Yaws and other endemic treponematoses


Picture from "Yaws: Recognition booklet for communities"
Endemic treponematoses

Endemic treponematoses are a group of chronic bacterial infections caused by treponemes. These infections are:

  • Yaws, also known as framboesia or pian, caused by Treponema pallidum subsp. Pertenue;
  • Endemic syphilis, also known as bejel, caused by T. pallidum subs. Endemicum;
  • Pinta caused by T carateum.

All these infections often affect the skin and present skin lesions.

Bejel occurs principally in the Sahel region of Africa and Arabian Peninsula and pinta is restricted only to Latin America.


Yaws is the most common of these infections, occurring mainly in poor communities in warm, humid tropical regions of Africa, Asia, Latin America and Western Pacific.

Almost 75% of people affected are children under 15 years, although peak incidence occurs in children between the ages 6–10.


Yaws is transmitted primarily through skin contact with an infected person. A single skin lesion develops at the point of entry of the bacterium after 2-4 weeks. If left untreated, multiple lesions appear all over the body. Although rarely fatal, yaws can lead to chronic disfigurement and disability. Overcrowding, poor personal hygiene and poor sanitation facilitate the spread of the disease.


Two antibiotics are recommended for treatment of yaws:
1. Azithromycin: 30 mg/kg (maximum 2g) is the preferred first line treatment.
2. Benzathine penicillin: 1.2 million units (adults) and 0.6 million units (children). Benzathine penicillin is used wherever azithromycin is unavailable or when the patient cannot be treated with azithromycin.

Elimination to eradication

Experts believe that yaws can easily be controlled and possibly eradicated as the disease occurs only in humans. Past experience has showed that elimination is possible in many countries. More recently, India eliminated yaws with no new cases since 2004. The NTD roadmap Accelerating work to overcome the global impact of neglected tropical diseases – A roadmap for implementation. Executive summary [pdf 1.2Mb] has targeted yaws for eradication by 2020. If successful, it will become the first disease to be eradicated through the use of antibiotics

Yaws in the news

15 May 2015 | Geneva
Yaws strategy development. Report of a meeting, 27–28 October 2014, Atlanta, USA
Ref: ISBN 978 92 4 150881

17 April 2015 | Geneva Eradication of yaws in India

  • Full article
    Weekly epidemiological record, No.16, 2015, 90, 161–168

19 February 2015 | Geneva
Mass Treatment with Single-Dose Azithromycin for Yaws

29 September 2014 | Geneva
Where the Road Ends, Yaws Begins? The Cost-effectiveness of Eradication versus More Roads


Cases of yaws treated with single-dose oral azithromycin
See pictures


Yaws Eradication Programme: