Haemophilus ducreyi DNA is detectable on the skin of asymptomatic children, flies and fomites in villages of Papua New Guinea

Houinei, Wendy; Godornes, Charmie; Kapa, August; Knauf, Sascha; Mooring, Eric Q.; González-Beiras, Camila; Watup, Ronald; Paru, Raymond; Advent, Paul; Bieb, Sivauk; Sanz, Sergi; Bassat, Quique; Spinola, Stanley M.; Lukehart, Sheila A.; Mitjà, Oriol

doi:10.1371/journal.pntd.0004958

Cited by 26 publications

(32 citation statements)

References 23 publications

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“…The choice of case-control study design could amount to recall bias particularly among the controls. Also, swabs from yaws-like ulcers in some endemic areas have shown infections with Haemophilus ducreyi alone or coinfections with T. pallidum subspecies pertenue and H. ducreyi [9,11,16,17,29]. The prevalence of substandard sanitary and personal hygienic conditions in yaws-endemic communities also facilitates the persistence of H. ducreyi infections in these communities [29].…”

Section: Discussionmentioning

confidence: 99%

Factors associated with cutaneous ulcers among children in two yaws-endemic districts in Ghana

et al. 2020

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Background: Yaws is a chronic relapsing disease caused by Treponema pallidum subspecies pertunue, which can result in severe disability and deformities. Children below the age of 15 years in resource-poor communities are the most affected. Several non-specific factors facilitate the continuous transmission and resurgence of the disease. Endemic communities in rural Ghana continue to report cases despite the roll out of several intervention strategies in the past years. The objective of this study was to determine the factors associated with cutaneous ulcers among children in two yaws-endemic districts in Ghana. Methods: A community-based unmatched 1:2 case-control study was conducted among children between 1 and 15 years. Data on socio-demographic, environmental and behavioral factors were collected using a structured questionnaire. Active case search and confirmation was done using the Dual Path Platform (DPP) Syphilis Screen and Confirm test kit. Data were analyzed using STATA 15. Logistic regression was done to determine the exposures that were associated with yaws infection at 0.05 significant level. Results: Sixty-two cases and 124 controls were recruited for the study. The adjusted multivariable logistic regression model showed that yaws infection was more likely among individuals who reside in overcrowded compound houses (aOR = 25.42, 95% CI: 6.15-105.09) and with poor handwashing habits (aOR = 6.46, 95% CI: 1.89-22.04). Male (aOR = 4.15, 95% CI: 1.29-13.36) and increasing age (aOR = 5.90, 95% CI: 1.97-17.67) were also associated with yaws infection. Conclusions: Poor personal hygiene, overcrowding and lack of access to improved sanitary facilities are the factors that facilitate the transmission of yaws in the Awutu Senya West and Upper West Akyem districts. Yaws was also more common among males and school-aged children. Improving living conditions, access to good sanitary facilities and encouraging good personal hygiene practices should be core features of eradication programs in endemic communities.

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Section: Discussionmentioning

confidence: 99%

Factors associated with cutaneous ulcers among children in two yaws-endemic districts in Ghana

et al. 2020

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“…ducreyi DNA on the skin of asymptomatic participants, on flies, and on bed sheets, suggesting that H . ducreyi survives on healthy, nongenital skin where even minor trauma could initiate infection [ 11 ]. In addition, these cases with HD-CU after a minor trauma could indicate that H .…”

Section: Discussionmentioning

confidence: 99%

Haemophilus ducreyi cutaneous ulcer contracted at Seram Island, Indonesia, presented in the Netherlands

et al. 2018

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OverviewWe describe the first case of a cutaneous ulcer caused by Haemophilus ducreyi imported from Indonesia to the Netherlands. Skin infections caused by H. ducreyi are uncommon in travellers and have been described in just a few case reports and were all contracted on the Pacific Islands.The caseA 22-year-old healthy male visited the Center of Tropical Medicine and Travel Medicine in February 2017 with a cutaneous ulcer of the right lateral malleolus 4 weeks after returning from Indonesia (Seram and Ambon Islands). He had noticed a small skin abrasion on the right ankle after slipping on a rock during a jungle trip on Seram Island. Back in the Netherlands, a painful ulcer developed at the same body location, and despite treatment with flucloxacillin, his complaints worsened. A swab that was taken for culture showed growth of small grey colonies that were characterised as H. ducreyi with matrix-assisted laser desorption/ionisation time-of-flight (MALDI-TOF) mass spectrometry. Treatment with ciprofloxacin for the diagnosis of H. ducreyi cutaneous ulcer was started, and the ulcer clearly diminished, leaving only a small healing ulcer.DiscussionH. ducreyi is normally the causative agent of genital ulcers but is increasingly recognised as a cause of chronic skin ulcers, e.g., in Papua New Guinea. In our patient, the infection was very likely contracted in the Maluku province of Indonesia and imported into the Netherlands. No reports of infection with H. ducreyi from Indonesia could be found in literature, but this case indicates that H. ducreyi is present in at least one of the northeastern islands of Indonesia, which is important for local healthcare. Additionally, it illustrates the role of this agent as a cause of cutaneous ulcers in previously healthy travellers.

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“…Transmission is skin to skin contact from active infectious lesions [ 14 ]. Early studies had suggested that flies may play a role in transmission but there is no definitive proof that this occurs [ 14 , 15 , 16 ]. The majority of active infections cases occur in children aged under 15 years.…”

Section: Epidemiologymentioning

confidence: 99%

Advances in the Treatment of Yaws

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2018

TropicalMed

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Yaws is one of the three endemic treponematoses and is recognised by the World Health Organization as a neglected tropical disease. Yaws is currently reported in 15 countries in the Pacific, South-East Asia, West and Central Africa, predominantly affects children, and results in destructive lesions of the skin and soft tissues. For most of the twentieth century penicillin-based treatment was the standard of care and resistance to penicillin has still not been described. Recently, oral azithromycin has been shown to be an effective treatment for yaws, facilitating renewed yaws eradication efforts. Resistance to azithromycin is an emerging threat and close surveillance will be required as yaws eradication efforts are scaled up globally.

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Haemophilus ducreyi DNA is detectable on the skin of asymptomatic children, flies and fomites in villages of Papua New Guinea

Cited by 26 publications

References 23 publications

Factors associated with cutaneous ulcers among children in two yaws-endemic districts in Ghana

Factors associated with cutaneous ulcers among children in two yaws-endemic districts in Ghana

Haemophilus ducreyi cutaneous ulcer contracted at Seram Island, Indonesia, presented in the Netherlands

Advances in the Treatment of Yaws

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