1. YAWS
PIAN
BUBAS
FRAMBOESIA

2. Yaws and its relatives are caused by spirochete bacteria
Treponema

3. Contagious , non venereal treponemal infection.
No cardiovascular or neurological abnormalities

4. Yaws is typically found in tropical areas of Africa, South America, and Asia

5. Between 1950 and 1970, WHO and UNICEF led a campaign to treat people in 46 countries

6. It worked, but these diseases now receive little attention

7. Caused by Treponema pertenue .
Reservoir of infection – Man
Age - It affect children < 15 years [peak incidence 6-10 years].
Immunity – no natural immunity. Provides partial immunity to veneral syphilis.

8. ENVIRONMENTAL FACTORS
Climate – endemic in warm and humid conditions
Social factors
scanty clothing
Poor personal cleanliness
Overcrowding
Bad housing
Low standard of living
Absence of soap

9. MODE OF TRANSMISSION Direct contact Fomites Vector
INCUBATION PERIOD 3 to 5 weeks

10. The endemic treponematoses are mainly transmitted by human-to-human contact

11. CLASSIFICATION Primary stage …..lesion at site of inoculation.
Secondary stage ….multiple skin lesion.
Latent stage …..no symptom but skin lesion can relapse.
Tertiary ….bone , joint & soft tissue deformality

12. OTHER CASSIFICATION
Early----: primary & secondary { contagious skin lesion }.
Late -----: tertiary (not contagious).

13. CLINICAL PRESENTATION
Primary lesion called….. mother yaw.[IP 9-90 days].
1ry papule---enlarge → papilloma {resolve spontaneously after 3-6 months }.
2ry may occur near the 1ry or elsewhere on the body {last for more than 6 months }
Macule , papules , nodules ,and hyperkeratotic lesion in palms & soles { CRAB YAWS } ,lesions may ulcerate.
Saber shin due to chronic untreated osteoperiostitis.
Pt with late yaws → juxtaarticular nodules → gangosa [ rhinopharyngitis mutilans ]

14. The first sign of yaws is a primary lesion known as a “mother yaw”

15. Without treatment, secondary widespread lesions form

16. After years without treatment, larger problems may develop
Saber shin / tibia
Gangosa

17. INVESTIGATIONS Diagnosis on clinical findings.
Non treponema test:VDRL. Positive in all stages except early lesions .
Dark-field examination ….. + ve .
Biopsy. 

18. These diseases can be diagnosed in two ways
Dark field microscopy
Serological Tests

19. MANAGEMENT
Benzathine penicillin ( penicillin G ) 1.2 million units IM once
Penicillin V for 7-10 days.[ for 1ry , 2ry &latent].
Tetracyclin 1-2 g\ day for 7-14 days.[tertiary]
Erythromycin [tertiary].
Doxycycline 200mg 1 st ,100 mg\day for 7-14 days.[tertiary].

20. Benzathine penicillin is the main drug of choice for treatment

21. CONTROL 1. Survey 2. Treatment
Total mass treatment ( more than 10% prevalence)
Juvenile mass treatment ( 5% to 10 %)
selective mass treatment (less than 5 %)
3. Resurvey and treatment
( every 6 to 12 months)
4. Surveillance
5. Environmental improvement
6. Resurgence of yaws
7. Evaluation