Optimising the use of molecular tools for the diagnosis of yaws.


Journal

Transactions of the Royal Society of Tropical Medicine and Hygiene
ISSN: 1878-3503
Titre abrégé: Trans R Soc Trop Med Hyg
Pays: England
ID NLM: 7506129

Informations de publication

Date de publication:
01 12 2019
Historique:
received: 08 05 2019
revised: 11 07 2019
accepted: 18 07 2019
pubmed: 15 10 2019
medline: 20 9 2020
entrez: 15 10 2019
Statut: ppublish

Résumé

Yaws is a neglected tropical disease and results in lesions of skin, soft tissues and bones. PCR plays an important part in surveillance. Children suspected to have yaws were enrolled. From the largest lesion, paired swabs were collected, one in transport medium and one as a dry swab. In children with multiple lesions we collected additional swabs from up to four subsequent lesions. Swabs in transport medium were maintained in a cold chain while dry swabs were stored at ambient temperature. Swabs were tested by PCR for Treponema pallidum and Haemophilus ducreyi. Of 55 individuals, 10 (18%) had at least one positive PCR for T. pallidum and 12 (22%) had at least one positive result for H. ducreyi. Concordance was 100% between swabs in transport medium and dry swabs. One patient had PCR-confirmed yaws on the swab of a third lesion when both the first and second lesions were PCR-negative. Storing swabs in transport medium and transporting in a cold chain did not improve yield, however, detection of T. pallidum is increased by swabbing additional lesions. As the target for yaws is eradication, approaches to sample collection need revisiting to ensure cases are not missed.

Sections du résumé

BACKGROUND
Yaws is a neglected tropical disease and results in lesions of skin, soft tissues and bones. PCR plays an important part in surveillance.
METHODS
Children suspected to have yaws were enrolled. From the largest lesion, paired swabs were collected, one in transport medium and one as a dry swab. In children with multiple lesions we collected additional swabs from up to four subsequent lesions. Swabs in transport medium were maintained in a cold chain while dry swabs were stored at ambient temperature. Swabs were tested by PCR for Treponema pallidum and Haemophilus ducreyi.
RESULTS
Of 55 individuals, 10 (18%) had at least one positive PCR for T. pallidum and 12 (22%) had at least one positive result for H. ducreyi. Concordance was 100% between swabs in transport medium and dry swabs. One patient had PCR-confirmed yaws on the swab of a third lesion when both the first and second lesions were PCR-negative.
CONCLUSIONS
Storing swabs in transport medium and transporting in a cold chain did not improve yield, however, detection of T. pallidum is increased by swabbing additional lesions. As the target for yaws is eradication, approaches to sample collection need revisiting to ensure cases are not missed.

Identifiants

pubmed: 31608961
pii: 5586880
doi: 10.1093/trstmh/trz083
doi:

Types de publication

Journal Article

Langues

eng

Sous-ensembles de citation

IM

Pagination

776-780

Informations de copyright

© The Author(s) 2019. Published by Oxford University Press on behalf of Royal Society of Tropical Medicine and Hygiene. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.

Auteurs

Morgan Munson (M)

Clinical Research Department, Faculty of Infectious and Tropical Diseases, London School of Hygiene & Tropical Medicine, Keppel Street, London, UK.

Benjamin Creswell (B)

Clinical Research Department, Faculty of Infectious and Tropical Diseases, London School of Hygiene & Tropical Medicine, Keppel Street, London, UK.

Kofi Kondobala (K)

Ghana Health Service, Accra, Ghana.

Bawa Ganiwu (B)

Ghana Health Service, Accra, Ghana.

Rita Dede Lomotey (RD)

Ghana Health Service, Accra, Ghana.

Paul Oppong (P)

Ghana Health Service, Accra, Ghana.

Frederick Opoku Agyeman (FO)

Ghana Health Service, Accra, Ghana.

Nana Kotye (N)

Ghana Health Service, Accra, Ghana.

Mukaila Diwura (M)

Ghana Health Service, Accra, Ghana.

Ebenezer Padi Ako (EP)

Ghana Health Service, Accra, Ghana.

Shirley Victoria Simpson (SV)

Department of Bacteriology, Noguchi Memorial Institute for Medical Research, University of Ghana, Legon, Ghana.

Kennedy Kwasi Addo (KK)

Department of Bacteriology, Noguchi Memorial Institute for Medical Research, University of Ghana, Legon, Ghana.

Harry Pickering (H)

Clinical Research Department, Faculty of Infectious and Tropical Diseases, London School of Hygiene & Tropical Medicine, Keppel Street, London, UK.

Becca L Handley (BL)

Clinical Research Department, Faculty of Infectious and Tropical Diseases, London School of Hygiene & Tropical Medicine, Keppel Street, London, UK.

Joanna Houghton (J)

Clinical Research Department, Faculty of Infectious and Tropical Diseases, London School of Hygiene & Tropical Medicine, Keppel Street, London, UK.

Cynthia Kwakye (C)

Ghana Health Service, Accra, Ghana.

Michael Marks (M)

Clinical Research Department, Faculty of Infectious and Tropical Diseases, London School of Hygiene & Tropical Medicine, Keppel Street, London, UK.
Hospital for Tropical Diseases, Mortimer Market Centre, London, UK.

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