Table 4

 Barriers to effective syphilis screening using rapid plasma reagin (RPR) tests

Health seekerHealth provider
Distance to clinicProcurement—limited quantities because of need for refrigeration
Failure to return for test results and treatmentLimited facilities for cold chain transport and storage
Clinic constraints:
• Few trained personnel
• Facilities inadequate, eg,
– refrigerator, centrifuge and rotator may not be available
– poor lighting
Organisation of services—drugs and diagnostics stock-outs