Field evaluation of the performance and testing costs of a rapid point-of-care test for syphilis in a red-light district of Manaus, Brazil

Benzaken, Adèle Schwartz; Sabidó, Meritxell; Galbán, Enrique; Pedroza, Valderiza; Vásquez, Felicien Gonçalves; Araújo, Adauto; Peeling, Rosanna W.; Mayaud, Philippe

doi:10.1136/sti.2007.029462

Cited by 35 publications

(47 citation statements)

References 25 publications

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“…This high prevalence is similar to the highest rates observed by other authors with populations labeled as "most vulnerable" to STDs, such as studies with women inmates in São Paulo (5.7%) 14 , adolescents in a correctional system in Espírito Santo (7.8%) 15 , sex workers of the city of Pelotas (7.5% and 6.1% among women and 11.6% among men) 16 , people seen in an STD clinic in Manaus (7.5%) 17 multicenter study involving 10 Brazilian cities, with sex workers (16.4%) 18 . A positive aspect found in our study was that a significant portion of the group (53.7%) is inserted in educational activities.…”

Section: Discussionmentioning

confidence: 83%

Prevalence of Syphilis and associated factors in homeless people of Sao Paulo, Brazil, using a Rapid Test

Pinto

Tancredi

Alencar

et al. 2014

Rev. bras. epidemiol.

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Introduction: Homeless people are a vulnerable group to sexually transmitted diseases (STD) with high prevalence of syphilis and hepatitis. Objectives: To estimate the prevalence of syphilis infection and its association with risky behaviors for STDs in a sample of homeless people, and to assess the feasibility of the use of rapid syphilis test (RST) in this population. Methods: Cross-sectional study, in a convenience sample of homeless people assisted in social support services of São Paulo, between 2006 and 2007. A structured questionnaire was applied and RST was performed. In addition, a blood sample for syphilis detection was also collected. The sensitivity and specificity of the RST was estimated using conventional laboratory diagnosis (VDRL + TPHA) as reference. Results: 1,405 volunteers were included in the study. The prevalence rate of syphilis was 7.0%, and was associated with homosexual practices (OR adj 4.9; 95%CI 2.6 -9.4), prior history of STD (OR adj 2.6; 95%CI 1.7 -4.0) and with self-referred non-white race (OR adj 1.9; 95%CI 1.1 -3.4). The sensitivity and specificity of the RST for syphilis were, respectively, 81.4 and 92.1%. Conclusion: The high prevalence of syphilis infection among homeless people shows the need for actions for its control and the utilization of RST that can be considered an efficient strategy due to its sensitivity and specificity. Public Health policymakers must strengthen actions for syphilis control, with screening tests for syphilis and early treatment, decreasing morbidity with the improvement of sexual and reproductive health of the population in general and especially the most vulnerable.

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Section: Discussionmentioning

confidence: 83%

Prevalence of Syphilis and associated factors in homeless people of Sao Paulo, Brazil, using a Rapid Test

Pinto

Tancredi

Alencar

et al. 2014

Rev. bras. epidemiol.

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“…Tests that could overcome this main technological handicap would be welcomed. Barriers to testing that need to be addressed are the pain caused by the fi nger puncture and poor knowledge of syphilis in a clearly high-risk population (6). The main study limitation is the possible selection bias of the target population who sought testing at the clinic.…”

Section: Discussionmentioning

confidence: 99%

“…The study was undertaken within a larger fi eld evaluation of a novel POC test for the detection of treponemal antibodies (VisiTect Syphilis, Omega Diagnostics, Alloa, Scotland) ( Figure 1) in a sexually transmitted infections clinic located in a "red-light" area near the harbor of Manaus, Brazil (6). Before the evaluation, all staff were trained in the use of the test.…”

Section: The Studymentioning

confidence: 99%

Rapid Point-of-Care Diagnostic Test for Syphilis in High-Risk Populations, Manaus, Brazil

Sabidó¹,

Benzaken²,

de-Andrade-Rodrigues³

et al. 2009

Emerg. Infect. Dis.

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We assessed the acceptability and operational suitability of a rapid point-of-care syphilis test and identifi ed barriers to testing among high-risk groups and healthcare professionals in a sexually transmitted infections clinic in Manaus, Brazil. Use of this test could considerably alleviate the impact of syphilis in hard-to-reach populations in the Amazon region of Brazil.T he new generation of rapid point-of-care (POC) syphilis diagnostic tests has shown good reliability and can be performed in any clinical setting. These tests can provide fast results during a patient's initial visit (1).Implementation of syphilis screening programs can be hampered by operational and technical diffi culties (2-4) such as inadequate training, poor supervision, inconsistent quality control, disruptions in receiving medical supplies, and erratic electricity or refrigeration facilities needed to perform the test or store its reagents (5). Patients' barriers to testing are often structural (accessibility and clinic hours) or fi nancial (4). Further, test-seeking behavior can be negatively affected by the silent nature of the infection, the patient's limited syphilis-related knowledge, and the perceived quality of healthcare provided. Overcoming any of these barriers would result in increased accessibility of services to those most in need and effective implementation of testing within often fragile healthcare systems located in resource-limited countries. The StudyThe study was undertaken within a larger fi eld evaluation of a novel POC test for the detection of treponemal antibodies (VisiTect Syphilis, Omega Diagnostics, Alloa, Scotland) ( Figure 1) in a sexually transmitted infections clinic located in a "red-light" area near the harbor of Manaus, Brazil (6). Before the evaluation, all staff were trained in the use of the test. One month after the start of syphilis screening, 10 clinical staff and 2 laboratory technicians were interviewed to identify factors that facilitated or impeded performance of the test.Over a 6-week period, 60 patients, who had given informed oral consent, were interviewed while awaiting test results. The questionnaire was designed to examine reasons and potential barriers for syphilis testing, participant satisfaction with the information and attention received, and syphilis knowledge.A separate subsample of consecutive patients, who were not interviewed, participated in a time-fl ow analysis. At all stages of the consultation, staff recorded, on forms given to the patient, the exact start and fi nish time of contact with the patient and the number of minutes required to perform each task with the patient (Figure 2). Time difference between tasks is the waiting time.Descriptive analysis of quantitative data was done by using STATA version 9.0 (StataCorp, College Station, TX, USA). Detailed notes on qualitative items were analyzed thematically, coded, and categorized according to underlying themes included in the questionnaire. Categorized information was classifi ed into 5 themes (confi dence in test re...

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“…A lower sensitivity was found for a whole blood in comparison with serum or plasma. Additionally, the sensitivity was lower in the field conditions than in assay performed in the laboratory (Benzaken et al, 2008;Mabey et al, 2006a;Mishra et al, 2010). Determine Syphilis TP (Abbott) has recombinant antigen TpN47 immobilized on nitrocellulose strips and use 50uL of sample, either whole blood, serum or plasma and results can be read in 5 to 20 minutes.…”

Section: Treponema Specific Rapid Diagnostic Test (Point Of Care -Poc)mentioning

confidence: 99%

“…A finger prick blood samples were tested with Visitec Syphilis to assess the performance of this rapid test to o detect syphilis in field evaluation of high risk populations. Visitec Syphilis test had identified 79% (30/38) of active syphilis cases (Benzaken et al, 2008). Qualpro Syphicheck-WB rapid syphilis test (Qualpro Diagnostic, India) use two recombinant antigens TpN17 and TpN47 to capture specific antibodies.…”

Section: Treponema Specific Rapid Diagnostic Test (Point Of Care -Poc)mentioning

confidence: 99%

Laboratorial Diagnosis of Syphilis

Sato¹

2011

Syphilis - Recognition, Description and Diagnosis

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Field evaluation of the performance and testing costs of a rapid point-of-care test for syphilis in a red-light district of Manaus, Brazil

Abstract: VisiTect Syphilis had low sensitivity in field use and was less cost effective than conventional VDRL. However, rapid and correct identification of a high proportion of active syphilis cases combined with operational characteristics suggest a role in high risk populations.

Cited by 35 publications

References 25 publications

Prevalence of Syphilis and associated factors in homeless people of Sao Paulo, Brazil, using a Rapid Test

Prevalence of Syphilis and associated factors in homeless people of Sao Paulo, Brazil, using a Rapid Test

Rapid Point-of-Care Diagnostic Test for Syphilis in High-Risk Populations, Manaus, Brazil

Laboratorial Diagnosis of Syphilis

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