{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,3,30]],"date-time":"2026-03-30T18:51:27Z","timestamp":1774896687144,"version":"3.50.1"},"update-to":[{"DOI":"10.1371\/journal.pntd.0013772","type":"new_version","label":"New version","source":"publisher","updated":{"date-parts":[[2026,3,30]],"date-time":"2026-03-30T00:00:00Z","timestamp":1774828800000}}],"reference-count":24,"publisher":"Public Library of Science (PLoS)","issue":"3","license":[{"start":{"date-parts":[[2026,3,13]],"date-time":"2026-03-13T00:00:00Z","timestamp":1773360000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100000780","name":"European Union","doi-asserted-by":"crossref","award":["RIA2018D-2495-LAMP4Yaws"],"award-info":[{"award-number":["RIA2018D-2495-LAMP4Yaws"]}],"id":[{"id":"10.13039\/501100000780","id-type":"DOI","asserted-by":"crossref"}]}],"content-domain":{"domain":["www.plosntds.org"],"crossmark-restriction":false},"short-container-title":["PLoS Negl Trop Dis"],"abstract":"\n Background<\/jats:title>\n We aimed to establish an external quality assessment (EQA) programme for the yaws eradication campaign that would meet the needs of reference and district-level laboratories in low- and middle-income countries.<\/jats:p>\n <\/jats:sec>\n \n Methodology\/Principal Findings<\/jats:title>\n \n We designed proficiency testing items (PTIs) using a plasmid containing gene target sequences for\n Treponema pallidum<\/jats:italic>\n (\n TP<\/jats:italic>\n ) and\n Haemophilus ducreyi<\/jats:italic>\n (\n HD<\/jats:italic>\n ). The storage stability of the plasmids under different environmental conditions was then tested. A proficiency testing panel of seven swabs loaded with different concentrations of plasmids in different combinations, as well as human HEK293 cells to simulate the sample background, was prepared and sent to participating reference (RL) and district (DL) laboratories in Ghana, C\u00f4te d\u2019Ivoire and Cameroon followed by three rounds of blinded proficiency testing. We tested quantitative real-time PCR (qPCR) performance of reference laboratories and loop-mediated isothermal amplification (LAMP) performance of district laboratories and retested 20% of human field samples at the London School of Hygiene & Tropical Medicine laboratories\u00a0to further assess qPCR quality.\n <\/jats:p>\n <\/jats:sec>\n \n Findings<\/jats:title>\n \n PTIs proved to be stable in dry conditions with no significant loss of copy number. Participating laboratories achieved qPCR results with a concordance of 95.0-100.0% (97.7%\u2009\u00b1\u20095.2% (mean\u00b1standard deviation ((SD)) with the provider and a concordance of 76.0-100.0% (\n TP<\/jats:italic>\n : 90.3\u2009\u00b1\u200913.7% and\n HD<\/jats:italic>\n : 78.5\u2009\u00b1\u20097.5% (mean\u00b1SD)) for LAMP results, with inconsistencies, particularly in the detection of low\n HD<\/jats:italic>\n plasmid DNA levels combined with high\n TP<\/jats:italic>\n plasmid copies. Retesting of field samples resulted in 100% correct\n TP<\/jats:italic>\n and\n HD<\/jats:italic>\n sample identification by the African reference laboratories.\n <\/jats:p>\n <\/jats:sec>\n \n Conclusions\/Significance<\/jats:title>\n We have developed a functional plasmid-based EQA programme specifically designed to meet the needs of resource-poor settings in the tropics. The programme is suitable as a blueprint for other disease programmes.<\/jats:p>\n <\/jats:sec>","DOI":"10.1371\/journal.pntd.0013772","type":"journal-article","created":{"date-parts":[[2026,3,13]],"date-time":"2026-03-13T17:49:02Z","timestamp":1773424142000},"page":"e0013772","update-policy":"https:\/\/doi.org\/10.1371\/journal.pntd.corrections_policy","source":"Crossref","is-referenced-by-count":0,"title":["External quality assessment for yaws elimination in low- and middle-income countries using plasmid-based proficiency test items"],"prefix":"10.1371","volume":"20","author":[{"given":"Claudia","family":"Mueller","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Serges","family":"Tchatchouang","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Laud 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