Table 3. Advantages and limitations of five ways of detecting yaws.

Means of detecting yaws	What the approach adds	Limitations and logistics needed	Comments
Passive detection at clinic following awareness workshops and continuing education	Increased clinic staff awareness of yaws; building confidence in diagnosing and treating yaws	Few of those afflicted with yaws appear to visit clinics for this ailment	It would be productive to trace yaws cases back to their communities and implement recommended eradication protocols
NTD outreach by clinic staff to remote communities	Raising of CHW awareness of yaws; on site treatment; necessary to reach remote communities	Staff can only reach a small percentage of communities; high cost in staff time and resources; significant opportunity costs	• Relies on active CHW involvement in identifying potential cases • Could be combined/integrated with other public health activities like vaccination campaigns–if they are well received by the community
Innovative mass outreach events for NTDs like BU	Culturally sensitive education using question: answer format driven by formative research responds to local perceptions and concerns; support by local leaders, healers; raises status of CHW and increases their motivation to be proactive; translation of information across languages when necessary; on site screening and treatment	• Requires resources and coordination between CHW and health staff; support of local leaders • Only offering free treatment for select diseases and not all chronic skin diseases difficult for community members to understand	• Serves as a magnet drawing large crowds and those afflicted with a range of skin diseases; legitimizes school based screening and treatment programs • Combine with: school based follow up screening programs for yaws cases; wound care education programs
School based programs	Reaches school children as group at risk; school children learn to recognize signs of yaws; children attending school identify other children with signs of yaws not attending school	Cooperation of teachers and trust of parents is necessary in order for children to be treated on site	Need to be sure stigmatization does not occur when yaws cases are identified in school; can be combined/integrated with other school health activities such as basic wound and skin care practices
House to house surveys	Blanket coverage if residents are at home	High cost in staff time and resources; significant, opportunity costs; needs to be carried out in season when maximum number of people are in residence	• Might be called for in high yaws prevalence communities if mass drug distribution is required • May be combined/integrated with other public health activities like vaccination campaigns