Trial reportPLoS neglected tropical diseases2017
A Single Dose Oral Azithromycin versus Intramuscular Benzathine Penicillin for the Treatment of Yaws-A Randomized Non Inferiority Trial in Ghana.
Trial report in PLoS neglected tropical diseases, 2017. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 14 papers, 1 of them a synthesis that pooled it.
What it found
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
14 citing papers in PubMed, 1 synthesis or guideline pooled it, 24 citations in OpenAlex.
- Integrated mass drug administration for yaws eradication: evidence from a comparative observational study in Papua New Guinea and a systematic review with network meta-analysis.BMJ global health · 2026Pooled it
- Comparative efficacy of low-dose versus standard-dose azithromycin for patients with yaws: a randomised non-inferiority trial in Ghana and Papua New Guinea.The Lancet. Global health · 2018Trial
- Article
- Mapping the distribution of yaws and Haemophilus ducreyi in the western north region of Ghana.BMC infectious diseases · 2025Observational
- Yaws in Africa: Past, Present and Future.Diseases (Basel, Switzerland) · 2025Review
- Infections caused byClinical microbiology reviews · 2024Review
- Diagnostics to support the eradication of yaws-Development of two target product profiles.PLoS neglected tropical diseases · 2022Article
- Mass drug administration of antibacterials: weighing the evidence regarding benefits and risks.Infectious diseases of poverty · 2022Review
- A Loop-Mediated Isothermal Amplification Assay for the Detection ofThe American journal of tropical medicine and hygiene · 2020Article
- Factors associated with cutaneous ulcers among children in two yaws-endemic districts in Ghana.Infectious diseases of poverty · 2020Article
- Enteroparasitism in Hard-to-Reach Community Dwellers: A Cross-Sectional Study in Ga West Municipality in Ghana.Journal of parasitology research · 2020Article
- Advances in the Treatment of Yaws.Tropical medicine and infectious disease · 2018Review
- Re-emergence of yaws after single mass azithromycin treatment followed by targeted treatment: a longitudinal study.Lancet (London, England) · 2018Article
- Complete genome sequences of two strains of Treponema pallidum subsp. pertenue from Ghana, Africa: Identical genome sequences in samples isolated more than 7 years apart.PLoS neglected tropical diseases · 2017Article
Corrections and comments
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Authors and funding
9 authors at 6 institutions in 3 countries.
Funding
Abstract
backgroundYaws is a treponemal infection that was almost eradicated fifty years ago; however, the disease has re-emerged in a number of countries including Ghana. A single-dose of intramuscular benzathine penicillin has been the mainstay of treatment for yaws. However, intramuscular injections are painful and pose safety and logistical constraints in the poor areas where yaws occurs. A single center randomized control trial (RCT) carried out in Papua New Guinea in 2012 demonstrated the efficacy of a single-dose of oral azithromycin for the treatment of yaws. In this study, we also compared the efficacy of a single oral dose of azithromycin as an alternative to intramuscular benzathine penicillin for the treatment of the disease in another geographic setting. METHODOLOGY: We conducted an open-label, randomized non-inferiority trial in three neighboring yaws-endemic districts in Southern Ghana. Children aged 1-15 years with yaws lesions were assigned to receive either 30mg/kg of oral azithromycin or 50,000 units/kg of intramuscular benzathine penicillin. The primary end point was clinical cure rate, defined as a complete or partial resolution of lesions 3 weeks after treatment. The secondary endpoint was serological cure, defined as at least a 4-fold decline in baseline RPR titre 6 months after treatment. Non- inferiority of azithromycin treatment was determined if the upper bound limit of a 2 sided 95% CI was less than 10%.
findingsThe mean age of participants was 9.5 years (S.D.3.1, range: 1-15 years), 247(70%) were males. The clinical cure rates were 98.2% (95% CI: 96.2-100) in the azithromycin group and 96.9% (95% CI: 94.1-99.6) in the benzathine penicillin group. The serological cure rates at 6 months were 57.4% (95% CI: 49.9-64.9) in the azithromycin group and 49.1% (95% CI: 41.2-56.9) in the benzathine penicillin group, thus achieving the specified criteria for non-inferiority.
conclusionsA single oral dose of azithromycin, at a dosage of 30mg/kg, was non-inferior to a single dose of intramuscular benzathine penicillin for the treatment of early yaws among Ghanaian patients, and provides additional support for the WHO policy for use of oral azithromycin for the eradication of yaws in resource-poor settings.
trial registrationPan African Clinical Trials Registry PACTR2013030005181 http://www.pactr.org/.
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Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.