RT Journal Article
SR Electronic
T1 Improved rapid diagnostic tests to detect syphilis and yaws: a systematic review and meta-analysis
JF Sexually Transmitted Infections
JO Sex Transm Infect
FD BMJ Publishing Group Ltd
SP 608
OP 616
DO 10.1136/sextrans-2022-055546
VO 98
IS 8
A1 Ying Zhang
A1 Su Mei Goh
A1 Maeve B Mello
A1 Rachel C Baggaley
A1 Teodora Wi
A1 Cheryl C Johnson
A1 Kingsley B Asiedu
A1 Michael Marks
A1 Minh D Pham
A1 Christopher K Fairley
A1 Eric P F Chow
A1 Oriol Mitjà
A1 Igor Toskin
A1 Ronald C Ballard
A1 Jason J Ong
YR 2022
UL http://sti.bmj.com/content/98/8/608.abstract
AB Background Current rapid tests for syphilis and yaws can detect treponemal and non-treponemal antibodies. We aimed to critically appraise the literature for rapid diagnostic tests (RDTs) which can better distinguish an active infection of syphilis or yaws.Methods We conducted a systematic review and meta-analysis, searching five databases between January 2010 and October 2021 (with an update in July 2022). A generalised linear mixed model was used to conduct a bivariate meta-analysis for the pooled sensitivity and specificity. Heterogeneity was assessed using the I2 statistic. We used the Quality Assessment of Diagnostic Accuracy Studies (QUADAS) to assess the risk of bias and Grading of Recommendations, Assessment, Development and Evaluations (GRADE) to evaluate the certainty of evidence.Results We included 17 studies for meta-analyses. For syphilis, the pooled sensitivity and specificity of the treponemal component were 0.93 (95% CI: 0.86 to 0.97) and 0.98 (95% CI: 0.96 to 0.99), respectively. For the non-treponemal component, the pooled sensitivity and specificity were 0.90 (95% CI: 0.82 to 0.95) and 0.97 (95% CI: 0.92 to 0.99), respectively. For yaws, the pooled sensitivity and specificity of the treponemal component were 0.86 (95% CI: 0.66 to 0.95) and 0.97 (95% CI: 0.94 to 0.99), respectively. For the non-treponemal component, the pooled sensitivity and specificity were 0.80 (95% CI: 0.55 to 0.93) and 0.96 (95% CI: 0.92 to 0.98), respectively.Conclusions RDTs that can differentiate between active and previously treated infections could optimise management by providing same-day treatment and reducing unnecessary treatment.PROSPERO registration number CRD42021279587.