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Kularatne R, Blondeel K, Kasaro M, Maseko V, Bosomprah S, Silva R, Laverty M, Kurbonov F, Mirandola M, Peeling RW. Clinic-based evaluation of point-of-care dual HIV/syphilis rapid diagnostic tests at primary healthcare antenatal facilities in South Africa and Zambia. BMC Infect Dis 2024; 24:600. [PMID: 38898466 PMCID: PMC11186134 DOI: 10.1186/s12879-024-09463-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/18/2022] [Accepted: 05/31/2024] [Indexed: 06/21/2024] Open
Abstract
BACKGROUND Southern African countries have the largest global burden of HIV and syphilis, with a high prevalence among women of reproductive age. Although antenatal screening is standard of care, syphilis screening has generally lagged behind HIV screening. We aimed to evaluate the performance and operational characteristics of two commercial dual HIV/syphilis point-of-care tests (POCTs) for simultaneous maternal HIV/syphilis screening. METHODS A clinic-based evaluation of dual HIV/syphilis POCTs (SD Bioline and Chembio) was conducted at five primary healthcare centres (PHCs) in South Africa and Zambia. POCT results using capillary fingerprick blood were compared to reference laboratory syphilis and HIV serological assays. RESULTS Three thousand four hundred twelve consenting pregnant women aged ≥ 18 years were enrolled. The prevalence of treponemal antibody seropositivity and HIV infection ranged from 3.7 to 9.9% (n = 253) and 17.8 to 21.3% (n = 643), respectively. Pooled sensitivity for syphilis compared to the reference assay was 66.0% (95%CI 57.7-73.4) with SD Bioline and 67.9% (95%CI 58.2-76.3) with Chembio. Pooled specificity for syphilis was above 98% with both POCTs. The sensitivities of SD Bioline and Chembio assays were 78.0% (95%CI 68.6-85.7) and 81.0% (95%CI 71.9-88.2), respectively compared to an active syphilis case definition of treponemal test positive with a rapid plasma reagin titre of ≥ 8. The negative predictive values (NPVs) based on various prevalence estimates for syphilis with both assays ranged from 97 to 99%. The pooled sensitivity for HIV was 92.1% (95%CI 89.4-94.2) with SD Bioline; and 91.5% (95%CI 88.2-93.9) with Chembio. The pooled specificities for HIV were 97.2% (95%CI 94.8-98.5) with SD Bioline and 96.7% (95%CI 95.1-97.8) with Chembio. The NPV based on various prevalence estimates for HIV with both assays was approximately 98%. Most participating women (91%) preferred dual POCTs over two single POCTs for HIV and syphilis, and healthcare providers gave favourable feedback on the utility of both assays at PHC level. CONCLUSIONS Based on the need to improve antenatal screening coverage for syphilis, dual HIV/syphilis POCTs could be effectively incorporated into antenatal testing algorithms to enhance efforts towards elimination of mother-to-child transmission of these infections.
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Affiliation(s)
- Ranmini Kularatne
- Centre for HIV & STI, National Institute for Communicable Diseases, Johannesburg, South Africa
- Department of Clinical Microbiology & Infectious Diseases, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa
| | - Karel Blondeel
- Faculty of Medicine and Health Sciences, Ghent University, Ghent, Belgium.
| | - Margaret Kasaro
- University of North Carolina Global Projects Zambia, Lusaka, Zambia
- Department of Obstetrics and Gynecology, School of Medicine, University of North Carolina, Chapel Hill, USA
- Center for Infectious Diseases Research in Zambia, Lusaka, Zambia
| | - Venessa Maseko
- Centre for HIV & STI, National Institute for Communicable Diseases, Johannesburg, South Africa
| | - Samuel Bosomprah
- Center for Infectious Diseases Research in Zambia, Lusaka, Zambia
- Department of Biostatistics, School of Public Health, University of Ghana, Legon, Accra, Ghana
| | | | | | | | - Massimo Mirandola
- Department of Diagnostics and Public Health, Infectious Diseases Section, University of Verona, Verona, Italy
| | - Rosanna W Peeling
- Department of Clinical Research, London School of Hygiene and Tropical Medicine, Verona, UK
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Gios L, Mirandola M, Cordioli M, Zorzi A, Sherriff N, Vera J, Wlazly D, Hassan-Ibrahim MO, Padovese V, Anabel Darmanin, Peeling RW, Unemo M, Blondeel K, Toskin I. A multi-country comparative study of two treponemal tests for the serodiagnosis of syphilis amongst men who have sex with men (MSM): Chemo-luminescent assay vs Treponema pallidum particle agglutination assay. BMC Infect Dis 2024; 24:313. [PMID: 38486194 PMCID: PMC10941351 DOI: 10.1186/s12879-024-09100-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/23/2023] [Accepted: 02/02/2024] [Indexed: 03/17/2024] Open
Abstract
INTRODUCTION International guidelines recommend routine screening for syphilis (aetiological agent: Treponema pallidum subspecies pallidum) amongst key populations and vulnerable populations using tests detecting treponemal and non-treponemal antibodies. Whilst treponemal tests have high sensitivities and specificities, they differ regarding subjective or objective interpretation, throughput and workload. Chemiluminescence immunoassays (CLIAs) are cost- and time-effective automated methods for detecting treponemal antibodies. The Treponema pallidum particle agglutination assay (TPPA) has been considered the "gold standard" treponemal assay, however, this includes a highly manual procedure, low throughput and subjective interpretation. The present multi-country study evaluated the ADVIA Centaur® Syphilis CLIA (Siemens Healthcare) assay compared to the reference SERODIA-TP·PA® (Fujirebio Diagnostics) for the serodiagnosis of syphilis amongst men who have sex with men (MSM). METHOD 1,485 MSM were enrolled in Brighton (UK), Malta, and Verona (Italy) as part of a larger WHO multi-country and multi-site ProSPeRo study. Ethical approval was obtained. Serum was tested with the ADVIA Centaur® Syphilis CLIA assay and SERODIA-TP·PA®, in accordance with the manufacturers' instructions, for a first round of validation. A second round of validation was carried out for discrepant results that were additionally tested with both Western Blot (Westernblot EUROIMMUN®) and an Immunoblot (INNO-LIA, Fujirebio Diagnostics). Sensitivity, specificity, positive and negative predictive value (PPV and NPV), likelihood ratios (positive/negative), and the Diagnostic Odds Ratio (DOR)/pre-post-test probability (Fagan's nomogram) were calculated. RESULTS Out of 1,485 eligible samples analysed in the first phase, the SERODIA-TP·PA® identified 360 positive and 1,125 negative cases. The ADVIA Centaur® Syphilis CLIA assay (Siemens) identified 366 positives, missclassifying one TPPA-positive sample. In the second phase, the ADVIA Centaur® Syphilis CLIA resulted in 1 false negative and 4 false positive results. Considering the syphilis study prevalence of 24% (95% CI: 22-26.7), The sensitivity of the ADVIA Centaur® Syphilis CLIA assay was 99.7% (95% CI: 98.5-100), and the specificity was 99.4% (95% CI: 98.7-99.7). The ROC area values were 0.996 (95% CI: 0.992-0.999), and both the PPV and NPV values were above 98% (PPV 98.1%, 95% CI: 96.1-99.2; NPV 99.9%, 95% CI: 99.5-100). CONCLUSIONS The ADVIA Centaur® Syphilis CLIA assay showed similar performance compared to the SERODIA-TP·PA®. Considering the study is based on QUADAS principles and with a homogeneous population, results are also likely to be generalisable to MSM population but potentially not applicable to lower prevalence populations routinely screened for syphilis. The automated CLIA treponemal assay confirmed to be accurate and appropriate for routine initial syphilis screening, i.e. when the reverse testing algorithm is applied.
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Affiliation(s)
- Lorenzo Gios
- Infectious Division of Infectious Diseases, Department of Medicine, Verona University Hospital, Verona, Italy.
- WHO Collaborating Centre for Sexual Health and Vulnerable Populations - Epidemiology Unit - Division of Infectious Diseases, Department of Medicine, Verona University Hospital, Verona, Italy.
- Infectious Diseases Section, Department of Diagnostics and Public Health, University of Verona, Piazzale L. Scuro, 10, 37134, Verona, Italy.
| | - Massimo Mirandola
- Infectious Division of Infectious Diseases, Department of Medicine, Verona University Hospital, Verona, Italy
- WHO Collaborating Centre for Sexual Health and Vulnerable Populations - Epidemiology Unit - Division of Infectious Diseases, Department of Medicine, Verona University Hospital, Verona, Italy
- School of Sport and Health Sciences, University of Brighton, Brighton, UK
| | - Maddalena Cordioli
- Infectious Division of Infectious Diseases, Department of Medicine, Verona University Hospital, Verona, Italy
- WHO Collaborating Centre for Sexual Health and Vulnerable Populations - Epidemiology Unit - Division of Infectious Diseases, Department of Medicine, Verona University Hospital, Verona, Italy
| | - Antonella Zorzi
- WHO Collaborating Centre for Sexual Health and Vulnerable Populations - Epidemiology Unit - Division of Infectious Diseases, Department of Medicine, Verona University Hospital, Verona, Italy
- Virology and Microbiology Unit, Department of Pathology and Diagnostics, Verona University Hospital, Verona, Italy
| | - Nigel Sherriff
- School of Sport and Health Sciences, University of Brighton, Brighton, UK
| | - Jaime Vera
- Brighton & Sussex Medical School, University of Sussex and University of Brighton, Brighton, UK
| | - Dominika Wlazly
- Brighton & Sussex Medical School, University of Sussex and University of Brighton, Brighton, UK
| | - Mohammed Osman Hassan-Ibrahim
- Department of Microbiology & Infection, Royal Sussex County Hospital, University Hospitals Sussex NHS Foundation Trust (Brighton & Haywards Heath Sites), Brighton, UK
| | - Valeska Padovese
- Genitourinary Clinic, Department of Dermatology and Venereology, Mater Dei Hospital, Msida, Malta, L-Imsida, Malta
| | - Anabel Darmanin
- Genitourinary Clinic, Department of Dermatology and Venereology, Mater Dei Hospital, Msida, Malta, L-Imsida, Malta
| | - Rosanna W Peeling
- Clinical Research Department, London School of Hygiene & Tropical Medicine, London, UK
- Medical Microbiology Department, University of Manitoba, Winnipeg, MB, Canada
| | - Magnus Unemo
- WHO Collaborating Centre for Gonorrhoea and Other STIs, Department of Laboratory Medicine, Örebro University, Örebro, Sweden
- Institute for Global Health, University College London (UCL), London, UK
| | - Karel Blondeel
- Department of Sexual and Reproductive Health and Research (includes the UNDP/UNFPA/UNICEF/WHO/World Bank Special Programme of Research, Development and Research Training in Human Reproduction [HRP]), World Health Organization, Geneva, Switzerland
- Faculty of Medicine and Health Sciences, Ghent University, Ghent, Belgium
| | - Igor Toskin
- Department of Sexual and Reproductive Health and Research (includes the UNDP/UNFPA/UNICEF/WHO/World Bank Special Programme of Research, Development and Research Training in Human Reproduction [HRP]), World Health Organization, Geneva, Switzerland
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Sherriff N, Mirandola M, Silva R, Cordioli M, Sawyer A, Gios L, Zorzi A, Huber J, Vera J, Richardson D, Hassan-Ibrahim M, Wlazly D, Padovese V, Barbara C, Darmanin A, Schembri A, Caceres C, Vargas S, Blondeel K, Kiarie J, Kurbonov F, Peeling RW, Thwin SS, Toskin I. Independent clinic-based evaluation of dual POCTs for screening for HIV and syphilis in men who have sex with men in Italy, Malta, Peru, and the United Kingdom. BMC Infect Dis 2024; 24:192. [PMID: 38418941 PMCID: PMC10902927 DOI: 10.1186/s12879-024-09019-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/01/2022] [Accepted: 01/11/2024] [Indexed: 03/02/2024] Open
Abstract
INTRODUCTION Globally, the incidence of HIV and syphilis can be reduced by the use of validated point of care tests (POCTs). As part of the WHO PRoSPeRo Network, we aimed to evaluate the performance, acceptability, and operational characteristics of two dual HIV/syphilis POCTs (Bioline HIV/Syphilis Duo (Abbott) and DPP® HIV-Syphilis assay (Chembio) for the screening of HIV and syphilis amongst men who have sex with men (MSM). METHOD AND ANALYSES A cross sectional study of 2,577 MSM in Italy, Malta, Peru, and the United Kingdom (UK) presenting to seven clinic sites, were enrolled. Finger prick blood was collected to perform POCTs and results compared with standard laboratory investigations on venepuncture blood. Acceptability and operational characteristics were assessed using questionnaires. Diagnostic meta-analysis was used to combine data from the evaluation sites. RESULTS Based on laboratory tests, 23.46% (n = 598/2549) of participants were confirmed HIV positive, and 35.88% of participants (n = 901/2511) were positive on treponemal reference testing. Of all participants showing evidence of antibodies to Treponema pallidum, 50.56% (n = 455/900) were Rapid Plasma Reagin (RPR) test reactive. Of HIV positive individuals, 60.62% (n = 354/584) had evidence of antibodies to T. pallidum, and of these 60.45% (n = 214/354) exhibited reactive RPR tests indicating probable (co)infection. For Bioline POCT, pooled sensitivities and specificities for HIV were 98.95% and 99.89% respectively, and for syphilis were 73.79% and 99.57%. For Chembio pooled sensitivities and specificities for HIV were 98.66% and 99.55%, and for syphilis were 78.60% and 99.48%. Both tests can detect greater than 90% of probable active syphilis cases, as defined by reactive RPR and treponemal test results. These dual POCTs were preferred by 74.77% (n = 1,926) of participants, due to their convenience, and the operational characteristics made them acceptable to health care providers (HCPs). CONCLUSIONS Both the Bioline and the Chembio dual POCT for syphilis and HIV had acceptable performance, acceptability and operational characteristics amongst MSM in the PRoSPeRo network. These dual POCTs could serve as a strategic, more cost effective, patient and healthcare provider (HCP) friendly alternative to conventional testing; in clinical and other field settings, especially those in resource-limited settings.
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Affiliation(s)
- Nigel Sherriff
- School of Sport and Health Sciences, University of Brighton, Village Way, Falmer, BN1 9PH, UK.
- Centre for Transforming Sexuality and Gender, University of Brighton, Edward Street, Brighton, BN2 0JG, UK.
| | - Massimo Mirandola
- School of Sport and Health Sciences, University of Brighton, Village Way, Falmer, BN1 9PH, UK
- Infectious Diseases Section, Department of Diagnostics and Public Health, University of Verona, Verona, Italy
| | - Ronaldo Silva
- World Health Organization, Department of Sexual and Reproductive Health and Research (includes the UNDP/UNFPA/UNICEF/WHO/World Bank Special Programme of Research, Development and Research Training in Human Reproduction [HRP]), Geneva, Switzerland
| | - Maddalena Cordioli
- Infectious Diseases Section, Department of Diagnostics and Public Health, University of Verona, Verona, Italy
| | - Alexandra Sawyer
- School of Sport and Health Sciences, University of Brighton, Village Way, Falmer, BN1 9PH, UK
| | - Lorenzo Gios
- Infectious Diseases Section, Department of Diagnostics and Public Health, University of Verona, Verona, Italy
| | - Antonella Zorzi
- Microbiology and Virology Unit, Molecular Biology Department, Padua University Hospital, Padua, Italy
| | - Jorg Huber
- School of Sport and Health Sciences, University of Brighton, Village Way, Falmer, BN1 9PH, UK
| | - Jaime Vera
- Brighton & Sussex Medical School, University of Sussex, Brighton, UK
| | - Daniel Richardson
- Brighton & Sussex Medical School, University of Sussex, Brighton, UK
| | - Mohammed Hassan-Ibrahim
- Department of Microbiology & Infection, Royal Sussex County Hospital, University Hospitals Sussex NHS Foundation Trust, Brighton, UK
| | - Dominika Wlazly
- Royal Sussex County Hospital Brighton, CIRU Research Laboratory, Brighton, UK
| | - Valeska Padovese
- Department of Dermatology and Venereology, Genito-Urinary Clinic, Mater Dei Hospital, Msida, Malta
| | | | | | - Aaron Schembri
- Infectious Diseases Unit, Mater Dei Hospital, Msida, Malta
| | - Carlos Caceres
- Centro de Investigación Interdisciplinaria en Sexualidad, Sida y Sociedad, Universidad Peruana Cayetano Heredia, Lima, Peru
| | - Silver Vargas
- Centro de Investigación Interdisciplinaria en Sexualidad, Sida y Sociedad, Universidad Peruana Cayetano Heredia, Lima, Peru
| | - Karel Blondeel
- World Health Organization, Department of Sexual and Reproductive Health and Research (includes the UNDP/UNFPA/UNICEF/WHO/World Bank Special Programme of Research, Development and Research Training in Human Reproduction [HRP]), Geneva, Switzerland
- Faculty of Medicine and Health Sciences, Ghent University, Ghent, Belgium
| | - James Kiarie
- World Health Organization, Department of Sexual and Reproductive Health and Research (includes the UNDP/UNFPA/UNICEF/WHO/World Bank Special Programme of Research, Development and Research Training in Human Reproduction [HRP]), Geneva, Switzerland
| | - Firdavs Kurbonov
- World Health Organization, Department of Sexual and Reproductive Health and Research (includes the UNDP/UNFPA/UNICEF/WHO/World Bank Special Programme of Research, Development and Research Training in Human Reproduction [HRP]), Geneva, Switzerland
| | - Rosanna W Peeling
- Department of Clinical Research, London School of Hygiene and Tropical Medicine, London, UK
| | - Soe Soe Thwin
- World Health Organization, Department of Sexual and Reproductive Health and Research (includes the UNDP/UNFPA/UNICEF/WHO/World Bank Special Programme of Research, Development and Research Training in Human Reproduction [HRP]), Geneva, Switzerland
| | - Igor Toskin
- World Health Organization, Department of Sexual and Reproductive Health and Research (includes the UNDP/UNFPA/UNICEF/WHO/World Bank Special Programme of Research, Development and Research Training in Human Reproduction [HRP]), Geneva, Switzerland
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Cao W, Fakile YF, Shukla MR, Pettus K, Lupoli K, Hong J, Pillay A, Kularatne R, Oumzil H, Padovese V, Sherriff N, SSewanyana I, Vargas SK, Zorzi A, Blondeel K, Toskin I, Kersh EN. External quality assessment to support the WHO ProSPeRo study for the evaluation of two dual HIV/syphilis point-of-care tests in seven countries. BMC Infect Dis 2024; 24:194. [PMID: 38418989 PMCID: PMC10902925 DOI: 10.1186/s12879-024-09027-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/27/2022] [Accepted: 01/17/2024] [Indexed: 03/02/2024] Open
Abstract
BACKGROUND Sexually transmitted infections (STIs) such as syphilis and HIV remain to be a significant public health issue worldwide. Dual rapid point-of-care tests (POCTs) have shown promise for detecting antibodies to HIV and syphilis but have not been fully evaluated in the field. Our study supported the WHO ProSPeRo study on Sexually Transmitted Infection Point-of-Care Testing (STI POCT) by providing external quality assessment (EQA) for HIV and syphilis testing in reference laboratories and their associated clinical sites in seven countries. METHODS HIV/syphilis serum liquid and dried tube specimen (DTS) panels were prepared by CDC. Liquid panels were distributed to the reference laboratories for three rounds of testing using commercially and locally available laboratory-based serological tests. DTS panels were sent to the clinical testing sites for 8 rounds of POC testing using the Abbott SD BIOLINE HIV/Syphilis Duo test (hereafter referred to as SD BIOLINE) and the Chembio Dual Path Platform (DPP) HIV-Syphilis assay. EQA panels were tested at CDC using the Rapid Plasma Reagin (RPR) test and the Treponema pallidum Particle Agglutination assay (TP-PA) for syphilis antibodies. Genetic Systems HIV-1/HIV-2 Plus O EIA, Geenius HIV Supplemental Assay and the Oraquick Advance HIV test were used to detect HIV antibodies in the EQA panels. Results from the reference laboratories and POCT sites were compared to those obtained at the CDC and a percentage agreement was calculated. RESULTS Qualitative RPR and TP-PA performed at the reference laboratories demonstrated 95.4-100% agreement with CDC results while quantitative RPR and TP-PA tests demonstrated 87.7% and 89.2% agreement, respectively. A 93.8% concordance rate was observed for qualitative HIV testing in laboratories. EQA testing at clinical sites using dual tests showed 98.7% and 99.1% agreement for detection of HIV antibodies and eight out of 10 sites had > 95.8% agreement for syphilis testing. However, two clinical sites showed only 65.0-66.7% agreement for SD BIOLINE and 84.0-86.7% for DPP, respectively, for syphilis testing. CONCLUSIONS Overall, laboratories demonstrated high EQA performance in this study. Both HIV/syphilis POCTs gave expected results in the clinic-based evaluations using DTS. However, testing errors were identified in a few testing sites suggesting the necessity for continuous training and monitoring the quality of POC testing.
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Affiliation(s)
- Weiping Cao
- Division of STD Prevention, Centers for Disease Control and Prevention, Atlanta, GA, 30329, USA.
| | - Yetunde F Fakile
- Division of STD Prevention, Centers for Disease Control and Prevention, Atlanta, GA, 30329, USA
| | - Mayur R Shukla
- Division of STD Prevention, Centers for Disease Control and Prevention, Atlanta, GA, 30329, USA
| | - Kevin Pettus
- Division of STD Prevention, Centers for Disease Control and Prevention, Atlanta, GA, 30329, USA
| | - Kathryn Lupoli
- Division of Global HIV &TB, Centers for Disease Control and Prevention, Atlanta, GA, USA
| | - Jaeyoung Hong
- Division of STD Prevention, Centers for Disease Control and Prevention, Atlanta, GA, 30329, USA
| | - Allan Pillay
- Division of STD Prevention, Centers for Disease Control and Prevention, Atlanta, GA, 30329, USA
| | - Ranmini Kularatne
- Centre for HIV & STI, National Institute for Communicable Diseases, Johannesburg, South Africa
| | - Hicham Oumzil
- National Reference Laboratory for HIV, Virology Department, National Institute of Hygiene, and Pedagogy and Research Unit of Microbiology, School of Medicine and Pharmacy, Mohammed V University in Rabat, Rabat, Morocco
| | - Valeska Padovese
- Genitourinary Clinic, Department of Dermatology and Venereology, Mater Dei Hospital, Msida, 2090, Malta
| | - Nigel Sherriff
- School of Sport and Health Sciences, University of Brighton, Brighton, UK
| | - Isaac SSewanyana
- Central Public Health Laboratories, Ministry of Health, Plot 1062, 106 Old Butabika Rd, Kampala, Uganda
| | - Silver K Vargas
- Center for Interdisciplinary Research in Sexuality, AIDS and Society, Universidad Peruana Cayetano Heredia, Lima, Peru
| | - Antonella Zorzi
- Virology and Microbiology Unit, Department of Pathology and Diagnostics, Verona University Hospital, Verona, Italy
- Virology and Microbiology Unit, Department of Molecular Medicine, Padua University Hospital, Padua, Italy
| | - Karel Blondeel
- Department of Sexual and Reproductive Health and Research, UNDP-UNFPA-UNICEF-WHO-World Bank Special Programme of Research, Development and Research Training in Human Reproduction (HRP), World Health Organization, Geneva, Switzerland
- Faculty of Medicine and Health Sciences, Ghent University, Ghent, Belgium
| | - Igor Toskin
- Department of Sexual and Reproductive Health and Research, UNDP-UNFPA-UNICEF-WHO-World Bank Special Programme of Research, Development and Research Training in Human Reproduction (HRP), World Health Organization, Geneva, Switzerland
| | - Ellen N Kersh
- Division of STD Prevention, Centers for Disease Control and Prevention, Atlanta, GA, 30329, USA.
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Soares DC, Filho LCF, Souza dos Reis H, Rodrigues YC, Freitas FB, de Oliveira Souza C, Damacena GN, Véras NMC, Gaspar PC, Benzaken AS, da Felicidade Ribeiro Favacho J, Macedo O, Bazzo ML. Assessment of the Accuracy, Usability and Acceptability of a Rapid Test for the Simultaneous Diagnosis of Syphilis and HIV Infection in a Real-Life Scenario in the Amazon Region, Brazil. Diagnostics (Basel) 2023; 13:diagnostics13040810. [PMID: 36832298 PMCID: PMC9955085 DOI: 10.3390/diagnostics13040810] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/20/2022] [Revised: 01/18/2023] [Accepted: 01/20/2023] [Indexed: 02/23/2023] Open
Abstract
We field-assessed the accuracy, acceptability, and feasibility of the SD BIOLINE HIV/Syphilis Duo rapid diagnostic test in three groups: pregnant women, female sex workers (FSW), and men who have sex with men (MSM). Venous blood samples collected in the field were compared with the respective gold standard methods: SD BIOLINE HIV/Syphilis Duo Treponemal Test versus FTA-abs (Wama brand) treponemal laboratory test for syphilis, and SD BIOLINE HIV/Syphilis Duo Test versus the fourth generation Genscreen Ultra HIV Ag-Ag (Bio-Rad brand) laboratory test for HIV. From a total of 529 participants, 397 (75.1%) were pregnant women, 76 (14.3%) FSW and 56 (10.6%) MSM. Sensitivity and specificity parameters of HIV were 100.0% (95% CI: 82.35-100.0%) and 100.0% (95% CI: 99.28-100.0%), respectively. Sensitivity and specificity parameters found for TP antibody detection were 95.00% (95% CI: 87.69-98.62%) and 100.0% (95% CI: 98.18-100.0%), respectively. The SD BIOLINE HIV/Syphilis Duo Test showed high acceptability among participants (85.87%) and health professionals (85.51%), as well as easy usability by professionals (91.06%). The usability of the SD BIOLINE HIV/Syphilis Duo Test kit would not be a barrier to accessing rapid testing, if the product were incorporated into the list of health service supplies.
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Affiliation(s)
- Daniela Cristina Soares
- Laboratory of Sexually Transmitted Infections, Bacteriology and Mycology Section, Evandro Chagas Institute (IEC), Ananindeua 67030-000, Brazil
- Correspondence:
| | - Luciano Chaves Franco Filho
- Laboratory of Sexually Transmitted Infections, Bacteriology and Mycology Section, Evandro Chagas Institute (IEC), Ananindeua 67030-000, Brazil
| | - Herald Souza dos Reis
- Laboratory of Sexually Transmitted Infections, Bacteriology and Mycology Section, Evandro Chagas Institute (IEC), Ananindeua 67030-000, Brazil
| | - Yan Corrêa Rodrigues
- Laboratory of Sexually Transmitted Infections, Bacteriology and Mycology Section, Evandro Chagas Institute (IEC), Ananindeua 67030-000, Brazil
| | - Felipe Bonfim Freitas
- Retrovirus Laboratory, Virology Section, Evandro Chagas Institute (IEC), Ananindeua 67030-000, Brazil
| | - Cintya de Oliveira Souza
- Laboratory of Sexually Transmitted Infections, Bacteriology and Mycology Section, Evandro Chagas Institute (IEC), Ananindeua 67030-000, Brazil
| | - Giseli Nogueira Damacena
- Institute of Scientific and Technological Communication and Information in Health, Oswaldo Cruz Foundation, Rio de Janeiro 21045-360, Brazil
| | - Nazle Mendonça Collaço Véras
- Department of Diseases of Chronic Condition and Sexually Transmitted Infections, Ministry of Health, Brasilia 70723-040, Brazil
| | - Pamela Cristina Gaspar
- Department of Diseases of Chronic Condition and Sexually Transmitted Infections, Ministry of Health, Brasilia 70723-040, Brazil
| | - Adele Schwartz Benzaken
- Fiocruz Amazônia, Manaus 69057-070, Brazil
- AIDS Healthcare Foudation (AHF), Los Angeles, CA 90028, USA
| | - Joana da Felicidade Ribeiro Favacho
- Laboratory of Sexually Transmitted Infections, Bacteriology and Mycology Section, Evandro Chagas Institute (IEC), Ananindeua 67030-000, Brazil
| | - Olinda Macedo
- Retrovirus Laboratory, Virology Section, Evandro Chagas Institute (IEC), Ananindeua 67030-000, Brazil
| | - Maria Luiza Bazzo
- Graduate Program in Pharmacy, Center for Health Sciences, Federal University of Santa Catarina, Florianópolis 88040-900, Brazil
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Machefsky AM, Loosier PS, Cramer R, Bowen VB, Kersh EN, Tao G, Gift TL, Hogben M, Carry M, Ludovic JA, Thorpe P, Bachmann LH. A New Call to Action to Combat an Old Nemesis: Addressing Rising Congenital Syphilis Rates in the United States. J Womens Health (Larchmt) 2021; 30:920-926. [PMID: 34254848 DOI: 10.1089/jwh.2021.0282] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
Congenital syphilis (CS) is on the rise in the United States and is a growing public health concern. CS is an infection with Treponema pallidum in an infant or fetus, acquired via transplacental transmission when a pregnant woman has untreated or inadequately treated syphilis. Pregnant women with untreated syphilis are more likely to experience pregnancies complicated by stillbirth, prematurity, low birth weight, and early infant death, while their children can develop clinical manifestations of CS such as hepatosplenomegaly, bone abnormalities, developmental delays, and hearing loss. One of the ways CS can be prevented is by identifying and treating infected women during pregnancy with a benzathine penicillin G regimen that is both appropriate for the maternal stage of syphilis and initiated at least 30 days prior to delivery. In this article we discuss many of the challenges faced by both public health and healthcare systems with regards to this preventable infection, summarize missed opportunities for CS prevention, and provide practical solutions for future CS prevention strategies.
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Affiliation(s)
- Aliza M Machefsky
- Division of STD Prevention, Centers for Disease Control and Prevention, Atlanta, Georgia, USA
- Gilstrap Fellowship, CDC Foundation, Atlanta, Georgia, USA
| | - Penny S Loosier
- Division of STD Prevention, Centers for Disease Control and Prevention, Atlanta, Georgia, USA
| | - Ryan Cramer
- Division of STD Prevention, Centers for Disease Control and Prevention, Atlanta, Georgia, USA
| | - Virginia B Bowen
- Division of STD Prevention, Centers for Disease Control and Prevention, Atlanta, Georgia, USA
| | - Ellen N Kersh
- Division of STD Prevention, Centers for Disease Control and Prevention, Atlanta, Georgia, USA
| | - Guoyu Tao
- Division of STD Prevention, Centers for Disease Control and Prevention, Atlanta, Georgia, USA
| | - Thomas L Gift
- Division of STD Prevention, Centers for Disease Control and Prevention, Atlanta, Georgia, USA
| | - Matthew Hogben
- Division of STD Prevention, Centers for Disease Control and Prevention, Atlanta, Georgia, USA
| | - Monique Carry
- Division of STD Prevention, Centers for Disease Control and Prevention, Atlanta, Georgia, USA
| | - Jennifer A Ludovic
- Division of STD Prevention, Centers for Disease Control and Prevention, Atlanta, Georgia, USA
| | - Phoebe Thorpe
- Division of STD Prevention, Centers for Disease Control and Prevention, Atlanta, Georgia, USA
| | - Laura H Bachmann
- Division of STD Prevention, Centers for Disease Control and Prevention, Atlanta, Georgia, USA
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