Can a Rapid Test Justify as a Screening Test for Syphilis in Hard-To-Reach Population? Its Evaluation

Authors : Dr. Radha D. Datkar; Dr. Jayesh I. Mukhi; Manisha K. Sharma; Sonali S. Gosavi; Kalindi S. Deogade; Dr. Vandana A. Agarwal

Volume/Issue : Volume 8 - 2023, Issue 10 - October

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Introduction: Syphilis has re-emerged as a global public health threat with an estimated 6 million new cases every year. Asymptomatic nature of infection for a considerable time is a major reason for spread and challenge for prevention. Early diagnosis and treatment especially in hard-to-reach populations is essential for its control. Aim of this study was to evaluate the performance of rapid test for syphilis among the attendees in a sexually transmitted infection clinic. Material & Methods: The study was conducted from September 2022 to August 2023 at Government Medical College and Hospital Nagpur. It was a prospective cross- sectional study wherein 118 patients of clinically suspected syphilis attending the regional center for STI were tested by rapid test for qualitative detection of IgM, IgA, IgG antibodies to Treponema pallidum (Syphicheck: Oscar, Delhi India). Evaluation of the rapid test was done using Treponemal Pallidum Hemagglutination Assay (TPHA) as gold standard. Non treponemal test namely Venereal Disease Research Laboratory (VDRL) was also performed. Results: Out of 118 serum samples TPHA was positive in 52 samples, negative in 63 samples and indeterminate in 3 samples. The 3 indeterminate samples were excluded from evaluation of the other two tests. Out of 115 serum samples, in 52 samples a positive rapid test was in agreement with TPHA giving a sensitivity of 100%. In 3 samples rapid test was positive but TPHA was negative giving a specificity of 92.64%. The positive and negative predictive value of rapid test were 89.65% and 100% respectively. A reactive VDRL test correlated with TPHA in 46 samples giving a sensitivity of 88.46%. It was reactive in 11 samples which were negative by TPHA giving a specificity of 82.53%. All these 11 samples were positive in a low titre of ≤ 1:4. Conclusion: Sensitivity and specificity of rapid test was 100% and 92.64% whereas positive and negative predictive values were 89.65% and 100% respectively. The rapid test was easy to perform, required no technical expertise and is suitable for hard-to-reach population.

Keywords : Syphilis, Treponema Pallidum, VDRL, TPHA.


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