Yaws, a non-venereal treponemal infection. Still endemic in some parts of the world.

Yaws is an infection that mainly affects the poorest populations living in humid tropical areas. We reviewed the literature on yaws, the most common non-venereal treponemal infection, using the standard Prescrire methodology. Yaws is often transmitted directly from person to person. It starts as a single lesion, later leading to multiple contagious lesions. Yaws mainly affects children. The infection remains asymptomatic for several years. In about 10% of cases, late reactivation leads to bone lesions, deformities and disability. Diagnosis of yaws is based on the clinical and epidemiological context. Serological tests cannot distinguish between yaws and syphilis or other non-venereal treponematoses. Curative treatment consists of a single injection of benzathine benzylpenicillin. The results of a randomised trial suggest that a single oral dose of azithromycin is as effective as penicillin. In India, yaws was successfully eradicated through a programme based on providing information to the population at risk, screening and treatment.