World Health Organization (WHO), Country Office for Ghana, Accra, Ghana.
Department of Epidemiology and Disease Control, School of Public Health, College of Health, Sciences, University of Ghana, Accra, Ghana.
Infect Dis Poverty. 2020 Mar 12;9(1):26. doi: 10.1186/s40249-020-00641-2.
Yaws is a chronic relapsing disease caused by Treponema pallidum subspecies pertunue, which can result in severe disability and deformities. Children below the age of 15 years in resource-poor communities are the most affected. Several non-specific factors facilitate the continuous transmission and resurgence of the disease. Endemic communities in rural Ghana continue to report cases despite the roll out of several intervention strategies in the past years. The objective of this study was to determine the factors associated with cutaneous ulcers among children in two yaws-endemic districts in Ghana.
A community-based unmatched 1:2 case-control study was conducted among children between 1 and 15 years. Data on socio-demographic, environmental and behavioral factors were collected using a structured questionnaire. Active case search and confirmation was done using the Dual Path Platform (DPP) Syphilis Screen and Confirm test kit. Data were analyzed using STATA 15. Logistic regression was done to determine the exposures that were associated with yaws infection at 0.05 significant level.
Sixty-two cases and 124 controls were recruited for the study. The adjusted multivariable logistic regression model showed that yaws infection was more likely among individuals who reside in overcrowded compound houses (aOR = 25.42, 95% CI: 6.15-105.09) and with poor handwashing habits (aOR = 6.46, 95% CI: 1.89-22.04). Male (aOR = 4.15, 95% CI: 1.29-13.36) and increasing age (aOR = 5.90, 95% CI: 1.97-17.67) were also associated with yaws infection.
Poor personal hygiene, overcrowding and lack of access to improved sanitary facilities are the factors that facilitate the transmission of yaws in the Awutu Senya West and Upper West Akyem districts. Yaws was also more common among males and school-aged children. Improving living conditions, access to good sanitary facilities and encouraging good personal hygiene practices should be core features of eradication programs in endemic communities.
雅司病是由苍白密螺旋体亚种 pertunue 引起的慢性复发性疾病，可导致严重残疾和畸形。资源匮乏社区 15 岁以下的儿童受影响最大。一些非特异性因素促进了疾病的持续传播和死灰复燃。尽管加纳农村的流行社区在过去几年中推出了多项干预策略，但仍继续报告病例。本研究旨在确定加纳两个雅司病流行地区儿童发生皮肤溃疡的相关因素。
采用社区为基础的 1:2 病例对照研究，在 1 至 15 岁儿童中进行。使用结构化问卷收集社会人口学、环境和行为因素的数据。采用 Dual Path Platform（DPP）梅毒筛查和确认试剂盒进行主动病例搜索和确认。使用 STATA 15 进行数据分析。采用逻辑回归确定 0.05 显著性水平下与雅司病感染相关的暴露因素。
本研究共招募了 62 例病例和 124 例对照。调整后的多变量逻辑回归模型显示，居住在拥挤的复合房屋中的个体（aOR=25.42，95%CI：6.15-105.09）和洗手习惯差的个体（aOR=6.46，95%CI：1.89-22.04）更容易感染雅司病。男性（aOR=4.15，95%CI：1.29-13.36）和年龄增长（aOR=5.90，95%CI：1.97-17.67）也与雅司病感染相关。
个人卫生条件差、拥挤和缺乏改善的卫生设施是导致 Awutu Senya West 和 Upper West Akyem 地区雅司病传播的因素。雅司病在男性和学龄儿童中更为常见。改善生活条件、获得良好的卫生设施和鼓励良好的个人卫生习惯应成为消除流行社区雅司病的核心措施。
