Abstract
Introduction. Rapid syphilis screening could facilitate caseidentification
in populations at high risk for sexually transmitted
infections (STI). The aim of this study was to compare the
performance and the cost-effectiveness of a rapid immunochromatography
syphilis test with a traditional ELISA screening test
in patients with suspected infectious syphilis or patients at high
risk for STI/syphilis.
Methods. Consecutive patients attending a STI clinic cosensually
underwent serological testing with two different tests. Sensitivity,
specificity, Positive Predictive Values, Negative Predictive Values
and effectiveness of the two tests were evaluated with respect to
definitive diagnosis.
Results. In our population, the immunochromatography essay
(Abbott Determine Syphilis TP) had a sensitivity of 95.0% (95%
CI 88.7-97.8) and a specificity of 97.7% (95% CI 94.7-99.0). The
ELISA test had a sensitivity of 95.0% (95% CI 88.8-97.9) and a
specificity of 97.2% (95% CI 94.1-98.7). The Positive Predictive
Value for ELISA was 94.1% (95% CI 87.6-97.3) and 95.0% (95%
CI 88.7-97.8) for the rapid test. The Negative Predictive Value was
97.7% (95% CI 94.7-99) for both ELISA and the rapid tests.
The cost-effectiveness analysis showed that the rapid test was less
expensive than ELISA (? 26.46 vs ? 40.57) and yielded a similar
number of right diagnoses.
Conclusions. The Abbott Determine Syphilis TP test is an accurate,
easy and inexpensive test that could facilitate the rapid detection
of syphilis in high-risk urban patients.
