An integrated active case detection and management of skin NTDs in yaws endemic health districts in Cameroon, Côte d'Ivoire and Ghana

PLoS Negl Trop Dis. 2024 Oct 4;18(10):e0011790. doi: 10.1371/journal.pntd.0011790. eCollection 2024 Oct.

Abstract

Background: Integrated approaches to mapping skin Neglected Tropical Diseases (NTDs) may be cost-effective way to guide decisions on resource mobilization. Pilot studies have been carried out, but large-scale data covering multiple countries endemic for skin NTDs are lacking. Within the LAMP4YAWS project, we collected integrated data on the burden of multiple skin NTDs.

Methods: From March 2021 to March 2023, integrated case searches for yaws alongside other skin conditions were performed in endemic health districts of yaws in Cameroon, Côte d'Ivoire, and Ghana. Integrated activities included training, social mobilization and active case detection. Initial screening involved a brief clinical examination of participants to determine if any skin conditions were suspected. Cases of skin NTDs were then referred to a health facility for appropriate management.

Results: Overall 61,080 individuals screened, 11,387 (18.6%) had skin lesions. The majority of individuals (>90%) examined were children aged 15 years old and under. The proportion of serologically confirmed yaws cases was 8.6% (18/210) in Cameroon, 6.8% (84/1232) in Côte d'Ivoire, and 26.8% (440/1643) in Ghana. Other skin conditions based on clinical examination included: scabies, Buruli ulcer, leprosy, lymphatic filariasis (lymphoedema and hydrocele), tungiasis, and fungal infections. The most common conditions were scabies and superficial fungal infections. In Cameroon, scabies and superficial fungal infections accounted for 5.1% (214/4204) and 88.7% (3730/4204) respectively, 25.2% (1285/5095) and 50.4% (2567/5095) in Côte d'Ivoire. In Ghana, 20% (419/2090) of individuals had scabies but superficial fungal infections were not routinely recorded and were reported in only 1.3% (28/2090). Other skin NTDs were less common across all three countries.

Conclusion: This study confirms that integrated screening allows simultaneous detection of multiple skin NTDs, maximising use of scarce resources.

MeSH terms

  • Adolescent
  • Adult
  • Cameroon / epidemiology
  • Child
  • Child, Preschool
  • Cote d'Ivoire / epidemiology
  • Endemic Diseases
  • Female
  • Ghana / epidemiology
  • Humans
  • Infant
  • Male
  • Middle Aged
  • Neglected Diseases* / diagnosis
  • Neglected Diseases* / epidemiology
  • Skin Diseases / diagnosis
  • Skin Diseases / epidemiology
  • Yaws* / diagnosis
  • Yaws* / epidemiology
  • Young Adult

Grants and funding

There is only one grant that funded all the authors. This study was fully funded by the European and Developing Countries Clinical Trial Partnership (EDCTP) as part of the LAMP4yaws project. Grant number: RIA2018D-2495 to MM. The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript.