02749nas a2200289   4500000000100000008004100001260003700042653002400079653005700103100001400160700001400174700001400188700001200202700001400214700002100228700002100249700001600270700001100286700001400297700001600311245014200327856009900469300001300568490000700581520185700588022001402445       2022                            d  bPublic Library of Science (PLoS)10aInfectious Diseases10aPublic Health, Environmental and Occupational Health1 aCooper PJ1 aAnselmi M1 aCaicedo C1 aLopez A1 aVicuña Y1 aCagua Ordoñez J1 aRivera Bonilla J1 aRodriguez A1 aSoto A1 aGuevara A1 aStevenson B00aYaws elimination in Ecuador: Findings of a serological survey of children in Esmeraldas province to evaluate interruption of transmission  uhttps://journals.plos.org/plosntds/article/file?id=10.1371/journal.pntd.0010173&type=printable  ae00101730 v163 a<p>Background The WHO roadmap for neglected tropical diseases includes yaws eradication requiring certification of elimination of transmission in all endemic and formerly endemic countries worldwide. A community-based programme for yaws control was considered to have achieved elimination of the infection in the endemic focus in Ecuador after 1993. We did a serosurvey of children in this focus to provide evidence for interruption of transmission.</p>

<p>Methods Survey of serum samples collected from children aged 2 to 15 years living in the formerly endemic and in geographically contiguous areas. A convenience sample of sera collected between 2005 were 2017 from non-yaws studies, were analyzed using immunochromatic rapid tests to screen (OnSite Syphilis Ab Combo Rapid Test) for Treponema pallidum-specific antibodies and confirm (DPP Syphilis Screen and Confirm) seroreactivity based on the presence antibodies to treponemal and non-treponemal antigens. Results Seroreactivity was confirmed in 6 (0.14%, 95% CI 0.06–0.30) of 4,432 sera analyzed and was similar in formerly endemic (0.11%, (95% CI 0.01–0.75) and non-endemic (0.14%, 95% CI 0.06–0.34) communities. All seroreactors were of Afro-Ecuadorian ethnicity and most were male (4/6) and aged 10 or more years (5/6), the latter possibly indicating venereal syphilis. Only 1 seroreactor lived in a community in the Rio Santiago, that was formerly hyperendemic for yaws. Conclusion We observed very low levels of treponemal transmission in both formerly endemic and non-endemic communities which might be indicative of congenital or venereal syphilis and, if yaws, would likely be insufficient to maintain transmission of this endemic childhood infection. Additional surveys of children aged 1 to 5 years are planned in Rio Santiago communities to exclude yaws transmission.</p>
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