Barcelona Institute for Global Health, Barcelona Centre for International Health Research, Hospital Clinic, University of Barcelona, Barcelona, Spain; Lihir Medical Centre-International SOS, Newcrest Mining, Lihir Island, Papua New Guinea.
Department of Clinical Research, London School of Hygiene and Tropical Medicine, London, UK; Hospital for Tropical Diseases, University College London Hospitals NHS Trust, London, UK.
Lancet Glob Health. 2015 Jun;3(6):e324-31. doi: 10.1016/S2214-109X(15)00011-X.
To achieve yaws eradication, the use of the new WHO strategy of initial mass treatment with azithromycin and surveillance twice a year needs to be extended everywhere the disease occurs. However, the geographic scope of the disease is unknown. We aimed to synthesise published and unpublished work to update the reported number of people with yaws at national and subnational levels and to estimate at-risk populations.
We searched PubMed and WHO databases to identify published data for prevalence of active and latent yaws from Jan 1, 1990, to Dec 31, 2014. We also searched for ongoing or recently completed unpublished studies from the WHO yaws surveillance network. We estimated yaws prevalence (and 95% CIs). We collected yaws incidence data from official national surveillance programmes at the first administrative level from Jan 1, 2010, to Dec 31, 2013, and we used total population data at the second administrative level to estimate the size of at-risk populations.
We identified 103 records, of which 23 published articles describing 27 studies and four unpublished studies met the inclusion criteria. Prevalence of active disease ranged from 0·31% to 14·54% in yaws-endemic areas, and prevalence of latent yaws ranged from 2·45% to 31·05%. During 2010-13, 256 343 yaws cases were reported to WHO from 13 endemic countries, all of which are low-income and middle-income countries. 215 308 (84%) of 256 343 cases reported to WHO were from three countries-Papua New Guinea, Solomon Islands, and Ghana. We estimated that, in 2012, over 89 million people were living in yaws-endemic districts.
Papua New Guinea, Solomon Islands, and Ghana should be the focus of initial efforts at implementing the WHO yaws eradication strategy. Community-based mapping and active surveillance must accompany the implementation of yaws eradication activities.
None.
为了实现雅司病的消除，需要在所有发生该病的地方推广世界卫生组织新的初期用阿奇霉素大规模治疗和每年两次监测的策略。然而，该病的地理范围尚不清楚。我们旨在综合已发表和未发表的资料，更新国家和亚国家一级报告的雅司病患者人数，并估计受感染人群。
我们在 PubMed 和世界卫生组织数据库中检索了 1990 年 1 月 1 日至 2014 年 12 月 31 日期间发表的关于活动性和潜伏性雅司病患病率的资料。我们还搜索了世界卫生组织雅司病监测网络正在进行或最近完成的未发表的研究。我们估计了雅司病的患病率（和 95%置信区间）。我们从 2010 年 1 月 1 日至 2013 年 12 月 31 日从国家一级首次行政级别收集了官方国家监测方案的雅司病发病率数据，并使用二级行政级别上的总人口数据来估计受感染人群的规模。
我们发现了 103 条记录，其中 23 篇已发表的文章描述了 27 项研究，还有 4 项未发表的研究符合纳入标准。雅司病流行地区的活动性疾病患病率范围为 0·31%至 14·54%，潜伏性雅司病患病率范围为 2·45%至 31·05%。2010-13 年期间，13 个流行国家向世界卫生组织报告了 256343 例雅司病病例，这些国家均为低收入和中等收入国家。256343 例向世界卫生组织报告的病例中，215308 例（84%）来自巴布亚新几内亚、所罗门群岛和加纳这三个国家。我们估计，2012 年有超过 8900 万人生活在雅司病流行地区。
巴布亚新几内亚、所罗门群岛和加纳应成为实施世界卫生组织雅司病消除战略的初始重点。在实施雅司病消除活动的同时，必须进行基于社区的绘图和主动监测。
无。
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