Control of yaws and other endemic treponematoses: implementation of vertical and/or integrated programs.

Previous mass campaigns against the endemic treponematoses have taught investigators several lessons that, along with current constraints and altered circumstances, must be considered in the formulation of a contemporary strategy for the control or eradication of yaws, endemic syphilis, or pinta. A time-limited, vertical approach is necessary in highly endemic areas initially to reduce the level of transmission. Elsewhere, control activities should be integrated into other primary health care interventions, especially health education, water and sanitation programs, maternal and child health care, and provision of essential drugs. Control of the endemic treponematoses is an ideal means of strengthening primary health care in endemic areas.