Yaws: strict compliance with WHO’s Morges strategy critical to achieve eradication
13 February 2018 | Geneva –– The WHO Morges Strategy to eradicate yaws recommends large-scale treatment of at-risk communities with an initial round of single-dose oral azithromycin to accelerate interruption of yaws transmission.
Mass treatment should cover AT LEAST 90% of the targeted population. If lower coverage is achieved, another round of mass treatment should be considered.
Following mass treatment, active community-based surveillance should be enhanced to identify new cases for treatment together with their contacts.
The Morges strategy has four components.1 Endemic countries should adhere to all of them to achieve interruption of transmission. Monitoring of antimicrobial resistance should become an essential part of the strategy.
A recent study published in the Lancet reported five cases of resistance to azithromycin in Papua New Guinea.
Important note for health workers
Clinical monitoring should be carried out 4 weeks after mass treatment and any proven persistent cases (presumed treatment failures) or new infections identified in any community should be carefully evaluated (samples collected for laboratory confirmation by polymerase chain reaction of yaws and determination of any mutations that confer resistance to azithromycin). Cases of confirmed resistance (or presumed treatment failures) should be treated with benzathine benzylpenicillin injection.