Centre Pasteur du Cameroun, Yaounde, Cameroon.
National Yaws, Leishmaniasis, Leprosy and Buruli ulcer Control Programme, Ministry of Public Health, Yaounde, Cameroon.
PLoS Negl Trop Dis. 2021 Feb 16;15(2):e0009180. doi: 10.1371/journal.pntd.0009180. eCollection 2021 Feb.
Outbreaks of yaws-like ulcerative skin lesions in children are frequently reported in tropical and sub-tropical countries. The origin of these lesions might be primarily traumatic or infectious; in the latter case, Treponema pallidum subspecies pertenue, the yaws agent, and Haemophilus ducreyi, the agent of chancroid, are two of the pathogens commonly associated with the aetiology of skin ulcers. In this work, we investigated the presence of T. p. pertenue and H. ducreyi DNA in skin ulcers in children living in yaws-endemic regions in Cameroon. Skin lesion swabs were collected from children presenting with yaws-suspected skin lesions during three outbreaks, two of which occurred in 2017 and one in 2019. DNA extracted from the swabs was used to amplify three target genes: the human β2-microglobulin gene to confirm proper sample collection and DNA extraction, the polA gene, highly conserved among all subspecies of T. pallidum, and the hddA gene of H. ducreyi. A fourth target, the tprL gene was used to differentiate T. p. pertenue from the other agents of human treponematoses in polA-positive samples. A total of 112 samples were analysed in this study. One sample, negative for β2-microglobulin, was excluded from further analysis. T. p. pertenue was only detected in the samples collected during the first 2017 outbreak (12/74, 16.2%). In contrast, H. ducreyi DNA could be amplified from samples from all three outbreaks (outbreak 1: 27/74, 36.5%; outbreak 2: 17/24, 70.8%; outbreak 3: 11/13, 84.6%). Our results show that H. ducreyi was more frequently associated to skin lesions in the examined children than T. p. pertenue, but also that yaws is still present in Cameroon. These findings strongly advocate for a continuous effort to determine the aetiology of ulcerative skin lesions during these recurring outbreaks, and to inform the planned mass treatment campaigns to eliminate yaws in Cameroon.
在热带和亚热带国家，经常有儿童出现雅司病样溃疡性皮肤损伤的爆发。这些损伤的起源可能主要是创伤性或感染性的；在后一种情况下，苍白密螺旋体亚种苍白亚种，即雅司病病原体，和杜克雷嗜血杆菌，即软性下疳病原体，是与皮肤溃疡病因学相关的两种常见病原体。在这项工作中，我们调查了在喀麦隆雅司病流行地区生活的儿童中，皮肤溃疡中是否存在苍白密螺旋体亚种苍白亚种和杜克雷嗜血杆菌 DNA。从 2017 年两次和 2019 年一次爆发期间出现疑似雅司病皮肤损伤的儿童身上采集皮肤损伤拭子。从拭子中提取的 DNA 用于扩增三个靶基因：人β2-微球蛋白基因，以确认正确的样本采集和 DNA 提取，苍白密螺旋体所有亚种高度保守的 polA 基因，以及杜克雷嗜血杆菌的 hddA 基因。第四个靶基因 tprL 基因用于在 polA 阳性样本中区分苍白密螺旋体亚种苍白亚种和人类密螺旋体病的其他病原体。本研究共分析了 112 个样本。一个β2-微球蛋白阴性的样本被排除在进一步分析之外。仅在 2017 年第一次爆发采集的样本中检测到苍白密螺旋体亚种苍白亚种（12/74，16.2%）。相比之下，杜克雷嗜血杆菌 DNA 可从所有三个爆发的样本中扩增（爆发 1：27/74，36.5%；爆发 2：17/24，70.8%；爆发 3：11/13，84.6%）。我们的结果表明，与检查的儿童皮肤损伤相比，杜克雷嗜血杆菌更为常见，但雅司病仍在喀麦隆流行。这些发现强烈主张在这些反复爆发期间继续努力确定溃疡性皮肤损伤的病因，并告知计划在喀麦隆开展的消除雅司病的大规模治疗运动。
