{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,14]],"date-time":"2026-10-14T14:56:47Z","timestamp":1791989807099,"version":"4.4.0"},"reference-count":42,"publisher":"Public Library of Science (PLoS)","issue":"9","license":[{"start":{"date-parts":[[2023,9,27]],"date-time":"2023-09-27T00:00:00Z","timestamp":1695772800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["www.plosone.org"],"crossmark-restriction":false},"short-container-title":["PLoS ONE"],"abstract":"<jats:sec id=\"sec001\">\n<jats:title>Background<\/jats:title>\n<jats:p>A recent study detected cutaneous leishmaniasis (CL) in 31.9% of persons with skin ulcers in the Oti Region of Ghana, resulting in a need to investigate other potential causes of the unexplained skin ulcers.<\/jats:p>\n<\/jats:sec>\n<jats:sec id=\"sec002\">\n<jats:title>Methodology\/Principal findings<\/jats:title>\n<jats:p>A community based cross-sectional study was conducted in the Oti region to investigate skin ulcers of undetermined aetiologies. To confirm a diagnosis of cutaneous leishmaniasis, Buruli ulcer, <jats:italic>Haemophilus ducreyi<\/jats:italic> ulcers, or yaws, DNA obtained from each patient skin ulcer sample was systematically subjected to polymerase chain reaction (PCR) for <jats:italic>Leishmania spp<\/jats:italic>., <jats:italic>Mycobacterium ulcerans<\/jats:italic>, <jats:italic>Haemophilus ducreyi<\/jats:italic>, and <jats:italic>Treponema pallidum<\/jats:italic> sub species <jats:italic>pertenue<\/jats:italic>. A total of 101 skin ulcer samples were obtained from 101 persons. Co-infection of more than one organism was observed in 68.3% of the samples. Forty (39.6%) participants had a positive result for <jats:italic>Leishmania spp<\/jats:italic>., 68 (67.3%) for <jats:italic>Treponema pallidum<\/jats:italic> sub. Sp. <jats:italic>pertenue<\/jats:italic>, and 74 (73.3%) for <jats:italic>H<\/jats:italic>. <jats:italic>ducreyi<\/jats:italic>. Twenty (19.8%) of the patient ulcers were simultaneously infected with <jats:italic>Leishmania spp<\/jats:italic>., <jats:italic>Treponema pallidum<\/jats:italic> sub. Sp. <jats:italic>pertenue<\/jats:italic>, and <jats:italic>H<\/jats:italic>. <jats:italic>ducreyi<\/jats:italic>. None of the patients\u2019 lesions yielded a positive result for <jats:italic>Mycobacterium ulcerans<\/jats:italic>.<\/jats:p>\n<\/jats:sec>\n<jats:sec id=\"sec003\">\n<jats:title>Conclusions\/Significance<\/jats:title>\n<jats:p>This study detected single and mixed occurrence of the causative organisms of CL, yaws, and <jats:italic>H<\/jats:italic>. <jats:italic>ducreyi<\/jats:italic> cutaneous ulcers in CL endemic communities of the Oti Region in Ghana. These findings emphasize the importance of integrating multiple skin diseases on a common research platform and calls for the development of a comprehensive guideline for diagnosing and treating tropical ulcers in the study areas.<\/jats:p>\n<\/jats:sec>","DOI":"10.1371\/journal.pone.0292034","type":"journal-article","created":{"date-parts":[[2023,9,27]],"date-time":"2023-09-27T17:29:22Z","timestamp":1695835762000},"page":"e0292034","update-policy":"https:\/\/doi.org\/10.1371\/journal.pone.corrections_policy","source":"Crossref","is-referenced-by-count":12,"title":["Endemic infectious cutaneous ulcers syndrome in the Oti Region of Ghana: Study of cutaneous leishmaniasis, yaws and Haemophilus ducreyi cutaneous ulcers"],"prefix":"10.1371","volume":"18","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-5778-1472","authenticated-orcid":true,"given":"Richard Adjei","family":"Akuffo","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Carmen","family":"Sanchez","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ivy","family":"Amanor","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jennifer Seyram","family":"Amedior","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nana Konama","family":"Kotey","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Francis","family":"Anto","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Thomas","family":"Azurago","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Anthony","family":"Ablordey","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Felicia","family":"Owusu-Antwi","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Abate","family":"Beshah","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4642-789X","authenticated-orcid":true,"given":"Yaw Ampem","family":"Amoako","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Richard Odame","family":"Phillips","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Michael","family":"Wilson","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kingsley","family":"Asiedu","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7165-8358","authenticated-orcid":true,"given":"Jose-Antonio","family":"Ruiz-Postigo","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Javier","family":"Moreno","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mourad","family":"Mokni","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"340","published-online":{"date-parts":[[2023,9,27]]},"reference":[{"key":"pone.0292034.ref001","unstructured":"World Health Organization. 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