ROGER BEN BSC. NURSING

1. YAWS PREVENTION AND
CONTROL
Presented by :-
Roger Ben

2. YAWS / FRAMBESIA TROPICA / THYMOSIS
Contagious, non- venerable,
infectious disease caused by
Treponema pertenue .
• Clinically characterized by primary
papillomatous, skin lesions called “
Mother YAWS.” in face and trunk.
• Late bone and skin destruction.

3. GEOGRAPHIC DISTRIBUTION OF YAWS IN
GLOBAL LEVEL :-
•Some parts of Africa,
South- east Asia and
Central America.
•Asia – Papua ,
Indonesia, New
Guinea , South Pacific
and India.

4. YAWS IN INDIA :-
• Hilly Forests and Tribal communities ,19 September 2011
disease free certification.
• States affected :-
1. Andhra Pradesh.
2. Assam.
3. Gujarat.
4. Chattisgarh.
5. Jharkhand.
6. Madhya Pradesh.
7. Maharashtra.
8. Orissa.
9. Uttar Pradesh.
10. Tamil Nadu.

5. EPIDEMIOLOGICAL TRIAD :-
Agent :- Treponema
pertenue
Environment:-
• Warm and humid
climate.
• Tribal people.
• Poor personal hygiene.
• Low standard of living.
Host :-
Young children
less than 15 yrs
Both sexes.

6. CONT...
•Incubation period :- 2 – 6 ( or )3 – 5 weeks.
•Reservoir :- man
•Mode of transmission :-
1. Direct contact :- skin – skin contact with
secretions.
2. Fomites indirectly through fomites.
3. Mechanical transmission :- vectors flies and
insects , transmitting of infection.

7. CLINICAL MANIFESTATIONS :-
1. Prodromal period :-
•Headache.
•Weakness.
•Chill.
•Fever.
•Arthralgia.
•Muscle and joint pain in
night time.

8. CONT...
1. Primary lesions:-
• Inoculation – 2 weeks to 6
Months.
•Exposed parts of body begins as
papules and cause papilloma.
•Granulomatous eruptions.
•Enlarged lymph glands.
•Pitted scarwith dark margins heals
after 3-6 months.

9. CONT...
2. Secondary lessions :-
•Multiple cutaneous lessions.
•Macules, papules, nodules
,& Ulceration.
•Lymphadenitis.
•Periosteal infection &
destruction of cartilage.

10. CONT...
3.Late YAWS :-
• Skin lesions.
• Bone deformities.
• Hyperkeratosis of Palms & soles.
• Gummas of skull, sternum and tibia.
• CRAB YAWS :- lessions of palm and
soles.
• Gangosa :- soft palate , hard palate &
nose.
Complications :-
1. Deformities of lower limbs and nose.

11. LABORATORY INVESTIGATIONS:-
1. Non – treponemal test :- Rapid plasma Reagent
& VDRL
2. Confirmatory tests :-
•Treponema pallidum hemagglutination. ( TPHA).
•Micro hemagglutination Treponema pallidum. (MHA
– TP).
•Flourescent treponema antibody absorption.
( FTA – ABS ).
•Polymerase chain reaction ( PCR).
•Biopsy of lessions.

12. CONTROL AND PREVENTION OF YAWS
:-
1. SURVEY :-
• Clinical survey
of all families
in endemic
areas.
•Should not
cover less than
95% of
population.

13. 2. TREATMENT OF YAWS:-
1. Total mass treatment :-
• More than 10% of whole population under risk.
/Hyper-endemic.
2.Juvenile mass treatment :-
• Prevalent rate of children below 15 yrs – extra
familial & Close contact. / Meso-endemic.
3.Selective mass treatment :-
• Hypo-endemic / Prevalence rate / treatment for
family contact & close extrafamilial contact.

14. TREATMENT DRUGS :-
•Antibiotics.
•Penincillin G
benzathine / 1.2
million units / IM/
60,000 units in
children.
•Tetracyclin.
•Erythromycin.
•Azithromycin ./ 30
mg per kg.

15. 3. RESURVEY AND TREATMENT :-
• Resurvey every 6-12
months to asses the
magnitude of the
problems.

16. 4. SURVEILLANCE :-
•Surveillance and containment
measures for affected villages ,
households,& contact of known
YAWS cases.
• Epidemiological investigations to
trace possible sources of infection
, prophylactic treatment of
contacts, monthly follow up
households & treatment of last
active case.

17. 5.ENVIRONMENTAL IMPROVEMENT:-
• Poor socio-economic
conditions.
• Improvement of personal &
domestic hygiene.
• Adequate water supply.
• Better housing conditions.
• Improve quality of life.
• Regular bathing with generous
use of soap.

18. 6. EVALUATIONS :-
•Serological studies :-
whether YAWS has been
under control.
•Number of YAWS
antibodies found among
children born since Yaws
mass campaign was
completed.

19. YAWS ERADICATION
PROGRAMME