Irawan Yudo, Giantini Astuti, Yasnova Nevi
Department of Dermatology and Venereology, Faculty of Medicine Universitas Indonesia, Jakarta, Indonesia.
Department of Clinical Pathology, Faculty of Medicine Universitas Indonesia, Jakarta, Indonesia.
J Infect Dev Ctries. 2024 Nov 30;18(11):1734-1738. doi: 10.3855/jidc.17753.
Yaws remains a public health problem in Indonesia, and it is the largest contributor to Yaws cases in Southeast Asia. Yaws is caused by bacterial infection of Treponema pallidum subspecies pertenue, mainly affecting the skin and bones. An estimated 75% of new cases were found in children under 15. The diagnosis of yaws is based on clinical findings with serological confirmation. Rapid diagnostic tests (RDT) have been developed to diagnose Yaws faster and simpler and can thus be used in areas with limited resources.
In this study, sensitivity and specificity of the solid phase immunochromatographic assay of Standard Q Syphilis Antibody (Ab) RDT was performed compared to Treponema Pallidum Haemagglutination Assay (TPHA Plasmatec®) and Rapid Plasma Reagin (RPR) in 195 children with yaws age 2-15 years in Halmahera Barat, Maluku.
There were 116 children with clinical symptoms representative of yaws, but only 13 were serologically positive. The scar was the most commonly found lesion, and the most affected regions were the legs. The sensitivity and specificity of RDT compared to TPHA were 93.3% and 99.4%, respectively. The sensitivity and specificity of RDT compared to RPR were 100% and 98.4%, respectively.
Based on the excellent performance of this test, this study suggests that Standard Q Syphilis Ab RDT examination can be used as a screening test. However, unusual clinical findings, like scars in RDT reactive patients, indicated that RPR is still required to confirm the diagnosis of yaws.
雅司病在印度尼西亚仍是一个公共卫生问题，并且是东南亚雅司病病例的最大贡献者。雅司病由苍白密螺旋体亚种致病变种的细菌感染引起，主要影响皮肤和骨骼。估计75%的新病例在15岁以下儿童中发现。雅司病的诊断基于临床发现并经血清学确认。已开发出快速诊断试验（RDT）以便更快、更简单地诊断雅司病，因此可用于资源有限的地区。
在本研究中，在马鲁古省西哈马黑拉岛对195名2至15岁的雅司病儿童进行了标准Q梅毒抗体（Ab）RDT固相免疫层析测定与梅毒螺旋体血凝试验（TPHA Plasmatec®）和快速血浆反应素试验（RPR）相比的敏感性和特异性检测。
有116名儿童有代表雅司病的临床症状，但只有13名血清学呈阳性。瘢痕是最常见的病变，受影响最严重的部位是腿部。与TPHA相比，RDT的敏感性和特异性分别为93.3%和99.4%。与RPR相比，RDT的敏感性和特异性分别为100%和98.4%。
基于该试验的优异表现，本研究表明标准Q梅毒Ab RDT检测可作为一种筛查试验。然而，不寻常的临床发现，如RDT反应性患者出现瘢痕，表明仍需要RPR来确诊雅司病。
