Analysis of yaws surveillance data, Upper West Akim District, Eastern Region, Ghana, 2018-2023

Introduction: Yaws, caused by Treponema pallidum pertenue, primarily affects children in tropical, low-resource settings. Globally, 0.7% of suspected cases were confirmed in 2023. In Ghana, the prevalence is 0.3%, with Upper West Akim District contributing 8.3% of confirmed cases. If left untreated, 10% of cases will result in disfigurement. We analysed yaws surveillance data from 2018 to 2023 to describe its distribution, clinical characteristics, and follow-up practices. Methods: We conducted a secondary analysis of yaws surveillance data (2018-2023) using DHIMS-2 and confirmed case line lists. We included all ages and excluded cases with incomplete data. Sociodemographic, clinical, and laboratory variables were extracted using a standardised tool and analysed descriptively with Microsoft Excel (v21) and QGIS (v3.34.7). Results were presented as frequencies, percentages, and maps. Results: From 2018 to 2023, 2,826 suspected yaws cases were reported; 9.6% (270/2,826) tested positive by RDT and 7.1% (202/2,826) were confirmed by DPP, giving a 74.8% (202/270) confirmation rate among probable cases. The mean age was 11.8 years (SD ±7.2). Males 67.8% (137/202) and children aged 10-14 years 66.8% (135/202) were most affected. The Okurase subdistrict accounted for 62.4% (126/202) of all confirmed cases. Most cases 82.2% (166/202) were identified through active surveillance and presented as ulcers 92.1% (186/202). The case-to-contact treatment ratio was 1:6 (170/972). Conclusion: Yaws cases were clustered in the Okurase subdistrict, predominantly affecting males and children aged 10-14 years. The high proportion of suspected cases but low confirmation rate suggests over-suspicion due to broad case definition. Reliance on active detection and suboptimal contact follow-up (case-to-contact treatment below WHO-recommended ratio 1:10), indicates surveillance gaps. Strengthening clinician diagnosis, community surveillance, and contact tracing is critical for achieving yaws eradication goals.