Evaluation of an Intensive 3-round MDA Strategy Towards Yaws Eradication

• Status: Completed
• Trial end date: 2020-04-01
• Target enrollment: 0
• Participant gender: All

Summary

The current principle of yaws eradication (the Morges strategy) is based on single round mass drug administration (MDA) of azithromycin (AZI) called total community treatment (TCT) followed by targeted treatment of active cases every 6 months to detect and treat cases and contacts called total targeted treatment (TTT). Studies done in Papua New Guinea (PNG) show that 1 round of MDA will probably not suffice to stop transmission of infection. It may be preferable to conduct 3 rounds of MDA prior to the switch to TTT because of high coverage requirements to achieve elimination, particularly of latent cases. The investigators plan to determine whether 3 rounds of MDA are more effective for reaching yaws elimination. This research is needed to guide national programmatic implementation and needs to be done as soon as possible to scale up the program in the country.

The aim of this proposal is to ascertain the number of rounds of MDA with AZI to be included in an improved strategy towards yaws eradication. The study will be implemented in 38 wards of New Ireland Province (NIP). The investigators will compare two different distribution strategies of MDA: (A) strategy with 3 biannual rounds of MDA and (B) a single mass treatment round of MDA followed by targeted treatment of cases and contacts. The investigators will also monitor the risk of appearance of antimicrobial resistance in Treponema pertenue.

• Phase: Phase 4
• Accepts Healthy Volunteers?: Accepts Healthy Volunteers

Details

• Lead Sponsor: Lihir Medical Centre
• Collaborators: Barcelona Institute for Global Health; Harvard School of Public Health; Harvard School of Public Health (HSPH); National Department of Health of Papua New Guinea; University of Masarykova; World Health Organization
• Treatments: Azithromycin; Penicillin G; Penicillin G Benzathine; Penicillin G Procaine

Criteria

Inclusion Criteria:

• all people resident or not in wards in the study region present at time of implementation or in subsequent surveys

Exclusion Criteria:

• Children younger than 6 months

• Known allergy to macrolide antibiotics

• Refusal at village or individual levels