Modeling Treatment Strategies to Inform Yaws Eradication

Emerg Infect Dis. 2020 Nov;26(11):2685-2693. doi: 10.3201/eid2611.191491.

Abstract

Yaws is a neglected tropical disease targeted for eradication by 2030. To achieve eradication, finding and treating asymptomatic infections as well as clinical cases is crucial. The proposed plan, the Morges strategy, involves rounds of total community treatment (i.e., treating the whole population) and total targeted treatment (TTT) (i.e., treating clinical cases and contacts). However, modeling and empirical work suggests asymptomatic infections often are not found in the same households as clinical cases, reducing the utility of household-based contact tracing for a TTT strategy. We use a model fitted to data from the Solomon Islands to predict the likelihood of elimination of transmission under different intervention schemes and levels of systematic nontreatment resulting from the intervention. Our results indicate that implementing additional treatment rounds through total community treatment is more effective than conducting additional rounds of treatment of at-risk persons through TTT.

Keywords: Solomon Islands; TPE; Treponema pallidum; Treponema pallidum pertenue; bacteria; bacterial infections; contact tracing; mass drug administration; modeling; neglected tropical diseases; yaws.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Contact Tracing
  • Disease Eradication*
  • Humans
  • Melanesia
  • Models, Theoretical
  • Neglected Diseases / drug therapy
  • Neglected Diseases / epidemiology
  • Neglected Diseases / prevention & control
  • Treponema pallidum
  • Yaws* / drug therapy
  • Yaws* / epidemiology
  • Yaws* / prevention & control