Evaluation of a previous mass campaign against endemic syphilis in Bosnia and Herzegovina.

It is now almost 30 years since penicillin was introduced to combat the endemic treponematoses of childhood, prevalent in rural areas of many developing countries. Preparations such as PAM and benzathine penicillin were shown to produce effective blood and tissue concentrations of 4 days' to 3 weeks' duration after single intramuscular injections. Long-acting treatment thus became available which could be used on clinical as well as epidemiological indications, and organized community-wide campaigns could be undertaken in endemic treponematoses areas. This development gave hope that disease could be eliminated by the wide use of a drug alone. On the basis of pilot studies of yaws in Haiti (Levitan, Rodriguez, Jacobs, Petrus, and Durand, 1953), endemic childhood syphilis in Yugoslavia (Grin, 1953), and pinta in Mexico (Edmundson, Lopez, Rico, and Olansky, 1953), mass penicillin campaigns were undertaken by health administrations in 46 countries in the context of the WHO Treponematoses Programme. In the first decade national and international attention was focused on the setting up of a programme and on control of disease. With declining clinical prevalence, orientation turned towards concurrent epidemiological surveillance. In the last few years seroepidemiological studies of the changing pattern of disease and infection became possible and a method-