Jing Peng1, Yanfang Lu1, Hongbing Yu2, Shiji Wu1, Tingting Li1, Huijun Li1, Lingyan Deng1, Ziyong Sun1. 1. Department of Laboratory Medicine, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China. 2. Department of Pediatrics, BC Children's Hospital Research Institute, University of British Columbia, Vancouver, Canada.
Abstract
Background: Two serologic syphilis screening algorithms recommended by the US Centers for Disease Control and Prevention (US CDC) and the European Centre for Disease Prevention and Control (ECDC), respectively, are commonly used for syphilis screening; however, which one is optimal remains to be determined. Methods: We conducted a prospective study of 119891 subjects to analyze the consistency of the US CDC- and ECDC-recommended algorithms. The US CDC-recommended algorithm begins with a treponemal immunoassay, followed by a rapid plasma reagin (RPR) test. RPR-nonreactive samples are confirmed by the Treponema pallidum particle agglutination assay (TPPA). The ECDC-recommended algorithm begins with a treponemal immunoassay, followed by a confirmatory treponemal test. If the confirmatory test is reactive, a quantitative nontreponemal assay is used to assess the disease activity and treatment response. In the present study, a total of 119891 serum samples from a large hospital (sixth largest in China) were included, and each sample was screened with a chemiluminescent immunoassay (CIA). CIA-reactive samples were then simultaneously tested with RPR and TPPA. The consistency of these 2 algorithms was determined by calculating the percentage of agreement and κ coefficient. Results: The overall percentage of agreement and κ value between these 2 algorithms were 99.996% and 0.999, respectively. The positivity rate for syphilis as determined by the US CDC- and ECDC-recommended algorithms was 1.43% and 1.42%, respectively. Conclusions: Our results suggest that the US CDC-recommended algorithm and the ECDC-recommended algorithm have comparable performances for syphilis screening in low-prevalence populations.
Background: Two serologic syphilis screening algorithms recommended by the US Centers for Disease Control and Prevention (US CDC) and the European Centre for Disease Prevention and Control (ECDC), respectively, are commonly used for syphilis screening; however, which one is optimal remains to be determined. Methods: We conducted a prospective study of 119891 subjects to analyze the consistency of the US CDC- and ECDC-recommended algorithms. The US CDC-recommended algorithm begins with a treponemal immunoassay, followed by a rapid plasma reagin (RPR) test. RPR-nonreactive samples are confirmed by the Treponema pallidum particle agglutination assay (TPPA). The ECDC-recommended algorithm begins with a treponemal immunoassay, followed by a confirmatory treponemal test. If the confirmatory test is reactive, a quantitative nontreponemal assay is used to assess the disease activity and treatment response. In the present study, a total of 119891 serum samples from a large hospital (sixth largest in China) were included, and each sample was screened with a chemiluminescent immunoassay (CIA). CIA-reactive samples were then simultaneously tested with RPR and TPPA. The consistency of these 2 algorithms was determined by calculating the percentage of agreement and κ coefficient. Results: The overall percentage of agreement and κ value between these 2 algorithms were 99.996% and 0.999, respectively. The positivity rate for syphilis as determined by the US CDC- and ECDC-recommended algorithms was 1.43% and 1.42%, respectively. Conclusions: Our results suggest that the US CDC-recommended algorithm and the ECDC-recommended algorithm have comparable performances for syphilis screening in low-prevalence populations.
Authors: Ângelo Antônio Oliveira Silva; Ueriton Dias de Oliveira; Larissa de Carvalho Medrado Vasconcelos; Leonardo Foti; Leonardo Maia Leony; Ramona Tavares Daltro; Amanda Leitolis; Fernanda Washington de Mendonça Lima; Marco Aurélio Krieger; Nilson Ivo Tonin Zanchin; Fred Luciano Neves Santos Journal: PLoS One Date: 2020-06-18 Impact factor: 3.240