Prioritizing surveillance activities for certification of yaws eradication based on a review and model of historical case reporting

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Term Occurence Count Dictionary
AIDS 6 infectiousdiseases
bejel 1 infectiousdiseases
dracunculiasis 1 infectiousdiseases
infectious disease 1 infectiousdiseases
syphilis 2 infectiousdiseases
trachoma 1 infectiousdiseases
yaws 70 infectiousdiseases

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AIDS 23084 systems due to armed conflict;aidsit is a three-year moving average (mean) of the estimated number of AIDS -related deaths per 10 000 population, available from UNAIDS since 1990, and assumed equal to 0 in the
AIDS 23144 average (mean) of the estimated number of AIDS-related deaths per 10 000 population, available from UN AIDS since 1990, and assumed equal to 0 in the period 1945–1989 and for all countries not reporting data
AIDS 23256 1990, and assumed equal to 0 in the period 1945–1989 and for all countries not reporting data to UN AIDS ; this variable is meant to serve as a proxy for reorientation of yaws surveillance systems toward other
AIDS 35916 one year of more than 25 battle-related deaths in armed conflict. By the year 2000, 50 were reporting AIDS -related deaths of more than 1 per 10 000 population.In the next section, we report on factors associated
AIDS 37575 CONt0.33**0.39**0.36**(0.13)(0.13)(0.12)Armed conflict in previous period, CONt-3-0.020.020.00(0.13)(0.13)(0.13)Average AIDS deaths in current period, per 10 000 population, sqrt(aidst)-0.19***-0.15**-0.21***(0.05)(0.05)(0.05)Mass
AIDS 39095 independence (becoming less negatively associated the greater the number of years since independence), AIDS deaths per 10 000 population, and number of years since the most recent case report. Positively associated
bejel 5996 is made up of: yaws, caused by Treponema pallidum subsp. pertenue; endemic syphilis (also known as bejel ), caused by T. pallidum subsp. endemicum; and pinta, caused by T. carateum. Of these, yaws produces
dracunculiasis 9235 that all countries are free of the disease. To achieve global certification of guinea worm disease ( dracunculiasis ) eradication, for example, WHO has been formally certifying every individual country, even if no indigenous
infectious disease 14973 reported case numbers from health ministry publications and ProMED, an internet-based reporting system on infectious disease outbreaks [[12]].We included documents reporting active primary/secondary cases with clinical manifestations,
syphilis 5972 bacterial infections. This group is made up of: yaws, caused by Treponema pallidum subsp. pertenue; endemic syphilis (also known as bejel), caused by T. pallidum subsp. endemicum; and pinta, caused by T. carateum. Of
syphilis 8373 by eliminating conditions which favour ongoing transmission. Interruption of transmission of endemic syphilis in Bosnia-Herzegovina, for example, was achieved by mass treatment campaigns “against a background
trachoma 47701 active surveillance. Integration of active surveillance with other large scale prevalence surveys for trachoma and other neglected tropical diseases could be considered [[28]–[30]].Supporting informationS1 FigFlow
yaws 97 Title: PLoS Neglected Tropical DiseasesPrioritizing surveillance activities for certification of yaws eradication based on a review and model of historical case reportingAlternative Title: Prioritizing
yaws 236 model of historical case reportingAlternative Title: Prioritizing surveillance for certification of yaws eradicationChristopher Fitzpatrick (Conceptualization) (Data curation) (Formal analysis) (Investigation)
yaws 1511 12/2018Publication date (collection): 12/2018AbstractBackgroundThe World Health Organization (WHO) has targeted yaws for global eradication. Eradication requires certification that all countries are yaws-free. While only
yaws 1598 has targeted yaws for global eradication. Eradication requires certification that all countries are yaws -free. While only 14 Member States currently report cases to WHO, many more are known to have a history
yaws 1709 While only 14 Member States currently report cases to WHO, many more are known to have a history of yaws and some of them may have ongoing transmission. We reviewed the literature and developed a model of
yaws 2146 be required.MethodsWe reviewed published and unpublished documents to extract data on the number of yaws cases reported to WHO or appearing in other literature in any year between 1945 and 2015. We classified
yaws 2414 currently endemic; c) being previously endemic (current status unknown); or d) having no history of yaws . We constructed a panel dataset for the years 1945–2015 and ran a regression model to identify factors
yaws 3738 cases in the absence of active surveillance is less than 50%.DiscussionCountries with a history of yaws need to be prioritized so that international resources for global yaws eradication may be deployed efficiently.
yaws 3809 50%.DiscussionCountries with a history of yaws need to be prioritized so that international resources for global yaws eradication may be deployed efficiently. Heretofore, the focus has been on mass treatment in countries
yaws 4472 disabling and disfiguring disease. When the World Health Organization (WHO) was established in 1948, yaws was among the major public health problems that the new health agency chose to prioritize. In 2013,
yaws 4598 public health problems that the new health agency chose to prioritize. In 2013, it formally targeted yaws for global eradication. While only 14 Member States currently report cases to WHO, many more are known
yaws 4727 While only 14 Member States currently report cases to WHO, many more are known to have a history of yaws and some of them may have ongoing transmission. Eradication requires certification that all countries
yaws 4846 them may have ongoing transmission. Eradication requires certification that all countries are free of yaws . Certification, in turn, requires surveillance–and in some settings this may require population surveys
yaws 5264 ongoing transmission. There are at least 86 countries or areas that stopped reporting cases but where yaws may still be present. Our model identified socioeconomic development and independence as factors associated
yaws 5464 factors associated with case reporting. Within the large and diverse group of countries with a history of yaws , we have identified a group of 20 countries with more than a 50% probability of reporting cases in the
yaws 5912 https://bitbucket.org/whontd/yaw_tst_plos/src.IntroductionThe endemic treponematoses are a group of chronic bacterial infections. This group is made up of: yaws , caused by Treponema pallidum subsp. pertenue; endemic syphilis (also known as bejel), caused by T.
yaws 6088 known as bejel), caused by T. pallidum subsp. endemicum; and pinta, caused by T. carateum. Of these, yaws produces the highest burden of disease globally. It is transmitted through direct skin-to-skin contact.
yaws 6429 resulting in pain as well as social stigma. About 10% of untreated cases suffer tertiary (late-stage) yaws , with permanent disability and disfigurement of the face, lower limbs and hands [[1]].In 1948, when
yaws 7000 they caused justified this urgency. In 1950, WHO estimated that 160 million people were infected with yaws [[2]].WHO- and UNICEF-led initiatives of 1948–1953 targeted yaws in Bechuanaland (Botswana), Ecuador,
yaws 7067 million people were infected with yaws [[2]].WHO- and UNICEF-led initiatives of 1948–1953 targeted yaws in Bechuanaland (Botswana), Ecuador, Haiti, India, Indonesia, Lao People’s Democratic Republic, Liberia,
yaws 7591 the time, no formal certification process to confirm local elimination had been developed. Vertical yaws programmes were progressively integrated into national primary health care systems. By 1995 WHO estimated
yaws 7907 during 2008 to 2012 [[2]]. It is difficult to ascertain whether the countries that stopped reporting yaws cases did so due to the interruption of transmission or simply the interruption of reporting.The endemic
yaws 8691 to cover the entire population” [[5]]. Among the factors to which are attributed the recession of yaws in Sri Lanka are: use of soap, improved water, and extended roads [[6]].In 2013, the sixty-sixth WHA
yaws 8852 extended roads [[6]].In 2013, the sixty-sixth WHA adopted resolution 66.12, targeting the eradication of yaws by 2020. Eradication is the “permanent reduction to zero of the worldwide incidence of an infection
yaws 9600 activities undertaken to proceed through the stages of certification.A country reporting zero new indigenous yaws cases over a complete calendar year is considered to be in the first, pre-certification stage. In some
yaws 10974 relatively active but localised surveillance may be required, particularly if there is transmission of yaws in a neighbouring country.The cost of global certification of guinea worm disease eradication has not
yaws 11571 disease is no longer a public health problem and interest in it has waned” [[11]].In the case of yaws eradication, the group of countries that will have to undertake surveillance is larger and more diverse,
yaws 11775 diverse, and the cost could be higher. In this study, we reviewed the literature for reports of active yaws cases and developed a descriptive model to identify countries in which passive surveillance is likely
yaws 12291 January 1945 and 21 September 2016. We updated the search on 21 December 2017.We searched for articles on yaws (frambesia). We considered other variations on the name, based on the languages of the major colonial
yaws 12960 (referring to particular clinical manifestations).In PubMed, our search included the following terms: yaws [MeSH] OR yaws[Title] OR treponematoses[Title] OR “Treponema pertenue”[Title] OR frambesi*[Title]
yaws 12974 particular clinical manifestations).In PubMed, our search included the following terms: yaws[MeSH] OR yaws [Title] OR treponematoses[Title] OR “Treponema pertenue”[Title] OR frambesi*[Title] OR framboesi*[Title]
yaws 13205 buba[Title] OR bouba[Title]. In Global Health–CABI, we applied the same search terms but using “ yaws ” as a subject term rather than a MeSH term.The search terms yaws OR treponematoses OR “Treponema
yaws 13272 the same search terms but using “yaws” as a subject term rather than a MeSH term.The search terms yaws OR treponematoses OR “Treponema pertenue” OR frambesia OR framboesia OR pian OR buba OR bouba were
yaws 15201 regardless of whether these were laboratory-confirmed or not. Active cases include both infectious yaws (i.e., presenting with skin lesions) and non-infectious yaws (i.e., presenting with cartilage and bone
yaws 15262 not. Active cases include both infectious yaws (i.e., presenting with skin lesions) and non-infectious yaws (i.e., presenting with cartilage and bone but no skin lesions). Reports of latent cases (i.e., infections
yaws 15819 ensure that the country of origin was nonetheless listed in our database as a country with a history of yaws .We reviewed all titles and available abstracts. If available abstracts were relevant but did not contain
yaws 17624 time of writing (Table 1).10.1371/journal.pntd.0006953.t001Table 1Grouping of countries according to yaws endemicity status in 2015.SubgroupDescriptionACurrent status knownCountries whose endemicity status
yaws 21257 report, available through this study; the choice of three years is determined by one of the criteria for yaws certification (see Introduction);REPit-3 is a lagged dependent variable to model the dynamics (persistence)
yaws 23326 countries not reporting data to UNAIDS; this variable is meant to serve as a proxy for reorientation of yaws surveillance systems toward other public health priorities in the 1990s [[20]];CAMit is a dummy variable
yaws 28149 available. Another 1744 documents were found to not contain case reports of non-imported active clinical yaws cases.A total of 413 abstracts or full-texts had relevant data that could be extracted. The flow diagram
yaws 28427 provided in Supporting Information S1 Fig and S2 Table.Status of endemicityWe describe here the status of yaws endemicity for the 194 Member States of WHO, as well as for 9 areas for which we found separate case
yaws 28788 Futuna Islands.Of the 203 countries and areas considered, 96 have reported active clinical non-imported yaws cases since 1945. Fig 1 displays the endemicity status for the 96 countries with some history of yaws
yaws 28890 yaws cases since 1945. Fig 1 displays the endemicity status for the 96 countries with some history of yaws case reports, as defined in this study. References to yaws were found for another 7 Member States, not
yaws 28949 for the 96 countries with some history of yaws case reports, as defined in this study. References to yaws were found for another 7 Member States, not displayed here because no specific case reports could be
yaws 29498 endemic; B.1: Previously endemic (current status unknown); B.2: No history of case reports. References to yaws were found for another 7 Member States, displayed here as not available (NA) because of non-specific
yaws 29780 Nauru and Nicaragua. In addition to Member States, there are 9 countries or areas with a history of yaws for which categorization is not displayed on this map: British Virgin Islands, French Guiana, Guadeloupe,
yaws 30316 WHO. 14 WHO Member States and one non-Member State (Wallis and Futuna Islands) are currently reporting yaws cases. These are all located within the African, South-East Asian and Western Pacific Regions (Table
yaws 31022 Guam, Martinique, Montserrat, New Caledonia, Puerto Rico, and Wallis and Futuna Islands.c References to yaws were found for another 7 Member States, not included here because of non-specific case reports: Bangladesh,
yaws 31276 Myanmar, Nauru and Nicaragua.The current status of another 79 countries and areas with a history of yaws case reports remains unknown. These previously endemic countries are widely distributed: 28 of 47 Member
yaws 31516 the Americas, and 15 of 27 in the Western Pacific. Europe is the only WHO Region with no history of yaws since 1945.The 14 currently endemic WHO Member States are all low- and lower-middle income countries
yaws 32361 Guam, Martinique, Montserrat, New Caledonia, Puerto Rico, and Wallis and Futuna Islands.c References to yaws were found for another 7 Member States, not included here because of non-specific case reports: Bangladesh,
yaws 33161 of countries reporting cases and cases reported, over the years 1945–2015. 54 countries reported yaws cases in 1950. The greatest number of cases reported in a given year was 2.35 million in 1954, in the
yaws 33624 Solomon Islands both temporarily stopped reporting cases.10.1371/journal.pntd.0006953.g002Fig 2Number of yaws cases reported, and countries and areas reporting cases and undertaking mass treatment campaigns, 1945–2015.The
yaws 33922 refers to the period 1948–1963 only.Fig 3 identifies the 96 countries and areas with some history of yaws case reports (A.1, A.2 and B.1 countries) with the year of the most recently reported case. Puerto Rico
yaws 34436 in 2005 and 2003, respectively.10.1371/journal.pntd.0006953.g003Fig 3Year of most recently reported yaws case in currently or previously endemic countries/areas, 2015.In addition to Member States, there are
yaws 34582 countries/areas, 2015.In addition to Member States, there are 9 countries or areas with a history of yaws for which data are not included in this map: British Virgin Islands, Guadeloupe, French Guiana, Guam,
yaws 34887 Salvador, Honduras, Marshall Islands, Myanmar, Nauru, and Nicaragua we found only general references to yaws endemicity (but no case reports). Created using R and World Health Organization shapefiles under Creative
yaws 36255 regression model are presented in Table 4.10.1371/journal.pntd.0006953.t004Table 4Association between yaws case reporting and selected variables in the years before the most recent case report, all countries
yaws 36379 selected variables in the years before the most recent case report, all countries with a history of yaws .In the leftmost column, short variable descriptions are provided with the variable names as they appear
yaws 38745 96 countries, with a total of 2232 observations. 19 of 96 countries and areas with some history of yaws last reported cases before 1960 and did not have sufficient observations for the specified lagged variables.In
yaws 38967 three models, most of the regression coefficients have the expected signs. Negatively associated with yaws case reporting are: independence (becoming less negatively associated the greater the number of years
yaws 39212 10 000 population, and number of years since the most recent case report. Positively associated with yaws case reporting are: case reporting in the previous period or the number of cases reported in the most
yaws 40924 are depicted in grey. In addition to Member States, there are 9 countries or areas with a history of yaws for which data are not included in this map: British Virgin Islands, Guadeloupe, French Guiana, Guam,
yaws 42419 fact that WHO has not received reports from these countries in all years since formal adoption of the yaws eradication target.DiscussionThere is a need to prioritize countries with a history of yaws so that
yaws 42511 of the yaws eradication target.DiscussionThere is a need to prioritize countries with a history of yaws so that international resources for global eradication can be deployed efficiently.So far the focus
yaws 42753 Member States that are currently reporting cases to WHO. A strategy for roll-out of mass treatment for yaws has been articulated [[9]]. WHO continues to focus on mobilizing the necessary resources, including
yaws 43669 certification. The dossier would have to include, based on current requirements, no evidence of clinical yaws among children aged 0–15 years and evidence of the absence of rapid plasma reagin sero-reactivity
yaws 44118 to complete an assessment of whether they indeed have satisfactory surveillance which could detect yaws cases if they occurred. Quality standards for “satisfactory surveillance” need to be formalized
yaws 44328 documented, based on the experience of the expert group led by WHO that certified the eradication of yaws in India in 2016.The remaining 66 previously endemic countries will likely need international support
yaws 45281 which the abstract or full-text could not be retrieved. However, when the title or abstract referred to yaws in a specific country, we confirmed that case reports had been extracted from other references. Most

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