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The Trade-Off between Accuracy and Accessibility of Syphilis Screening Assays.

Smit, P. W., Mabey, D., Changalucha, J., Mngara, J., Clark, B., Andreasen, A., Todd, J., Urassa, M., Zaba, B. and Peeling, R. W. (2013) The Trade-Off between Accuracy and Accessibility of Syphilis Screening Assays. PloS one, 8 (9). e75327. ISSN 1932-6203

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The availability of rapid and sensitive methods to diagnose syphilis facilitates screening of pregnant women, which is one of the most cost-effective health interventions available. We have evaluated two screening methods in Tanzania: an enzyme immunoassay (EIA), and a point-of-care test (POCT). We evaluated the performance of each test against the Treponema pallidum particle agglutination assay (TPPA) as the reference method, and the accessibility of testing in a rural district of Tanzania. The POCT was performed in the clinic on whole blood, while the other assays were performed on plasma in the laboratory. Samples were also tested by the rapid plasma Reagin (RPR) test. With TPPA as reference assay, the sensitivity and specificity of EIA were 95.3% and 97.8%, and of the POCT were 59.6% and 99.4% respectively. The sensitivity of the POCT and EIA for active syphilis cases (TPPA positive and RPR titer ≥1/8) were 82% and 100% respectively. Only 15% of antenatal clinic attenders in this district visited a health facility with a laboratory capable of performing the EIA. Although it is less sensitive than EIA, its greater accessibility, and the fact that treatment can be given on the same day, means that the use of POCT would result in a higher proportion of women with syphilis receiving treatment than with the EIA in this district of Tanzania.

Item Type: Article
Keywords: Syphilis, Pregnancy, women, Enzyme immunoassay, Antenatal clinics, Neonatal, Motarity, Treponema pallidum, agglutination,(TPPA),Tanzania
Subjects: Maternal & Neonatal Health > Antenatal care
Divisions: National Institute for Medical Research
Depositing User: Mr Joseph Madata
Date Deposited: 24 Oct 2013 13:28
Last Modified: 24 Oct 2013 13:28

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