International Journal of STD & AIDS > Volume 19, Number 5 > Pp. 316-320

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Original research articles

Field evaluation of simple rapid tests in the diagnosis of syphilis

Khairun Nessa MBBS PhD ^*, Anadil Alam MBBS MPH ^*, Faisal Arif Hasan Chawdhury MSc ^*, Mohsina Huq MSc ^*, Shamsun Nahar MSc , Gazi Salauddin MSc ^*, Shayema Khursheed MBBS ^*, Saifur Rahman MBBS MPH ^*, Emily Gurley MPH ^*, Robert F Breiman MD PhD ^* and Motiur Rahman MBBS PhD ^* 

^* International Centre for Diarrhoeal Disease Research, GPO Box 128, Dhaka 1000; Department of Microbiology, Jahangirnagar University, Savar, Dhaka, Bangladesh

Correspondence to: Dr Motiur Rahman, Associate Director, Laboratory Sciences Department, Family Health International, Asia Pacific Regional Office, 19th Floor, Tower 3, Sindhorn Building, 130–132 Wireless Road, Lumpini, Bangkok 10330, Thailand Email: mrahman{at}fhibkk.org

The aim of this study was to detect the sensitivity and specificity of rapid syphilis diagnostic tests (immunochromatographic strip [ICS] test and rapid test device [RTD]) performed by low-skilled paramedics in field clinics and by highly-skilled technologists in laboratories and compare them with the gold standard (rapid plasma reagin [RPR] and Treponema pallidum haemagglutination [TPHA]) tests for diagnosis of syphilis. A cross-sectional study was conducted among female sex workers (FSWs) in Dhaka, Bangladesh, from August 2004 to July 2005. Blood specimens were tested for syphilis using (i) ICS, (ii) RTD, (iii) RPR tests performed by low-skilled paramedics; and (i) ICS, (ii) RTD, (iii) RPR and (iv) TPHA tests by highly-skilled technologists. The sensitivity and specificity of the ICS and RTD test performed by low- and highly-skilled personnel were compared with the gold standard. A total of 684 FSWs were enrolled and the prevalence of syphilis among FSWs was 20.8% as determined by the gold standard. There was no significant difference in the performance of ICS test done by paramedics in the field when compared with the gold standard performed by highly-skilled technologists in the laboratory (sensitivity, 94.45%; specificity, 92.6%). The ICS test could fulfil the need for a non-invasive, rapid screening test for syphilis.

Key Words: syphilis • immunochromatographic strip test • rapid test device • sex workers • Bangladesh

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