Eradicating Syphilis mediated neonatal deaths in Ghana through active molecular biosurveillance

Syphilis is a devastating sexally transmitted infection (STI) caused by Treponema pallidum subspecies pallidum. There is no definitive diagnosis for this infection in Ghana and has been misdiagnosed severally. Due to the lack of an accurate diagnostics for treponemes in Ghana, several people do not know their infection status hence act as transmission reservoirs. The need for a molecular test to enable biosurveillance is critical towards any public health intervention in Ghana.

What is the context of this research?

Syphilis caused by Treponema pallidum remains endemic in poor-resource regions and is the leading cause of miscarriage in pregnant women and infant mortality (Muvunyi et al., 2011) necessitating the compulsory screening of all pregnant women and potential blood donors in Ghana. The disease presents with skin ulceration similar to other groups of infections caused by the bacterium Haemophilus ducreyi and Treponema pallidum subspecies treponema pertenue (Kolman et al., 1999). Unfortunately, the diagnosis of these life-threatening infections is rather sometimes unclear and does not establish the case of active infection.

What is the significance of this project?

The current diagnosis is limited to the use of visual inspection for skin ulcerations coupled with mediocre Rapid Diagnostics Tests (RDTs) which are less sensitive and specific. The development of a more sensitive and specific test that meets the WHO’s ASSURED criteria, which is molecular will go a long way to provide information on primary infection and subsequently prevalence information. These information will go a long way to enhance public health intervention strategies aimed at reducing mother to child transmission of syphilis during pregnancy, transmission during transfusion and infant mortality in Ghana and elsewhere.

What are the goals of the project?

The project primarily aims to develop a simple to use molecular qLAMP assay for diagnosing syphilis in Ghanaian hospitals and clinics. The assay development will be done using synthetic target for syphilis and the assay subsequently benchmarked using clinical and laboratory confirmed positive samples.

An extended clinical testing will be done using the assay on routine clinical samples to determine the efficacy of the test over an extended period of time.

When the positive predictive value of the assay is good enough to provide information to guide clinical decision making, the assay will be used to collect prevalence data on syphilis which will be entered into a custom-made dashboard for the project to record the epidemiological distribution of the disease.