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Background  The first yaws eradication campaign reduced the prevalence of yaws by 95%. In recent years, however, yaws has reemerged and is currently subject to a second, ongoing eradication campaign. Yet, the epidemiological status of Tanzania and 75 other countries with a known history of human yaws is currently unknown. Contrary to the situation in humans in Tanzania, recent infection of nonhuman primates (NHPs) with the yaws bacterium  Treponema pallidum  subsp.  pertenue  ( TPE ) have been reported. In this study, we consider a One Health approach to investigate yaws and describe skin ulcers and corresponding  T. pallidum  serology results among children living in the Tarangire-Manyara ecosystem, an area with increasing wildlife-human interaction in northern Tanzania.    Methods  To investigate human yaws in Tanzania, we conducted a cross-sectional study to screen and interview skin-ulcerated children aged 6 to 15 years, who live in close proximity to two national parks with high numbers of naturally  TPE -infected monkeys. Serum samples from children with skin ulcers were tested for antibodies against the bacterium using a treponemal ( Treponema pallidum  Particle Agglutination assay) and a non-treponemal (Rapid Plasma Reagin) test.    Results  A total of 186 children aged between 6 and 15 years (boys: 10.7 ± 2.1 (mean ± SD),  N  = 132; girls: 10.9 ± 2.0 (mean ± SD),  N  = 54) were enrolled. Seven children were sampled at health care facilities and 179 at primary schools. 38 children (20.4%) reported active participation in bushmeat hunting and consumption and 26 (13.9%) reported at least one physical contact with a NHP. None of the lesions seen were pathognomonic for yaws. Two children tested positive for treponemal antibodies (1.2%) in the treponemal test, but remained negative in the non-treponemal test.    Conclusions  We found no serological evidence of yaws among children in the Tarangire-Manyara ecosystem. Nevertheless, the close genetic relationship of human and NHPs infecting  TPE  strains should lead to contact prevention with infected NHPs. Further research investigations are warranted to study the causes and possible prevention measures of spontaneous chronic ulcers among children in rural Tanzania and to certify that the country is free from human yaws.

Serosurvey of Treponema pallidum infection among children with skin ulcers in the Tarangire-Manyara ecosystem, northern Tanzania