Effect of repeated mass drug administration on the transmission
of yaws: a retrospective genomic epidemiology study

J 2026

Effect of repeated mass drug administration on the transmission of yaws: a retrospective genomic epidemiology study

BARTON, Amber; Petra POSPÍŠILOVÁ; Camila G BEIRAS; Lucy N JOHN; Wendy HOUINEI et al.

Základní údaje

Originální název

Effect of repeated mass drug administration on the transmission of yaws: a retrospective genomic epidemiology study

Autoři

BARTON, Amber; Petra POSPÍŠILOVÁ; Camila G BEIRAS; Lucy N JOHN; Wendy HOUINEI; Lorenzo GIACANI; David ŠMAJS; Michael MARKS; Oriol MITJA; Mathew A BEALE a Nicholas R THOMSON

Vydání

LANCET MICROBE, AMSTERDAM, ELSEVIER, 2026, 2666-5247

Další údaje

Jazyk

angličtina

Typ výsledku

Článek v odborném periodiku

Obor

30303 Infectious Diseases

Stát vydavatele

Nizozemské království

Utajení

není předmětem státního či obchodního tajemství

Odkazy

URL

Impakt faktor

Impact factor: 20.400 v roce 2024

Označené pro přenos do RIV

Ano

Organizační jednotka

Lékařská fakulta

Klíčová slova anglicky

yaws; mass drug administration; genomic epidemiology; Treponema pallidum pertenue; antimicrobial resistance

Štítky

14110513, rivok

Změněno: 8. 4. 2026 10:51, Mgr. Tereza Miškechová

Anotace

V originále

Background Yaws, a neglected tropical disease caused by Treponema pallidum subspecies pertenue (T p pertenue), has evaded eradication, in part due to a high proportion of asymptomatic cases. Repeated mass drug administration (MDA), whereby an entire population is repeatedly treated irrespective of disease, could provide a solution. Here, we aimed to investigate the effect of MDA on the genomic epidemiology of T p pertenue. Methods We conducted a retrospective genomic epidemiology study on samples collected during a cluster-randomised trial of mass administration of azithromycin for yaws eradication in the Namatanai District of Papua New Guinea. Participants were in 38 wards (administrative units encompassing several villages) in three local-level government areas (LLGs). The experimental group received an initial round of MDA followed by two further rounds 6 months and 12 months after the first round. The control group received one round of MDA followed by two rounds of treatment targeting clinical cases and contacts only, on the same schedule as the MDA in the experimental group. A follow-up survey on both groups was done 18 months after the first MDA round. Swab samples were collected at each round from ulcerative and nodular skin lesions, and blood was collected by finger-prick for serological testing at 18 months. Metadata on ulcer size (cm) and duration (days) were recorded at each round, and treponemal and non-treponemal antibodies were recorded at 18 months. Samples from swabs positive for T p pertenue underwent library preparation and whole-genome sequencing. We examined the phylogenetic relationships between genomes, linking them with geospatial and patient metadata to understand the impact of MDA on T p pertenue diversity and transmission. Findings Swabs collected from 297 individuals with active yaws from April 30, 2018, to Nov 2, 2019, yielded 222 good-quality T p pertenue genomes. We identified 20 sublineages of T p pertenue in the control group and 21 in the experimental group at the beginning of the study. At the end of the study, there were 13 sublineages in the control group and three in the experimental group, of which two persisted in both groups. Three sublineages not detected at baseline were observed in the control group after commencing MDA. The two sublineages that persisted in both groups had non-synonymous mutations in penicillin-binding proteins. One of these sublineages evolved macrolide resistance in three individuals and was associated with lowered treponemal antibody (p=0.0036) and longer ulcer duration (p=0.015). Despite the study taking place within a small island, sublineages were geographically clustered, with pairs of samples from the same ward (odds ratio 7.1, 95% CI 5.7-8.8; p<0.0001) or neighbouring wards (4.3, 3.3-5.4; p<0.0001) more likely to share the same sublineages compared with pairs from different LLGs. Additionally, older individuals were more likely to share sublineages than were younger individuals (1.5, 1.2-1.9; p<0.0001). Interpretation Repeated MDA was successful in reducing and maintaining the genetic diversity of T p pertenue at a low level but was associated with the development of macrolide resistance. Yaws re-emergence after MDA was attributed to multiple sublineages, of which the majority were detected in the population before MDA. Participants within the same ward were more likely to share sublineages than those that were more widely geographically separated, suggesting that re-emergence was driven by local transmission.

Návaznosti

LX22NPO5103, projekt VaV

Název: Národní institut virologie a bakteriologie (Akronym: NIVB)

Investor: Ministerstvo školství, mládeže a tělovýchovy ČR, Národní institut virologie a bakteriologie, 5.1 EXCELES

Citovat

BARTON, Amber; Petra POSPÍŠILOVÁ; Camila G BEIRAS; Lucy N JOHN; Wendy HOUINEI; Lorenzo GIACANI; David ŠMAJS; Michael MARKS; Oriol MITJA; Mathew A BEALE a Nicholas R THOMSON. Effect of repeated mass drug administration on the transmission of yaws: a retrospective genomic epidemiology study. LANCET MICROBE. AMSTERDAM: ELSEVIER, 2026, roč. 7, č. 1, s. 1-11. ISSN 2666-5247. Dostupné z: https://doi.org/10.1016/j.lanmic.2025.101229.

@article{2565446,
   author = {Barton, Amber and Pospíšilová, Petra and Beiras, Camila G and John, Lucy N and Houinei, Wendy and Giacani, Lorenzo and Šmajs, David and Marks, Michael and Mitja, Oriol and Beale, Mathew A and Thomson, Nicholas R},
   article_location = {AMSTERDAM},
   article_number = {1},
   doi = {https://doi.org/10.1016/j.lanmic.2025.101229},
   keywords = {yaws; mass drug administration; genomic epidemiology; Treponema pallidum pertenue; antimicrobial resistance},
   language = {eng},
   issn = {2666-5247},
   journal = {LANCET MICROBE},
   title = {Effect of repeated mass drug administration on the transmission of yaws: a retrospective genomic epidemiology study},
   url = {https://www.sciencedirect.com/science/article/pii/S2666524725001570?via%3Dihub},
   volume = {7},
   year = {2026}
}

TY  - JOUR
ID  - 2565446
AU  - Barton, Amber - Pospíšilová, Petra - Beiras, Camila G - John, Lucy N - Houinei, Wendy - Giacani, Lorenzo - Šmajs, David - Marks, Michael - Mitja, Oriol - Beale, Mathew A - Thomson, Nicholas R
PY  - 2026
TI  - Effect of repeated mass drug administration on the transmission of yaws: a retrospective genomic epidemiology study
JF  - LANCET MICROBE
VL  - 7
IS  - 1
SP  - 1-11
EP  - 1-11
PB  - ELSEVIER
SN  - 26665247
KW  - yaws
KW  - mass drug administration
KW  - genomic epidemiology
KW  - Treponema pallidum pertenue
KW  - antimicrobial resistance
UR  - https://www.sciencedirect.com/science/article/pii/S2666524725001570?via%3Dihub
N2  - Background Yaws, a neglected tropical disease caused by Treponema pallidum subspecies pertenue (T p pertenue), has evaded eradication, in part due to a high proportion of asymptomatic cases. Repeated mass drug administration (MDA), whereby an entire population is repeatedly treated irrespective of disease, could provide a solution. Here, we aimed to investigate the effect of MDA on the genomic epidemiology of T p pertenue. Methods We conducted a retrospective genomic epidemiology study on samples collected during a cluster-randomised trial of mass administration of azithromycin for yaws eradication in the Namatanai District of Papua New Guinea. Participants were in 38 wards (administrative units encompassing several villages) in three local-level government areas (LLGs). The experimental group received an initial round of MDA followed by two further rounds 6 months and 12 months after the first round. The control group received one round of MDA followed by two rounds of treatment targeting clinical cases and contacts only, on the same schedule as the MDA in the experimental group. A follow-up survey on both groups was done 18 months after the first MDA round. Swab samples were collected at each round from ulcerative and nodular skin lesions, and blood was collected by finger-prick for serological testing at 18 months. Metadata on ulcer size (cm) and duration (days) were recorded at each round, and treponemal and non-treponemal antibodies were recorded at 18 months. Samples from swabs positive for T p pertenue underwent library preparation and whole-genome sequencing. We examined the phylogenetic relationships between genomes, linking them with geospatial and patient metadata to understand the impact of MDA on T p pertenue diversity and transmission. Findings Swabs collected from 297 individuals with active yaws from April 30, 2018, to Nov 2, 2019, yielded 222 good-quality T p pertenue genomes. We identified 20 sublineages of T p pertenue in the control group and 21 in the experimental group at the beginning of the study. At the end of the study, there were 13 sublineages in the control group and three in the experimental group, of which two persisted in both groups. Three sublineages not detected at baseline were observed in the control group after commencing MDA. The two sublineages that persisted in both groups had non-synonymous mutations in penicillin-binding proteins. One of these sublineages evolved macrolide resistance in three individuals and was associated with lowered treponemal antibody (p=0.0036) and longer ulcer duration (p=0.015). Despite the study taking place within a small island, sublineages were geographically clustered, with pairs of samples from the same ward (odds ratio 7.1, 95% CI 5.7-8.8; p<0.0001) or neighbouring wards (4.3, 3.3-5.4; p<0.0001) more likely to share the same sublineages compared with pairs from different LLGs. Additionally, older individuals were more likely to share sublineages than were younger individuals (1.5, 1.2-1.9; p<0.0001). Interpretation Repeated MDA was successful in reducing and maintaining the genetic diversity of T p pertenue at a low level but was associated with the development of macrolide resistance. Yaws re-emergence after MDA was attributed to multiple sublineages, of which the majority were detected in the population before MDA. Participants within the same ward were more likely to share sublineages than those that were more widely geographically separated, suggesting that re-emergence was driven by local transmission.
ER  -

BARTON, Amber; Petra POSPÍŠILOVÁ; Camila G BEIRAS; Lucy N JOHN; Wendy HOUINEI; Lorenzo GIACANI; David ŠMAJS; Michael MARKS; Oriol MITJA; Mathew A BEALE a Nicholas R THOMSON. Effect of repeated mass drug administration on the transmission of yaws: a retrospective genomic epidemiology study. \textit{LANCET MICROBE}. AMSTERDAM: ELSEVIER, 2026, roč.~7, č.~1, s.~1-11. ISSN~2666-5247. Dostupné z: https://doi.org/10.1016/j.lanmic.2025.101229.

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