03014nas a2200361   4500000000100000008004100001260001200042653003900054653002400093653002700117653001000144653003200154653001600186653000900202100001400211700001200225700001300237700001200250700001400262700001700276700001700293700001200310700001300322700001100335700001200346700001500358245009900373856007300472300000900545490000700554520207700561022001402638       2025                            d  c12/202510aTreponema pallidum subsp. pertenue10aHaemophilus ducreyi10aendemic treponematosis10aGhana10aNeglected Tropical Diseases10aSkin ulcers10aYaws1 aSimpson S1 aArima H1 aBehene E1 aNundu S1 aHammond J1 aAtta-Owusu R1 aNoah-Quarm P1 aKotey N1 aAsiedu K1 aAddo K1 aYotsu R1 aYamamoto T00aMapping the distribution of yaws and Haemophilus ducreyi in the western north region of Ghana.  uhttps://link.springer.com/content/pdf/10.1186/s12879-025-12082-z.pdf  a1-120 v253 a<p><strong>BACKGROUND: </strong></p>

<p>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.</p>

<p><strong>METHODS: </strong></p>

<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) 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.</p>

<p><strong>RESULTS: </strong></p>

<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 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.</p>

<p><strong>CONCLUSIONS: </strong></p>

<p>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.</p>
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