Published in PLOS One on 2026-05-28, this study is presented as an attributed evidence briefing. The excerpts below are the original researchers’ words, reproduced under their Creative Commons Attribution licence. Health Signal has selected the abstract and, where needed, opening background paragraphs; the complete methods, results, limitations and references remain in the linked paper.
Original authors: Aboa Paul Koffi, Didier Yao Koffi, Elysée Gobe Agodio, Théodore Yao, N’cho Mouroh Chantal N’guessan, Amari Jules Cesar Akpa, Eguzkiñe Muñoz Trevilla, Notie Berté, N’zebo N’goran, Nzrasse Florent Niamke, Agui Sylvetre Dizoe, N’goran Raphael N’dri, Priya Pathak, Beshah Abaté Mulugeta, Yves Thierry Barogui, Kingsley Bampoe Asiedu, Mamadou Kaloga
Source: PLOS One • DOI 10.1371/journal.pone.0348510
Read the complete primary study ↗ · Creative Commons Attribution licence
From the researchers
Abstract
Yaws is one of the skin-related neglected tropical disease (skin NTD). It is closely linked to poverty and occurs mainly in poor communities in hot, humid, tropical regions. Children in disadvantaged communities in the tropics are most affected. Following the recommendations of the WHO NTD Road map 2021–2030, Côte d’Ivoire planned an evaluation (clinical and serological investigation) to assess the true extent of yaws in the country. Côte d’Ivoire is one of the nine countries currently endemic for yaws in the WHO African Region. The aim of this investigation was to establish the endemicity of yaws and to gather information that will inform planning for yaws eradication in Côte d’Ivoire.
A public health intervention involving active case-finding was conducted in 345 health areas of 15 targeted health districts. All children aged 2–15 years in village primary schools and in households were systematically recruited and examined. All enrolled children with suspicious lesions were initially tested with Standard Diagnostic (SD) serological treponemal test. Cases positive for treponemal SD test were subsequently tested using the dual treponemal and non-treponemal point-of-care test (DPP), a rapid serological test that is used to confirm yaws. All confirmed cases were treated with a single dose of azithromycin according to age. Additionally, other skin NTD and skin conditions were detected.
A total of 3870 villages and hamlets were investigated in which 486 975 children were targeted. Overall, 65 918 (14.66%) children with various skin lesions were identified. Two hundred and ninety-one (291) RDT (Rapid Diagnostic Test) positive cases of yaws were documented. Half of the RDT positive cases (146/291) were confirmed as DPP positive. Children aged 5–14 years (n = 129) represented 88% of DPP positive cases. The four most common skin conditions identified were traumatic wounds (13 855; 21.07%), dermatophytosis (15 640; 23.8%), pityriasis versicolor (6998; 10.64%) and scabies (5955; 9.05%).
This rapid investigation confirmed the endemicity of yaws in Côte d’Ivoire at low and variable prevalence. Treatment interventions will be adapted to the level of endemicity that we have found. Analysis of the results opens avenues of research to better understand the endemicity of yaws in Côte d’Ivoire.
Introduction
Yaws, also known as Frambœsia tropica, is a non-venereal skin-related neglected tropical disease (skin NTD) [1,2] caused by infection with Treponema pallidum subspecies pertenue. Its spread is facilitated by overcrowding and poor hygienic conditions [3]. Among the endemic trepomenatoses (yaws, bejel and pinta), yaws is the most common and also the most damaging, causing skin complications and osteoarticular damage (bone deformation, mutilation, destruction of the nasal pyramid and chronic disability) [4]. It can also cause pain and skin induration, with or without inflammation, in bones and joints [4]. Yaws is closely linked to poverty and is most prevalent in poor communities in hot, humid and tropical regions of Africa, Asia, West Pacific and Latin America [5]. Nearly 75% of children aged under 15 years in disadvantaged communities in the tropics are at risk of developing yaws; incidence peaks in children aged 6–10 years [6]. Yaws has been known in Côte d’Ivoire since the 1950s. Between 1950 and 1960, the WHO and UNICEF developed and implemented a mass treatment program that led to a significant decline in the disease (Fitzpatrick et al., 2014). In recent years, however, the disease has re-emerged. Today, yaws is still considered endemic in Côte d’Ivoire, based on recent health data. Annual Report on Health Statistics (ARHS 2000). Following the recommendations of the WHO road map on NTDs 2021–2030 (the road map) [7], Côte d’Ivoire joined the eradication process and conducted a rapid epidemiological evaluation (clinical and serological investigation) to gain insights into the endemicity of yaws in the study areas.
Reading this evidence
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© 2026 Aboa Paul Koffi, Didier Yao Koffi, Elysée Gobe Agodio, Théodore Yao, N’cho Mouroh Chantal N’guessan, Amari Jules Cesar Akpa, Eguzkiñe Muñoz Trevilla, Notie Berté, N’zebo N’goran, Nzrasse Florent Niamke, Agui Sylvetre Dizoe, N’goran Raphael N’dri, Priya Pathak, Beshah Abaté Mulugeta, Yves Thierry Barogui, Kingsley Bampoe Asiedu, Mamadou Kaloga. Excerpts reproduced under CC BY. Selection, formatting and contextual notes by Health Signal. The researchers are the authors of the source study, not members of Health Signal’s staff.
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