WHO and its partners aim to interrupt yaws transmission in countries of endemicity and to certify others as being yaws-free. Transmission can be assessed using rapid plasma reagin (RPR) tests, reflecting current or recent infection, but RPR is operationally impractical. We evaluated changes in antibody levels against two recombinant treponemal antigens, rp17 (also known as Tp17) and TmpA, after antibiotic treatment given as part of a randomized controlled trial for yaws in Ghana and Papua New Guinea. Paired serum samples from children aged 6 to 15 years with confirmed yaws, collected before and after treatment, were tested for antibodies to rp17 and TmpA using a semiquantitative bead-based immunoassay. Of 344 baseline samples, 342 tested positive for anti-rp17 antibodies and 337 tested positive for anti-TmpA antibodies. Six months after treatment, the median decrease in anti-rp17 signal was 3.2%, whereas the median decrease in anti-TmpA was 53.8%. The magnitude of change in the anti-TmpA response increased with increasing RPR titer fold change. These data demonstrate that responses to TmpA decrease markedly within 6 months of treatment whereas (as expected) those to rp17 do not. Incorporating responses to TmpA as a marker of recent infection within an integrated sero-surveillance platform could provide a way to prioritize areas for yaws mapping.

中文翻译：

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加纳和巴布亚新几内亚阿奇霉素治疗雅司病前后两种重组密螺旋体抗原（rp17 和 TmpA）的抗体反应

世卫组织及其合作伙伴旨在阻断雅司病流行国家的传播，并证明其他国家没有雅司病。可以使用快速血浆反应素 (RPR) 测试来评估传播，以反映当前或最近的感染，但 RPR 在操作上是不切实际的。我们评估了在加纳和巴布亚新几内亚的雅司病随机对照试验中给予抗生素治疗后，针对两种重组密螺旋体抗原 rp17（也称为 Tp17）和 TmpA 的抗体水平变化。在治疗前后收集的 6 至 15 岁确诊的雅司病儿童的配对血清样本使用基于微珠的半定量免疫测定法检测 rp17 和 TmpA 的抗体。在 344 个基线样本中，342 个抗 rp17 抗体检测呈阳性，337 个抗 TmpA 抗体检测呈阳性。治疗六个月后，抗 rp17 信号的中位下降为 3.2%，而抗 TmpA 的中位下降为 53.8%。抗 TmpA 反应的变化幅度随着 RPR 滴度倍数变化的增加而增加。这些数据表明，对 TmpA 的反应在治疗后 6 个月内显着下降，而（如预期）对 rp17 的反应没有。将对 TmpA 的反应作为近期感染的标志物纳入综合血清监测平台，可以提供一种方法来确定偏航测绘区域的优先级。