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Diagnostic accuracy of a point-of-care syphilis test when used among pregnant women in Bolivia
  1. F Tinajeros1,
  2. D Grossman2,
  3. K Richmond3,
  4. M Steele4,
  5. S G Garcia5,
  6. L Zegarra6,
  7. R Revollo1
  1. 1Maternal Syphilis Project, Population Council, La Paz, Bolivia
  2. 2Ibis Reproductive Health, San Francisco, California, USA
  3. 3Population Council Regional Office for Latin America and the Caribbean, Albuquerque, New Mexico, USA
  4. 4Program for Appropriate Technologies in Health (PATH), Seattle, Washington, USA
  5. 5Population Council Regional Office for Latin America and the Caribbean, Mexico City, Mexico
  6. 6National Reference Laboratory (INLASA), La Paz, Bolivia
  1. Correspondence to:
 Freddy Tinajeros
 Calle 17 de Calacoto No 8082, La Paz, Bolivia; ftinajeros{at}popcouncil.org.bo

Abstract

Objective: To evaluate the performance of a point-of-care (POC) syphilis test when used in urban Bolivian maternity hospitals.

Methods: We tested 8892 pregnant women for syphilis using the Abbott Determine Syphilis TP rapid POC test and rapid plasma reagin (RPR) in the laboratory of four large urban maternity hospitals where national statistics reported a syphilis prevalence of at least 3%. Sera were stored and transferred to the national reference laboratory (INLASA) where RPR testing was repeated. When the reference laboratory staff observed a positive RPR result, a Treponema pallidum particle agglutination assay (TPPA) was performed to confirm these findings. We calculated test performance characteristics for the POC test and hospital RPR using RPR performed at the reference laboratory confirmed by TPPA as the reference standard. Participants received treatment during their initial visit based on the POC test results.

Results: The sensitivity, specificity, negative predictive value and positive predictive values of the POC syphilis test were: 91.8% (95% confidence intervals 88.4% to 94.5%), 98.5% (98.2% to 98.8%), 71.0% (66.6% to 75.2%), and 99.7% (99.5% to 99.8%), respectively. The RPR values were 75.7% (70.8% to 80.2%), 99.0% (98.9% to 99.3%), 76.9% (72.0% to 81.3%), and 99.0% (98.8% to 99.2%), respectively.

Conclusion: The Abbott Determine Syphilis TP test proved to be more sensitive than routine RPR and had comparable specificity. POC testing may be a simple way to expand syphilis screening to clinics with no laboratory facilities, improve case detection, and facilitate treatment delivery.

  • ANC, antenatal care
  • MOH, Ministry of Health
  • POC, point-of-care
  • RPR, rapid plasma reagin
  • TPPA, Treponema pallidum particle agglutination assay
  • VDRL, venereal diseases research laboratory
  • WHO, World Health Organization
  • Bolivia
  • maternal syphilis
  • rapid test
  • point-of-care

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Footnotes

  • Competing interests: none declared

  • * This study is one part of a larger feasibility and acceptability study implemented in both urban and rural communities of Bolivia.

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