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Syphilis screening in adolescents.

M L Shew1, J D Fortenberry

  • 1Department of Medicine, University of Oklahoma Health Sciences Center, Oklahoma City 73190.

The Journal of Adolescent Health : Official Publication of the Society for Adolescent Medicine
|June 1, 1992
PubMed
Summary

Routine syphilis screening for all sexually active adolescents yielded few active cases. Targeted screening for high-risk individuals or those with other sexually transmitted diseases is more effective for adolescent syphilis detection.

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Area of Science:

  • Adolescent Medicine
  • Infectious Diseases
  • Public Health

Background:

  • The American Academy of Pediatrics recommends routine syphilis screening for sexually active adolescents.
  • Limited data exist on the clinical utility of these syphilis screening recommendations.

Purpose of the Study:

  • To evaluate the yield of a syphilis screening program in an ambulatory adolescent medicine clinic.
  • To assess the effectiveness of rapid plasma reagin (RPR) testing in identifying active syphilis cases among adolescents.

Main Methods:

  • Screened 630 sexually active adolescents for syphilis using RPR testing.
  • Analyzed results to determine the prevalence of reactive serologies and active syphilis infections.
  • Correlated serological findings with clinical signs and symptoms of syphilis and other sexually transmitted diseases.

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Main Results:

  • Ten patients (1.6%) had reactive syphilis serologies.
  • Four patients (0.6%) had active syphilis infections.
  • Of the 10 reactive results, 6 were false positives or previously treated cases. Only 2 active cases presented with symptoms; the other 2 had other STDs but no syphilis symptoms.

Conclusions:

  • Routine syphilis screening for all sexually active adolescents in this clinic setting had a low yield.
  • Targeted syphilis screening is recommended for adolescents at high risk or those diagnosed with other sexually transmitted diseases.
  • Clinical judgment remains crucial in interpreting screening results and managing adolescent syphilis.