameroon and côte d’ivoire. PLOS Neglected Tropical Diseases, 18:e0012224, Jun 2024. URL: https://doi.org/10.1371/journal.pntd.0012224, doi:10.1371/journal.pntd.0012224. This article has 1 citations and is from a domain leading peer-reviewed journal.
(boaitey2024prevalenceofyaws pages 15-16): Yaw Agyekum Boaitey, Alex Owusu-Ofori, Amarachukwu Anyogu, Farhang Aghakhanian, Natasha Arora, Jonathan B. Parr, Philipp P. Bosshard, Saki Raheem, and Pascale Gerbault. Prevalence of yaws and syphilis in the ashanti region of ghana and occurrence of h. ducreyi, herpes simplex virus 1 and herpes simplex virus 2 in skin lesions associated with treponematoses. PLOS ONE, 19:e0295088, May 2024. URL: https://doi.org/10.1371/journal.pone.0295088, doi:10.1371/journal.pone.0295088. This article has 7 citations and is from a peer-reviewed journal.