{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,16]],"date-time":"2026-09-16T07:21:29Z","timestamp":1789543289509,"version":"build-2803163510"},"reference-count":16,"publisher":"Springer Science and Business Media LLC","issue":"1","license":[{"start":{"date-parts":[[2020,1,30]],"date-time":"2020-01-30T00:00:00Z","timestamp":1580342400000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2020,1,30]],"date-time":"2020-01-30T00:00:00Z","timestamp":1580342400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"name":"Philippine Dept. of Health; Department of Science and Technology, Republic of the Philippines"}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["Infect Dis Poverty"],"published-print":{"date-parts":[[2020,12]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec>\n<jats:title>Background<\/jats:title>\n<jats:p>Yaws is a chronic, highly contagious skin and bone infection affecting children living in impoverished, remote communities and caused by <jats:italic>Treponema pallidum<\/jats:italic> subspecies <jats:italic>pertenue<\/jats:italic>. The Philippines was thought to be free of yaws following the 1950s eradication campaign but it has been reported in the Liguasan Marsh area, Central Mindanao. This is the first documentation of yaws cases in the Philippines since the 1970s. We describe active and latent yaws recently detected in the Southern Philippines.<\/jats:p>\n<\/jats:sec><jats:sec>\n<jats:title>Case presentation<\/jats:title>\n<jats:p>Cross-sectional surveys and screening of skin diseases were conducted in one randomly selected public elementary school per selected municipality in Liguasan Marsh, covering three municipalities per province. Yaws suspects underwent screening and confirmatory serologic tests for <jats:italic>Treponema pallidum<\/jats:italic> using Dual Path Platform Syphilis Screen and Confirm Assay (DPP) and <jats:italic>Treponema pallidum<\/jats:italic> Particle Agglutination (TPPA). Children with yaws skin lesions and reactive confirmatory tests for <jats:italic>T. pallidum<\/jats:italic> and non-treponemal antibodies were considered confirmed yaws cases. Four children aged 5\u201310\u2009years old had confirmed secondary yaws in Tulunan Municipality, Cotabato Province and in Lambayong Municipality, Sultan Kudarat Province. All had secondary yaws lesions such as moist, cauliflower-like papillomas, thick yellow crusts on pink papules and nodules, whitish, papulosquamous papules and plaques, or hypopigmented patches with small papules on the periphery. Yaws papillomas and erosions were also found on the soles of the feet of one child. The index case had a skin punch biopsy of a partially treated papilloma on his axilla. Histopathological findings showed lichenoid psoriasiform dermatitis with plasma cells, consistent with yaws.<\/jats:p>\n<\/jats:sec><jats:sec>\n<jats:title>Conclusions<\/jats:title>\n<jats:p>The clinical, serological, and histopathological confirmation of four yaws cases among children has made the Philippines the 14th country endemic for yaws. This report can help health personnel recognize hidden cases of yaws based on skin signs and serological tests. Yaws remained unrecognized and unreported in the Philippines and in countries previously endemic for yaws probably due to the unsustained integration of the yaws program in the general health services and complacency after the 1950s eradication campaign. Our findings have provided the necessary evidence and stimulus to develop a yaws control and eradication program as one of the country\u2019s neglected tropical diseases.<\/jats:p>\n<\/jats:sec>","DOI":"10.1186\/s40249-019-0617-6","type":"journal-article","created":{"date-parts":[[2020,1,30]],"date-time":"2020-01-30T00:03:25Z","timestamp":1580342605000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":100,"title":["Yaws in the Philippines: first reported cases since the 1970s"],"prefix":"10.1186","volume":"9","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-5494-9455","authenticated-orcid":false,"given":"Belen Lardizabal","family":"Dofitas","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sherjan P.","family":"Kalim","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Camille B.","family":"Toledo","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jan Hendrik","family":"Richardus","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2020,1,30]]},"reference":[{"key":"617_CR1","unstructured":"Bravo FG TC, Ezzedine K. Endemic nonvenereal treponematosis. In: Fitzpatrick\u2019s Dermatology. Volume 1, 9th edn. Edited by Kang Sea. New York: McGraw-Hill Education; 2019. p. 3177-8."},{"issue":"5","key":"617_CR2","first-page":"303","volume":"38","author":"DS Nagreh","year":"1986","unstructured":"Nagreh DS. Yaws. CUTIS Trop Dermatol. 1986;38(5):303\u20135.","journal-title":"CUTIS Trop Dermatol"},{"key":"617_CR3","volume-title":"Summary report of a consultation on the eradication of yaws","author":"WHO","year":"2012","unstructured":"WHO. Summary report of a consultation on the eradication of yaws. Geneva: World Health Organization; 2012."},{"key":"617_CR4","volume-title":"Eradication of Yaws-- A Guide for Programme Managers","author":"WHO","year":"2018","unstructured":"WHO. Eradication of Yaws-- A Guide for Programme Managers. Geneva: World Health Organization; 2018."},{"key":"617_CR5","unstructured":"Google: Map of Liguasan Marsh, Mindanao. In: Google Maps. Google; 2019: Map of Mindanao Island and Liguasan Marsh. Accessed 11 Nov 2019."},{"key":"617_CR6","volume-title":"Google Maps. Google: Map of the Philippines","author":"Google","year":"2019","unstructured":"Google. Map of the Philippines. In: Google Maps. Google: Map of the Philippines; 2019."},{"issue":"1\u20133","key":"617_CR7","first-page":"345","volume":"8","author":"AH Cruz","year":"1953","unstructured":"Cruz AH. Integration of yaws control into the permanent health structure of the Philippines. Bull World Health Organ. 1953;8(1\u20133):345\u201353 discussion 365-348.","journal-title":"Bull World Health Organ"},{"issue":"9","key":"617_CR8","first-page":"675","volume":"17","author":"A Cruz","year":"1961","unstructured":"Cruz A, Suva J, Justiniano G. The yaws control programme in the Phiippines with WHO\/UNICEF assistance. J Philipp Med Assoc. 1961;17(9):675\u201382.","journal-title":"J Philipp Med Assoc"},{"issue":"3","key":"617_CR9","first-page":"219","volume":"41","author":"AH Cruz","year":"1965","unstructured":"Cruz AH, Justiniano GS Jr, Camena TC. A critical evaluation of yaws in the Philippines. J Philipp Med Assoc. 1965;41(3):219\u201359.","journal-title":"J Philipp Med Assoc"},{"key":"617_CR10","first-page":"101","volume-title":"Health Bo. Philippines","author":"Philippine Health Statistics 1961","year":"1961","unstructured":"Philippine Health Statistics 1961. Health Bo. Philippines; 1961. p. 101\u20133."},{"key":"617_CR11","first-page":"114","volume-title":"Health Bo. Philippines","author":"Philippine Health Statistics 1973","year":"1973","unstructured":"Philippine Health Statistics 1973. Health Bo. Philippines; 1973. p. 114\u20137."},{"key":"617_CR12","volume-title":"Report of a global meeting on yaws eradication surveillance, monitoring and evaluation, Geneva, 29\u201330 January 2018","author":"WHO","year":"2018","unstructured":"WHO. Report of a global meeting on yaws eradication surveillance, monitoring and evaluation, Geneva, 29\u201330 January 2018. Geneva: World Health Organization; 2018."},{"key":"617_CR13","volume-title":"The New Humanitarian","author":"Philippines","year":"2009","unstructured":"Philippines. High rate of treponematosis among pregnant IDP women. In: The New Humanitarian; 2009."},{"issue":"2\u20133","key":"617_CR14","first-page":"228","volume":"45","author":"A Meheus","year":"1992","unstructured":"Meheus A, Antal GM. The endemic treponematoses: not yet eradicated. World Health Stat Q. 1992;45(2\u20133):228\u201337.","journal-title":"World Health Stat Q"},{"key":"617_CR15","unstructured":"Yaws [https:\/\/www.who.int\/news-room\/fact-sheets\/detail\/yaws]."},{"issue":"4","key":"617_CR16","doi-asserted-by":"publisher","first-page":"e235","DOI":"10.1016\/S2214-109X(14)70019-1","volume":"2","author":"O Mitja","year":"2014","unstructured":"Mitja O, Lukeheart S, Pokowas G, Moses P, Kapa A, Godornes C. Haemophilus ducreyi as a cause of skin ulcers in children from a yaws-endemic area of Papua New Guinea: a prospective cohort study. Lancet Glob Health. 2014;2(4):e235\u201341.","journal-title":"Lancet Glob Health"}],"container-title":["Infectious Diseases of Poverty"],"original-title":[],"language":"en","link":[{"URL":"http:\/\/link.springer.com\/content\/pdf\/10.1186\/s40249-019-0617-6.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"http:\/\/link.springer.com\/article\/10.1186\/s40249-019-0617-6\/fulltext.html","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"http:\/\/link.springer.com\/content\/pdf\/10.1186\/s40249-019-0617-6.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2021,1,29]],"date-time":"2021-01-29T00:31:39Z","timestamp":1611880299000},"score":1,"resource":{"primary":{"URL":"https:\/\/idpjournal.biomedcentral.com\/articles\/10.1186\/s40249-019-0617-6"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2020,1,30]]},"references-count":16,"journal-issue":{"issue":"1","published-print":{"date-parts":[[2020,12]]}},"alternative-id":["617"],"URL":"https:\/\/doi.org\/10.1186\/s40249-019-0617-6","relation":{},"ISSN":["2049-9957"],"issn-type":[{"value":"2049-9957","type":"electronic"}],"subject":[],"published":{"date-parts":[[2020,1,30]]},"assertion":[{"value":"18 October 2019","order":1,"name":"received","label":"Received","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"16 December 2019","order":2,"name":"accepted","label":"Accepted","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"30 January 2020","order":3,"name":"first_online","label":"First Online","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"The study proposal was registered with and approved by the Technical Review Committee of the Philippine Council for Health Research and Development (PHRR No. 1361). Ethical approval was granted by the St. Cabrini Medical Center-Asian Eye Institute Ethics Review Committee (SCMC-AEI ERC No. 2016\u2013022). Written informed consent to participate in the study were secured from the parents or guardians of minors and from adult participants. Written informed assent were secured from minors aged 6\u201315\u2009years of age.","order":1,"name":"Ethics","group":{"name":"EthicsHeading","label":"Ethics approval and consent to participate"}},{"value":"Written informed consent for publication of study results and photographs were secured from the parents or guardians of minors and from adult participants. Written informed assent were secured from minors aged 6\u201315\u2009years of age.","order":2,"name":"Ethics","group":{"name":"EthicsHeading","label":"Consent for publication"}},{"value":"The authors declare that they have no competing interests.","order":3,"name":"Ethics","group":{"name":"EthicsHeading","label":"Competing interests"}}],"article-number":"1"}}