Continental-scale survey of Treponema pallidum in African nonhuman primates: expanding the range to the Mediterranean basin

Background: Treponema pallidum, the causative agent of yaws, bejel, and syphilis, is a significant pathogen affecting both humans and nonhuman primates (NHPs). While its presence is documented in several African NHP species, the continental-scale distribution, ecological drivers, and status in North African populations remain poorly understood. We conducted a large-scale, non-invasive survey to investigate the circulation of T. pallidum across African NHP populations and evaluate geographical and ecological patterns of exposure. Results: A total of 1,696 fecal samples from 11 wild NHP species collected across five African countries were screened for anti-T. pallidum antibodies using an automated chemiluminescent Simple Western assay, and fecal and dipteran samples were analyzed by molecular methods. Widespread seropositivity was observed across all African sites and multiple primate taxa, including great apes and cercopithecids. We provide the first evidence of T. pallidum antibodies in Barbary macaques (Macaca sylvanus) from North Africa, extending the known distribution of the pathogen to the Mediterranean basin. In West Africa, chimpanzees (Pan troglodytes verus) from Senegal and Guinea exhibited particularly high seroprevalence, confirming this region as a major endemic hotspot. In Central Africa, substantial circulation was documented in Cercopithecus wolfi, Cercopithecus ascanius, and western lowland gorillas (Gorilla gorilla gorilla). Arid/savanna biomes showed significantly higher exposure than Mediterranean and tropical rainforest biomes. No T. pallidum DNA was detected in fecal or dipteran samples. Conclusion: Our findings demonstrate widespread circulation of T. pallidum among African NHPs, reveal its presence in North African primate populations for the first time. The observed high seroprevalence, coupled with significant variations across species and geographical regions, suggests the existence of multiple transmission pathways adapted to specific host behaviors and environmental constraints. These results support the existence of a broad multihost sylvatic reservoir and provide new insights into the ecology of T. pallidum, with important implications for wildlife health, One Health surveillance, and yaws eradication efforts.