Yaws in Ecuador: impact of control measures on the disease in the Province of Esmeraldas.

OBJECTIVES To determine the impact of a community-based programme of yaws control in Esmeraldas province in Ecuador. METHODS Community health workers provided mass treatment and subsequent surveillance for the detection and treatment of new cases and their contacts over the period 1988 to 1993. Clinical and serological surveys were performed in the study area in 1988 and 1993. RESULTS Over the 5 year observation period, the number of communities with active infections had decreased by 75%, from 20 communities in 1988 to 5 in 1993. In 1993, 4 communities were found free of clinical infections as well as latent infections. There was a corresponding decrease of 94.6% in the prevalence of dermal lesions (from 11.2% to 0.6%), and a reduction of 97.3% in latent infections (from 93.6% to 2.5%). CONCLUSIONS The control of yaws using existing community-based health workers has proved very effective in Ecuador.