International Journal of STD & AIDS > Volume 19, Number 12 > Pp. 838-842

This Article Figures Only Full Text Full Text (PDF) Alert me when this article is cited Alert me if a correction is posted Services Email this article to a friend Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Download to citation manager Citing Articles Citing Articles via Google Scholar Google Scholar Articles by Yin, Y-P Articles by Cohen, M S Search for Related Content PubMed PubMed Citation Social Bookmarking                      What's this?

Original research articles

Improving strategies for syphilis control in China: selective testing of sexually transmitted disease patients – too little, too late?

Y-P Yin PhD ^*, S P Y Wong BA ^* , M-S Liu MD ^*, W-H Wei MT ^*, Y-H Yu MT ^*, X Gao MD ^**, Q Chen MD ^*, Z-Z Fu BA , F Cheng PhD , X-S Chen MD ^** and M S Cohen MD  

^* National STD Reference Laboratory and; ^** Department of STD Epidemiology, National Center for STD Control, Chinese Academy of Medical Sciences and Peking Union Medical College Institute of Dermatology, Nanjing, China; University of Pittsburgh School of Medicine, Pittsburgh, PA, USA; Department of STD Control of Guangxi Autonomous Region Institute of Dermatology, Nanjing; Family Health International Country Office in China, Beijing, China; Division of Clinical Infectious Disease, University of North Carolina Chapel Hill School of Medicine, Chapel Hill, NC, USA

Correspondence to: Dr Xiang-Sheng Chen, National Center for STD Control, China CDC, 12 Jiangwangmiao Road, Nanjing, Jiangsu, China 210042 Email: chenxs{at}vip.163.com

Syphilis testing guidelines in China are usually based on symptomatic criteria, overlooking risk assessment and ultimately opportunities for disease detection and control. We used data from 10,695 sexually transmitted disease (STD) clinic patients in Guangxi, China, to assess the efficacy of a potential screening tool inquiring about behavioural and health risk factors in identifying the STD patients who should not be triaged for syphilis testing under current guidelines, but on the contrary receive such testing. Validity testing of the screening tool was performed and receiver-operating characteristic curves were plotted to determine an optimal total risk score cut-off for testing. About 40.9% of patients with positive toluidine red unheated serum test and Treponema pallidum particle agglutination test did not show hallmark signs of syphilis. The screening tool was more sensitive in detecting infection in non-triaged male versus female patients (highest sensitivity = 90% vs. 55%) and the cut-off score to warrant testing was lower in non-triaged female patients than in non-triaged male patients (cut-off = 1 vs. 2). Most of the cases were missed among female STD patients. In spite of selective testing based on behavioural and health indicators that improve case detection, cases were still missed. Our study supports universal testing for syphilis in the STD population.

Key Words: syphilis • screening • STD patients • China

CiteULike    Complore    Connotea    Del.icio.us    Digg    Reddit    Technorati    What's this?