Volume : VIII, Issue : V, May - 2019

Applying reverse algorithm for syphilis screening in resource poor settings

Dr. Palaniappan, Dr. Daya Pauline

Abstract :

Background and Objective: The diagnosis of this chronic systemic venereal disease with multiple clinical presentations is challenging and is typically made by serologic testing. Traditionally screening is by a non–treponemal antibodies test –VDRL/RPR and confirmed by treponemal antibodies detection. Recently reverse algorithm is advocated, that is to screen first for treponemal antibodies followed by VDRL/RPR. The objective of this study is to apply an economicrapid ICT –Treponemal antibody assay for reverse screening and directly compå it’s performance with traditional algorithm. Methods: Seven hundred and fifty consecutive sera received from all departments for a period of three months (Jan to March 2018) at Sree Mookambika Institute of Medical Sciences at Kanyakumari district were screened for syphilis using ICT (Tulip Diagnostics) and RPR (Agappee)independently and all reactive sera were tested by TP–HA assay for confirmation (Omega diagnostics) Results: Out of 750 sera tested, 12 were reactive by ICT Treponemal antibody assay (Reverse screening) and 3 were reactive by RPR Non Treponemal antibody (Traditional). All three reactive by RPR were detected by ICT assay and positive by TP–HA also. Out of the 9 sera reactive by ICT only 4 were positive by TP–HA assay. Conclusion: In resource poor settings, rapid ICT treponemal antibody assay may be used to apply reverse screening for syphilis. Though reverse screening is prone for higher false reactive rate than traditional algorithm, the higher sensitivity enables to detect more successfully treated past syphilis and late/latent syphilis. A specific third treponemal antibody assay test is important whenever there is discordance between ICT and RPR assays.

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Article: Download PDF   DOI : 10.36106/ijsr  

Cite This Article:

APPLYING REVERSE ALGORITHM FOR SYPHILIS SCREENING IN RESOURCE POOR SETTINGS, Dr.Palaniappan, Dr.Daya Pauline INTERNATIONAL JOURNAL OF SCIENTIFIC RESEARCH : Volume-8 | Issue-5 | May-2019

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