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Background <p><i>Treponema pallidum</i> subspecies <i>pertenue</i> and <i>Haemophilus ducreyi</i> cause skin ulcers in impoverished communities. Historical serologic records from Ghana focus on <i>T. pallidum</i>, omitting potential <i>H. ducreyi</i> cases. The objective of this study was to investigate, for the first time, the presence and distribution of <i>T. p</i> .subsp. <i>pertenue</i> and/or <i>H. ducreyi</i> in skin lesions in two previously unstudied areas in Western North Region of Ghana.</p> Methods <p>We conducted observational cross-sectional surveys and screened skin lesions in the Aowin municipality and Suaman district in Western North Region, Ghana. Suspected yaws cases were tested for 1) treponemal and non-treponemal antibodies using a finger-prick blood test and 2) <i>Treponema pallidum</i> and <i>H. ducreyi</i> DNA in lesion swabs using polymerase chain reaction (PCR). GPS coordinates were recorded for all tests administered near patients’ schools or residences.</p> Results <p>Of the 11,917 individuals examined, 1,699 patients with suspected yaws consented to testing. In the Aowin municipality, the seroprevalence of current treponemal infections was 10.8%, while the prevalence of yaws and <i>H. ducreyi</i>, confirmed by PCR, was 2.3% and 4.3%, respectively. High RPR titers correlated with active yaws infection. However, <i>T. pallidum</i> DNA was confirmed in lesions with low RPR titers (≤1:4). Communities with high seropositivity rates were more likely to have PCR-confirmed yaws cases. No evidence of resistance to azithromycin was observed in <i>T. p.</i> subsp. <i>pertenue</i> isolates. Dual infections with <i>H. ducreyi</i> were uncommon. No treponemal-positive cases were identified in the Suaman district.</p> Conclusions <p>Serological surveillance without molecular testing may undermine efforts to interrupt yaws transmission. More comprehensive community surveillance detecting yaws and <i>H. ducreyi</i> infections is critical in developing strategies to achieve the WHOs yaws eradication goal.</p>

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Mapping the distribution of yaws and Haemophilus ducreyi in the western north region of Ghana

  • 期刊论文

  • 出版模式：

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  • 发表日期：

    2025年12月29日

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  • Shirley Victoria Simpson,
  • Hiroaki Arima,
  • Eric Behene,
  • Sabin S. Nundu,
  • John Hammond,
  • Rita Atta-Owusu,
  • Paul Noah-Quarm,
  • Nana Konama Kotey,
  • Kingsley Asiedu,
  • Kennedy Kwasi Addo,
  • Rie Roselyne Yotsu,
  • Taro Yamamoto

摘要

Background

Treponema pallidum subspecies pertenue and Haemophilus ducreyi cause skin ulcers in impoverished communities. Historical serologic records from Ghana focus on T. pallidum, omitting potential H. ducreyi cases. The objective of this study was to investigate, for the first time, the presence and distribution of T. p .subsp. pertenue and/or H. ducreyi in skin lesions in two previously unstudied areas in Western North Region of Ghana.

Methods

We conducted observational cross-sectional surveys and screened skin lesions in the Aowin municipality and Suaman district in Western North Region, Ghana. Suspected yaws cases were tested for 1) treponemal and non-treponemal antibodies using a finger-prick blood test and 2) Treponema pallidum and H. ducreyi DNA in lesion swabs using polymerase chain reaction (PCR). GPS coordinates were recorded for all tests administered near patients’ schools or residences.

Results

Of the 11,917 individuals examined, 1,699 patients with suspected yaws consented to testing. In the Aowin municipality, the seroprevalence of current treponemal infections was 10.8%, while the prevalence of yaws and H. ducreyi, confirmed by PCR, was 2.3% and 4.3%, respectively. High RPR titers correlated with active yaws infection. However, T. pallidum DNA was confirmed in lesions with low RPR titers (≤1:4). Communities with high seropositivity rates were more likely to have PCR-confirmed yaws cases. No evidence of resistance to azithromycin was observed in T. p. subsp. pertenue isolates. Dual infections with H. ducreyi were uncommon. No treponemal-positive cases were identified in the Suaman district.

Conclusions

Serological surveillance without molecular testing may undermine efforts to interrupt yaws transmission. More comprehensive community surveillance detecting yaws and H. ducreyi infections is critical in developing strategies to achieve the WHOs yaws eradication goal.