Present status of serological tests for syphilis.

The authors first discuss the advantages and disadvantages of the various serological tests now in common use, or coming into use, for the detection and management of syphilis and also compare the different antigens used in those tests. They lay stress on the difficulties caused by the "unit" system of recording results, whereby identical findings with two or more tests may be given different numerical values for each test, and suggest that results should instead be given in dilution reactivity end-points (dils).False positive reactions to serological tests and discrepancies in the results of different tests are then considered; it is pointed out that these discrepancies may be due to causes in the patient himself, in transit, or in the testing laboratory.Finally, the authors consider that in view of the growing number of serological tests for syphilis, and of modifications to those tests, there is now a need for selecting, in different areas of the world, a certain number of procedures which can be standardized for routine testing. Regional serological evaluation studies can be used to this end. A brief outline is given of the United States Public Health Service programme to assist State laboratories to maintain a high level of efficiency in serological testing and thus to exert an influence on other laboratories within each State.