03266nas a2200421   4500000000100000008004100001260001600042653002400058653002700082653003900109653003800148653001600186653001800202653000900220653001500229653001000244100001400254700001400268700001400282700001400296700001200310700001300322700001300335700001300348700001200361700001300373700001100386700001500397700001300412700001400425700001600439245014500455856015300600300000800753490000700761520206200768022001402830       2024                            d  bElsevier BV10aInfectious Diseases10aMicrobiology (medical)10aPulmonary and Respiratory Medicine10aSkin Neglected Tropical Diseases 10aIntegration10aBuruli ulcer 10aYaws10alaboratory10aGhana1 aAgbanyo A1 aAgbavor B1 aGyabaah S1 aOppong MN1 aDornu O1 aAntwi PB1 aLoglo AD1 aAbass KM1 aAmofa G1 aKotey NK1 aQuao B1 aFrimpong M1 aAsiedu K1 aAmoako YA1 aPhillips RO00aImplementation of an integrated control programme for neglected tropical diseases of the skin in Ghana: The essential role of the laboratory  uhttps://www.sciencedirect.com/science/article/pii/S2405579424000299/pdfft?md5=0ff774fb1b1988c3cbdb019b7263ae88&pid=1-s2.0-S2405579424000299-main.pdf  a1-80 v353 a<p id="st015"><strong>Introduction:</strong>&nbsp;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.</p>

<p id="st020"><strong>Methods:&nbsp;</strong>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.</p>

<p id="st025"><strong>Results:&nbsp;</strong>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&nbsp;<em>Treponema pallidum</em>, 28 as&nbsp;<em>Haemophilus ducreyi</em>&nbsp;and 7 as&nbsp;<em>Treponema pallidum/Haemophilus ducreyi</em>&nbsp;coinfection. Laboratory results were sent to the districts within a median (IQR) of 5 (3 – 9) days.</p>

<p id="st030"><strong>Conclusion:&nbsp;</strong>The implementation of integrated diagnostic confirmation for skin NTDs is feasible with provision of timely results within a week. Multiplex diagnostic tools differentiated&nbsp;<em>Treponema pallidum</em>&nbsp;and&nbsp;<em>Haemophilus ducreyi</em>. 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.</p>
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