Paving the way for syphilis reverse algorithm diagnostic strategy in the Indian scenario through treponemal POCT

BackgroundThe global burden of syphilis has remained persistently high with globally prevalent cases of syphilis, estimated to be 49.71 million in 2019. In India, where rates of syphilis screening remain sub-optimal, an accurate point-of-care (POC) test is convenient to carry out and guide immediate treatment. Here, we sought to evaluate the performance of an indigenous rapid POC test (Syphicheck -WB).MethodsThis study was carried out in the serology laboratory of our tertiary care center over 2 months. Five hundred serum samples were chosen randomly. Performance parameters of the POC test were calculated in comparison to the Treponema pallidum hemagglutination test, which was considered the reference standard.ResultsOne hundred and six samples (21.2%) were reactive for syphilis by the reference method (TPHA). The sensitivity and specificity of the POC test, were 81.13% and 98.48% respectively. The sensitivity and specificity of the reverse algorithm using POC test for screening, were 81.13% and 99.75% respectively, and of the traditional algorithm using VDRL were 77.36% and 100% respectively.ConclusionThis POC test is a promising candidate as a rapid treponemal screening test. It is likely to improve screening for syphilis under both laboratory as well as field conditions.