Prevalence of the related treponematoses syphilis and yaws and co-occurrence of pathogens causing similar skin lesions in Ghana

Yaws affects children in tropical regions while syphilis affects sexually active adults worldwide. Despite various campaigns towards eradication of yaws and elimination of syphilis, these two diseases are still present in Ghana. The agents causing these diseases, two Treponema pallidum subspecies, are genetically similar, but they have always been studied independently. In this context, this study aimed to assess the prevalence of these treponematoses and determine the co-occurrence of pathogens causing similar skin lesions in the Ashanti region of Ghana. A point-of-care test was used to determine their seroprevalence. Multiplex PCR and 16S rRNA gene sequencing were used to identify other microorganisms in these lesions. Additionally, 16S rRNA gene sequencing was used to compare the microbiota of yaws-like lesions with that of syphilis-like lesions. The results indicated that the seroprevalence of T. pallidum in individuals with yaws-like and syphilis-like lesions were 17.2% and 10.8%, respectively. Multiplex PCR results showed 9.1%, 1.8% and 0.9% of yaws-like lesions were positive for H. ducreyi, HSV-1 and T. pallidum respectively, and 28.26% of syphilis-like lesions were positive for HSV-2. 16S rRNA gene sequencing showed that 6.3% of yaws-like lesions were Heamophilus-positive, two yaws-like and one syphilis-like lesions were positive for Treponema and 3.6% yaws-like lesions were positive for Mycobacterium spp. Other microorganisms, including Pseudomonas spp, Klebsiella spp, Escherichia spp, Staphylococcus spp and Proteous spp, were identified as part of the microbiota of both yaws-like and syphilis-like lesions. The alpha diversity measures indicated that syphilis-like lesions were more diverse than yaws-like lesions, but the beta diversity measures suggested no significant dissimilarity between the microbiota of these lesions. Both yaws and syphilis are prevalent in the same geographical location, Ashanti region of Ghana. The presence of other medically important organisms as part of the microbiota of these lesions may prevent their complete resolution and impede the associated elimination and eradication campaigns.