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Syphilis testing practices in the Americas
Author(s) -
Trinh Thuy T.,
Kamb Mary L.,
Luu Minh,
Ham D. Cal,
Perez Freddy
Publication year - 2017
Publication title -
tropical medicine and international health
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.056
H-Index - 114
eISSN - 1365-3156
pISSN - 1360-2276
DOI - 10.1111/tmi.12920
Subject(s) - syphilis , medicine , treponematosis , geography , virology , human immunodeficiency virus (hiv) , sexually transmitted disease
Objective To present the findings of the Pan American Health Organization's 2014 survey on syphilis testing policies and practices in the Americas. Methods Representatives of national/regional reference and large, lower‐level laboratories from 35 member states were invited to participate. A semi‐structured, electronically administered questionnaire collected data on syphilis tests, algorithms, equipment/commodities, challenges faced and basic quality assurance (QA) strategies employed (i.e. daily controls, standard operating procedures, technician training, participating in external QA programmes, on‐site evaluations). Results The 69 participating laboratories from 30 (86%) member states included 41 (59%) national/regional reference and 28 (41%) lower‐level laboratories. Common syphilis tests conducted were the rapid plasma reagin (RPR) (62% of surveyed laboratories), venereal disease research laboratory (VDRL) (54%), fluorescent treponemal antibody absorption (FTA‐ABS) (41%) and Treponema pallidum haemagglutination assay (TPHA) (32%). Only three facilities reported using direct detection methods, and 28 (41% overall, 32% of lower‐level facilities) used rapid tests. Most laboratories (62%) used only traditional testing algorithms (non‐treponemal screening and treponemal confirmatory testing); however, 12% used only a reverse sequence algorithm (treponemal test first), and 14% employed both algorithms. Another nine (12%) laboratories conducted only one type of serologic test . Although most reference (97%) and lower‐level (89%) laboratories used at least one QA strategy, only 16% reported using all five basic strategies. Commonly reported challenges were stock‐outs of essential reagents or commodities (46%), limited staff training (73%) and insufficient equipment (39%) .Conclusions Many reference and clinical laboratories in the Americas face challenges in conducting appropriate syphilis testing and in ensuring quality of testing.