Yaws is re-emerging as a pathogen in the tropics. Mitja et al identified risk factors associated with treatment failure in patients with yaws. The authors are from Lihir Medical Centre in Papua New Guinea and the Barcelona Centre for International Health Research.
Yaws is caused by Treponema pallidum subspecies pertenue
Treatment failure was defined as a failure of a 4-fold decrease in VDRL titer at 1 or more years after treatment. Reinfection is believed to be the main reason for failure.
Risk factors for treatment failure:
(1) living in a village with a high incidence rate (> 1.5%) for yaws
(2) low initial VDRL (Venereal Disease Research Laboratory) titer. A titer <= 32 was a "robust" predictor of failure.
Additional conditions to exclude:
(1) antibiotic resistance
(2) noncompliance with medication
(3) inactive or counterfeit antibiotic
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