Investigation of bacterial agents in yaws-like ulcers in children and their environment in Cameroon: An experience from the Akonolinga Health District

BACKGROUND: Skin ulcers are health problem in children in tropical areas. Some clinically resemble yaws and this may cause inappropriate allocation of resources from the WHO yaws eradication plan. Studies have shown that bacteria other than the Treponema pallidum subspecies pertenue (bacterium causing yaws) were responsible for these lesions with certain associated risk factors. This study aimed to detect bacteria in yaws-like skin ulcers in Akonolinga Health District and the involvement of some matrices (pets, water, flies). METHODS: A cross-sectional study was conducted from April to June 2023. Swabs were collected from children aged 5-15 years with yaws-like lesions and their asymptomatic contacts. Alongside this, samples were also collected from domestic animals, rivers and flies in the vicinity of participants with yaws like lesions. DNA extracted from the samples collected was used to amplify specific genes to detect the bacteria: Treponema pallidum subspecies pertenue, Haemophilus ducreyi, Staphylococcus aureus and Arcanobacterium haemolyticum. RESULTS: Among the 5,931 children screened, 28 presented with yaws-like lesions. Swab samples were collected from these 28 symptomatic individuals as well as from 28 asymptomatic contacts. Among the targeted genes tested, only Staphylococcus aureus DNA could be amplified from the samples of symptomatic at 32.1% (9/28) and in asymptomatic at 21.42% (6/28) (p = 0.547). These bacterial DNA could not be amplified from samples from animal and environmental matrices. CONCLUSION: Staphylococcus aureus is a bacterium involved in yaws-like ulcers but also found in similar proportion among asymptomatic healthy controls. Further investigation in these skin ulcers is needed for wider diagnostic tools to manage affected population.