ABSTRACT
Introduction:
In this study, we
report on findings from approaches used, the outcomes and the lessons learnt from the
laboratory support provided for integrated control of
skin NTDs including
Buruli ulcer (BU), and
yaws in seven selected districts in
Ghana.
Methods:
Actions implemented from July 2018 to October 2022 included;
training district-level
health workers on
specimen collection, storage, and transport to
laboratories, integrated case searches, continual
monitoring and
supervision for trained
health workers,
laboratory confirmation of BU and
yaws samples and providing results of the analysed samples to guide
decision making. Descriptive
analysis of data was performed.
Results:
A total of 18,683 (including suspected BU 976; suspected
yaws 10,995) individuals were screened for BU and
yaws. Of 976 suspected BU cases, 16.8% [median (IQR) age 24 (12.0-37.8) years] were confirmed positive by IS2404
PCR; BU mostly presented as
ulcers (78.7%); category I (37.2%) and category II (36%). 480 individuals (4.4%) had DPP positive
yaws.
Multiplex PCR analysis of 75 selected DPP positive cases identified; 7 DPP positive
yaws cases as
Treponema pallidum, 28 as
Haemophilus ducreyi and 7 as
Treponema pallidum/
Haemophilus ducreyi coinfection.
Laboratory results were sent to the districts within a median (IQR) of 5 (3 - 9) days.
Conclusion:
The implementation of integrated diagnostic confirmation for
skin NTDs is feasible with
provision of timely results within a week. Multiplex diagnostic tools differentiated
Treponema pallidum and
Haemophilus ducreyi. There is a need to sustain active case search activities, enhance
health worker training, and improve
laboratory confirmation of cases as part of the overall strategy for the integrated control of
skin neglected tropical diseases.