Syphilis screening in out-of-hospital care

To estimate the rates of syphilis infection in inner-city patients managed by prehospital providers, a convenience sampling of prehospital patients who had intravenous lines initiated was screened for syphilis over a nine-month study period from February 1992 through October 1992. In a university-affiliated inner-city emergency department served by a city ambulance company, patients 18 years of age or older transported via ambulance who had had intravenous lines initiated at the scene or en route had a Venereal Disease Research Laboratory (VDRL) and microhemagglutination-Treponema pallidum (MHA-TP) drawn and performed by the state laboratory as a routine serological test. If the results were reactive with no previous history of syphilis recorded in the state registry, the state health department and/or one of the authors of this study contacted the patient for follow-up treatment. Age, race, sex, and diagnostic category (medical, surgical/obstetric, or neuropsychiatric) were recorded. Results were checked with the state syphilis registry. Latent syphilis was defined as a reactive VDRL and MHA-TP with no prior history of infection or record of infection in the state syphilis registry. Chi-squared test was used in statistical analysis for comparisons among ages, races, and sexes, with P > .05 considered significant. Three hundred two subjects 18 years of age and older consenting to a screening VDRL and MHA-TP had serum drawn. Two hundred seventy-nine patients were enrolled in the study after 23 patients were excluded because of improper data collection or insufficient serum collection. There were 174 men (63%) and 105 women (37%), with 73 white (26%) and 199 African-Americans (71%).(ABSTRACT TRUNCATED AT 250 WORDS)