Back to Search
Start Over
Effectiveness of single-dose azithromycin to treat latent yaws: a longitudinal comparative cohort study
- Source :
- Recercat. Dipósit de la Recerca de Catalunya, instname, The Lancet Global Health, Vol 5, Iss 12, Pp e1268-e1274 (2017), Dipòsit Digital de la UB, Universidad de Barcelona
- Publisher :
- Elsevier
-
Abstract
- BACKGROUND: Treatment of latent yaws is a crucial component of the WHO yaws eradication strategy to prevent relapse and the resulting transmission to uninfected children. We assessed the effectiveness of single-dose azithromycin to treat patients with latent yaws. METHODS: This population-based cohort study included children (age /=1:8) latent or active yaws, between April, 2013, and May, 2015. Latent yaws was defined as lack of suspicious skin lesions or presence of ulcers negative for Treponema pallidum subsp pertenue on PCR, and active yaws was defined as ulcers positive for T pertenue on PCR. All children received one oral dose of 30 mg/kg azithromycin. The primary endpoint was serological cure, defined as a two-dilution decrease in rapid plasma reagin titre by 24 months after treatment. Treatment of latent yaws was taken to be non-inferior to that of active yaws if the lower limit of the two-sided 95% CI for the difference in rates was higher than or equal to -10%. This study is registered with ClinicalTrials.gov, number NCT01955252. FINDINGS: Of 311 participants enrolled, 273 (88%; 165 with latent yaws and 108 with active yaws) completed follow-up. The primary endpoint was achieved in 151 (92%) participants with latent yaws and 101 (94%) with active yaws (risk difference -2.0%, 95% CI -8.3 to 4.3), meeting the prespecified criteria for non-inferiority. INTERPRETATION: On the basis of decline in serological titre, oral single-dose azithromycin was effective in participants with latent yaws. This finding supports the WHO strategy for the eradication of yaws based on mass administration of the entire endemic community irrespective of clinical status. FUNDING: Newcrest Mining Limited and ISDIN laboratories.
- Subjects :
- Male
medicine.medical_specialty
Adolescent
genetic structures
030231 tropical medicine
Population
Azithromycin
Polymerase Chain Reaction
Rapid plasma reagin
Serology
Cohort Studies
Papua New Guinea
03 medical and health sciences
0302 clinical medicine
Clinical trials
Radiation victims
Internal medicine
medicine
Clinical endpoint
Humans
Longitudinal Studies
Treponema pallidum
030212 general & internal medicine
Child
education
skin and connective tissue diseases
education.field_of_study
medicine.diagnostic_test
Transmission (medicine)
business.industry
lcsh:Public aspects of medicine
Absolute risk reduction
lcsh:RA1-1270
General Medicine
Anti-Bacterial Agents
Surgery
body regions
Víctimes de radiacions
Child, Preschool
Yaws
Female
business
medicine.drug
Cohort study
Assaigs clínics
Subjects
Details
- Database :
- OpenAIRE
- Journal :
- Recercat. Dipósit de la Recerca de Catalunya, instname, The Lancet Global Health, Vol 5, Iss 12, Pp e1268-e1274 (2017), Dipòsit Digital de la UB, Universidad de Barcelona
- Accession number :
- edsair.doi.dedup.....39426266f07c92ec1ef6dade094af055