title: Challenges and key research questions for yaws eradication.
abstract: Yaws is endemic in west Africa, southeast Asia, and the Pacific region. To eradicate yaws by 2020, WHO has launched a campaign of mass treatment with azithromycin. Progress has been made towards achievement of this ambitious goal, including the validation of point-of-care and molecular diagnostic tests and piloting of the strategy in several countries, including Ghana, Vanuatu, and Papua New Guinea. Gaps in knowledge need to be addressed to allow refinement of the eradication strategy. Studies exploring determinants of the spatial distribution of yaws are needed to help with the completion of baseline mapping. The finding that Haemophilus ducreyi causes lesions similar to yaws is particularly important and further work is needed to assess the effect of azithromycin on these lesions. The integration of diagnostic tests into different stages of the eradication campaign needs investigation. Finally, studies must be done to inform the optimum mass-treatment strategy for sustainable interruption of transmission.
authors.affiliation: Clinical Research Department, Faculty of Infectious and Tropical Diseases, London School of Hygiene & Tropical Medicine, London, UK; Hospital for Tropical Diseases, University College London Hospitals NHS Trust, London, UK. Electronic address: michael.marks@lshtm.ac.uk.
authors.forename: Michael
authors.initials: M
authors.lastname: Marks
authors.affiliation: ISGlobal, Barcelona Centre for International Health Research, Hospital Clínic-Universitat de Barcelona, Barcelona, Spain; Lihir Medical Centre, International SOS, Newcrest Mining, Lihir Island, Papua New Guinea.
authors.forename: Oriol
authors.initials: O
authors.lastname: Mitjà
authors.affiliation: Division for Communicable Diseases, Regional Office for the Western Pacific, World Health Organization, Manila, Philippines.
authors.forename: Lasse S
authors.initials: LS
authors.lastname: Vestergaard
authors.affiliation: Molecular Diagnostics and Typing Laboratory, Laboratory Reference and Research Branch, Division of STD Prevention, Centers for Disease Control and Prevention, Atlanta, GA, USA.
authors.forename: Allan
authors.initials: A
authors.lastname: Pillay
authors.affiliation: German Primate Center, Leibniz-Institute for Primate Research, Pathology Unit, Working Group Neglected Tropical Diseases, Göttingen, Germany.
authors.forename: Sascha
authors.initials: S
authors.lastname: Knauf
authors.affiliation: Molecular Diagnostics and Typing Laboratory, Laboratory Reference and Research Branch, Division of STD Prevention, Centers for Disease Control and Prevention, Atlanta, GA, USA.
authors.forename: Cheng-Yen
authors.initials: CY
authors.lastname: Chen
authors.affiliation: ISGlobal, Barcelona Centre for International Health Research, Hospital Clínic-Universitat de Barcelona, Barcelona, Spain; Centro de Investigação em Saúde de Manhiça, Maputo, Mozambique.
authors.forename: Quique
authors.initials: Q
authors.lastname: Bassat
authors.affiliation: Division of Parasitic Diseases and Malaria, Centers for Disease Control and Prevention, Atlanta, GA, USA.
authors.forename: Diana L
authors.initials: DL
authors.lastname: Martin
authors.affiliation: World Health Organization Consultant, Springhill, Brisbane, Queensland, Australia.
authors.forename: David
authors.initials: D
authors.lastname: Fegan
authors.affiliation: Ministry of Health, Port Vila, Vanuatu.
authors.forename: Fasihah
authors.initials: F
authors.lastname: Taleo
authors.affiliation: World Health Organization, Vanuatu Country Office, Port Vila, Vanuatu.
authors.forename: Jacob
authors.initials: J
authors.lastname: Kool
authors.affiliation: Departments of Medicine and Global Health, University of Washington, Seattle, WA, USA.
authors.forename: Sheila
authors.initials: S
authors.lastname: Lukehart
authors.affiliation: International Trachoma Initiative, The Task Force for Global Health, Decatur, GA, USA.
authors.forename: Paul M
authors.initials: PM
authors.lastname: Emerson
authors.affiliation: Clinical Research Department, Faculty of Infectious and Tropical Diseases, London School of Hygiene & Tropical Medicine, London, UK; Hospital for Tropical Diseases, University College London Hospitals NHS Trust, London, UK; Department of Control of Neglected Tropical Diseases, World Health Organization, Geneva, Switzerland.
authors.forename: Anthony W
authors.initials: AW
authors.lastname: Solomon
authors.affiliation: Center for Global Health, Centers for Disease Control and Prevention, Atlanta, GA, USA.
authors.forename: Tun
authors.initials: T
authors.lastname: Ye
authors.affiliation: Center for Global Health, Centers for Disease Control and Prevention, Atlanta, GA, USA.
authors.forename: Ronald C
authors.initials: RC
authors.lastname: Ballard
authors.affiliation: Clinical Research Department, Faculty of Infectious and Tropical Diseases, London School of Hygiene & Tropical Medicine, London, UK; Hospital for Tropical Diseases, University College London Hospitals NHS Trust, London, UK.
authors.forename: David C W
authors.initials: DCW
authors.lastname: Mabey
authors.affiliation: Department of Control of Neglected Tropical Diseases, World Health Organization, Geneva, Switzerland.
authors.forename: Kingsley B
authors.initials: KB
authors.lastname: Asiedu
mesh_terms: D000354:Africa, Western / Q000453:epidemiology; D000900:Anti-Bacterial Agents / Q000627:therapeutic use; D001210:Asia, Southeastern / Q000453:epidemiology; D017963:Azithromycin / Q000627:therapeutic use; D003955:Diagnostic Tests, Routine / Q000592:standards; D060740:Disease Eradication; D019353:Endemic Diseases; D006801:Humans; D010139:Pacific Islands / Q000453:epidemiology; D019371:Topography, Medical; D015001:Yaws / Q000175:diagnosis / Q000188:drug therapy / Q000453:epidemiology* / Q000517:prevention & control*
chemical_list: D000900:Anti-Bacterial Agents; D017963:Azithromycin