Point-of-Care Syphilis Testing: Implementation and Future Direction

Syphilis is caused by Treponema Pallidum and continues to be a significant cause of morbidity across the world with an increase in prevalence over the past two decades. This review aims to highlight rapid, point-of-care (POC) syphilis testing, which offers an innovative approach to improve access to syphilis testing among underserved communities.

POC syphilis testing can potentially shorten the time to treatment. Currently available tests generally have high sensitivity and specificity and report the presence or absence of treponemal antibodies and are not designed to perform non-treponemal antibody testing. Therefore, the main challenge of POC syphilis testing is the inability to distinguish between current infection and a past treated infection. In real-world settings, syphilis POC testing has been acceptable and generally accurate. POC syphilis testing has significant potential to improve access to care and would be most effective in non-clinical settings without readily available access to clinical services. This includes rural settings and other areas that have populations with significant barriers to healthcare, and especially among populations with a historically lower rate of diagnosed syphilis, including pregnant women. Keys to successful implementation include awareness and education on how to perform the test and interpret results, as well as use in suitable settings and among appropriate populations.