title: Evaluation of Multiplex-Based Antibody Testing for Use in Large-Scale Surveillance for Yaws: a Comparative Study.
abstract: WHO has targeted yaws for global eradication by 2020. The program goals are to interrupt the transmission in countries where yaws is endemic and to certify countries as yaws free where yaws was endemic in the past. No new rapid plasmin reagin (RPR) seroreactivity in young children is required for certification of elimination at a country level. We sought to evaluate whether antibody responses to specific treponemal antigens measured in a high-throughput multiplex bead array (MBA) assay differentiate past versus current infection and whether a nontreponemal lipoidal antigen test can be incorporated into the MBA. Serum and dried blood spot specimens collected for yaws surveillance projects in Ghana, Vanuatu, and Papua New Guinea (PNG) were run on MBA to measure antibodies against recombinant p17 (rp17) and treponemal membrane protein A (TmpA) treponemal antigens. Results were compared to standard treponemal laboratory (TPPA or TPHA [TPP(H)A]) and quantitative RPR test data. Of 589 specimens, 241 were TPP(H)A(+)/RPR(+), 88 were TPP(H)A(+)/RPR(-), 6 were TPP(H)A(-)/RPR(+), and 254 were negative for both tests. Compared to TPP(H)A, reactive concordance of rp17 was 93.7%, while reactive concordance of TmpA was only 81.9%. TmpA-specific reactivity showed good correlation with RPR titers (R(2) = 0.41; P < 0.0001). IgG responses to the lipoidal antigen used in RPR testing (cardiolipin) were not detected in the MBA. Our results suggest that TmpA can be used as a treponemal antigen marker for recent or active infection and potentially replace RPR in a high-throughput multiplex tool for large-scale yaws surveillance.
authors.affiliation: Centers for Disease Control and Prevention, Atlanta, Georgia, USA.
authors.forename: Gretchen M
authors.initials: GM
authors.lastname: Cooley
authors.affiliation: Lihir Medical Center, International SOS, Newcrest Mining, Lihir Island, Papua New Guinea University of Barcelona, Barcelona, Spain.
authors.forename: Oriol
authors.initials: O
authors.lastname: Mitja
authors.affiliation: Centers for Disease Control and Prevention, Atlanta, Georgia, USA.
authors.forename: Brook
authors.initials: B
authors.lastname: Goodhew
authors.affiliation: Centers for Disease Control and Prevention, Atlanta, Georgia, USA.
authors.forename: Allan
authors.initials: A
authors.lastname: Pillay
authors.affiliation: Centers for Disease Control and Prevention, Atlanta, Georgia, USA.
authors.forename: Patrick J
authors.initials: PJ
authors.lastname: Lammie
authors.affiliation: Centers for Disease Control and Prevention, Atlanta, Georgia, USA.
authors.forename: Arnold
authors.initials: A
authors.lastname: Castro
authors.affiliation: Lihir Medical Center, International SOS, Newcrest Mining, Lihir Island, Papua New Guinea.
authors.forename: Penias
authors.initials: P
authors.lastname: Moses
authors.affiliation: Centers for Disease Control and Prevention, Atlanta, Georgia, USA.
authors.forename: Cheng
authors.initials: C
authors.lastname: Chen
authors.affiliation: Centers for Disease Control and Prevention, Atlanta, Georgia, USA.
authors.forename: Tun
authors.initials: T
authors.lastname: Ye
authors.affiliation: Centers for Disease Control and Prevention, Atlanta, Georgia, USA.
authors.forename: Ronald
authors.initials: R
authors.lastname: Ballard
authors.affiliation: Centers for Disease Control and Prevention, Atlanta, Georgia, USA hzx3@cdc.gov.
authors.forename: Diana L
authors.initials: DL
authors.lastname: Martin
mesh_terms: D000293:Adolescent; D000907:Antibodies, Bacterial / Q000097:blood*; D002648:Child; D002675:Child, Preschool; D062665:Epidemiological Monitoring; D005260:Female; D005869:Ghana; D057166:High-Throughput Screening Assays / Q000379:methods; D006801:Humans; D007223:Infant; D008297:Male; D010219:Papua New Guinea; D012698:Serologic Tests / Q000379:methods*; D009514:Vanuatu; D015001:Yaws / Q000175:diagnosis* / Q000453:epidemiology*
chemical_list: D000907:Antibodies, Bacterial