Sex differences in the significance of isolated reactive treponemal chemiluminescence immunoassay results

2017 ◽  
Vol 94 (3) ◽  
pp. 187-191
Author(s):  
Rohan I Bopage ◽  
Ute Vollmer-Conna ◽  
Antonia W Shand ◽  
Jeffrey John Post
Keyword(s):  
Pregnant Women ◽  
Descriptive Analysis ◽  
Significant Proportion ◽  
Serological Tests ◽  
Syphilis Infection ◽  
Chemiluminescence Immunoassay ◽  
Immunoblot Assay ◽  
History Of ◽  
Record Review ◽  
Positive Results

ObjectivesThe significance of sera with isolated reactive treponemal chemiluminescence immunoassay (IRTCIA) results is unclear. Women have this phenotype more commonly than men. Most cohorts examining this phenotype have included predominantly men and have demonstrated evidence of past or subsequently confirmed syphilis infection in a significant proportion of cases. We hypothesised that a proportion of sera with IRTCIA results would be positive on immunoblot testing and that sera from women with IRTCIA would have different results in immunoblot testing than men.MethodsIRTCIA sera from a tertiary referral serology laboratory serving multiple clinical sites were analysed with a syphilis line immunoblot assay (LIA) and analysed by sex. Logistic regression was undertaken to assess factors associated with LIA status. Medical record review and descriptive analysis of a separate cohort of women with the IRTCIA phenotype from a single campus was also undertaken.ResultsOverall, 19/63 (30.1%) subjects with the IRTCIA phenotype were positive in the LIA, including 13 men and 6 women. Women were significantly less likely to have definitive results (positive or negative) than men (p=0.015). Pregnant women were less likely than non-pregnant women to have a negative LIA result (OR 0.57; p=0.03). Record review of 22 different women with IRTCIA reactivity showed that 2/22 (9.1%) had HIV and previous syphilis infection, 15/22 (68.2%) were pregnant and 3 (13.6%) had autoimmune disease.ConclusionsA significant proportion of sera with IRTCIA results on serological tests are reactive on LIA testing and some may not be false positive results. The interpretation of IRTCIA results should be undertaken in conjunction with an assessment of factors such as sex, pregnancy, a history of syphilis and other STIs and syphilis risk.

scholarly journals High susceptibility to varicella among urban and rural pregnant women in South India: a brief report

2021 ◽  
Vol 149 ◽  
Author(s):  
Leeberk Raja Inbaraj ◽  
Sindhulina Chandrasingh ◽  
Nalini Arun Kumar ◽  
Jothi Suchitra ◽  
Abi Manesh
Keyword(s):  
Pregnant Women ◽  
South India ◽  
Significant Proportion ◽  
Prevalence Ratio ◽  
Epidemiological Studies ◽  
Lethal Outcome ◽  
Factors Associated ◽  
Rural And Urban ◽  
History Of ◽  
Secondary Hospital

Abstract Varicella infection during pregnancy has serious and/or difficult implications and in some cases lethal outcome. Though epidemiological studies in developing countries reveal that a significant proportion of patients may remain susceptible during pregnancy, such an estimate of susceptible women is not known in India. We designed this study to study the prevalence and factors associated with susceptibility to varicella among rural and urban pregnant women in South India. We prospectively recruited 430 pregnant women and analysed their serum varicella IgG antibodies as surrogates for protection. We estimated seroprevalence, the validity of self-reported history of chickenpox and factors associated with varicella susceptibility. We found 23 (95% CI 19.1–27.3) of women were susceptible. Nearly a quarter (22.2%) of the susceptible women had a history of exposure to chickenpox anytime in the past or during the current pregnancy. Self-reported history of varicella had a positive predictive value of 82.4%. Negative history of chickenpox (adjusted prevalence ratio (PR) 1.85, 95% CI 1.15–3.0) and receiving antenatal care from a rural secondary hospital (adjusted PR 4.08, 95% CI 2.1–7.65) were significantly associated with susceptibility. We conclude that high varicella susceptibility rates during pregnancy were noted and self-reported history of varicella may not be a reliable surrogate for protection.

High Rate of Negative Results of Tuberculin and QuantiFERON Tests Among Individuals With a History of Positive Skin Test Results

2006 ◽  
Vol 27 (5) ◽  
pp. 436-441 ◽  
Author(s):  
Lloyd N. Friedman ◽  
Esther R. Nash ◽  
June Bryant ◽  
Susan Henry ◽  
Julia Shi ◽  
...  
Keyword(s):  
Skin Test ◽  
Significant Proportion ◽  
High Rate ◽  
Negative Group ◽  
Tuberculosis Screening ◽  
Positive Skin ◽  
Screening Programs ◽  
History Of ◽  
Positive Results

Objectives.To evaluate individuals at high risk for tuberculosis exposure who had a history of a positive tuberculin skin test (TST) result in order to determine the prevalence of unsuspected negative TST results. To confirm these findings with the QuantiFERON-TB test (QFT), an in vitro whole-blood assay that measures tuberculin-induced secretion of interferon-γ.Methods.This survey was conducted from November 2001 through December 2003 at 3 sites where TST screening is regularly done. Detailed histories and reviews of medical records were performed. TSTs were placed and read by 2 experienced healthcare workers, and blood was drawn for QFT. Any subject with a negative result of an initial TST during the study (induration diameter, <10 mm) underwent a second TST and a second QFT. The TST-negative group comprised individuals for whom both TSTs had an induration diameter of <10 mm. The confirmed-negative group comprised individuals for whom both TSTs yielded no detectable induration and results of both QFTs were negative.Results.A total of 67 immunocompetent subjects with positive results of a previous TST were enrolled in the study. Of 56 subjects who completed the TST protocol, 25 (44.6%; 95% confidence interval [CI], 31.6%-57.6%) were TST negative (P<.001). Of 31 subjects who completed the TST protocol and the QFT protocol, 8 (25.8%; 95% CI, 10.4%-41.2%) were confirmed negative (P<.005).Conclusions.A significant proportion of subjects with positive results of a previous TST were TST negative in this study, and a subset of these were confirmed negative. These individuals' TST status may have reverted or may never have been positive. It will be important in future studies to determine whether such individuals lack immunity to tuberculosis and whether they should be considered for reentry into tuberculosis screening programs.

scholarly journals Assessment of syphilis infection among pregnant women and its associated risk factors at Sovu health center in Rwanda

2020 ◽  
Vol 1 (3) ◽  
Author(s):  
Augustin Nshimiyimana ◽  
Joseph Mucumbitsi ◽  
Callixte Yadufashije ◽  
Francois N. Niyonzima
Keyword(s):  
Risk Factors ◽  
Pregnant Women ◽  
Health Center ◽  
Sexual Behaviors ◽  
Treponema Pallidum ◽  
Health Concern ◽  
Syphilis Infection ◽  
Cross Sectional ◽  
History Of ◽  
Associated Risk Factors

Syphilis in pregnant women caused by Treponema pallidum remains a major cause of reproductive morbidity and poor pregnancy outcomes in developing countries. Severe neonatal infections, stillbirths, perinatal deaths, and low birth weight babies are common among mothers with syphilis infection. The aim of the study was to assess the prevalence and risk factors associated to syphilis in pregnant women. A cross-sectional and retrospective studies were conducted among pregnant women who attended the prenatal service at the Gisovu health center. Participants were pregnant women who tested positive for syphilis based on lab results and responses collected from anonymous questionnaires completed with sexual behaviors, demographics, sexual partners, history of abortion, and knowledge about STDs. The prevalence of syphilis was 5.74%. Syphilis was associated to the history of previous abortion (P = 0.005 < 0.05), a low level of education (P = 0.049 < 0.05), and marital status (P = 0.044 < 0.05). The main associated behavioral factor was women who had sex with different partners using condom and did not acquire syphilis infection (P = 0.00 < 0.05). Syphilis is still a public health concern in patients and especially in pregnant women as shown by the findings of this study. It is very important to screen all pregnant women for syphilis and to strengthen the existing antenatal care services and health education on transmission and prevention of the disease.

scholarly journals Contact tracing of syphilis-seropositive pregnant women and syphilis-infection among their male partners in Bao'an District, Shenzhen, China

2020 ◽  
Author(s):  
Rui-lin Yan ◽  
Bao-qing Deng ◽  
Gui-chun Wen ◽  
Li-cheng Huang ◽  
Li-mei Li ◽  
...  
Keyword(s):  
Drug Abuse ◽  
Pregnant Women ◽  
Contact Tracing ◽  
Male Partners ◽  
Related Factors ◽  
Syphilis Infection ◽  
First Sex ◽  
History Of ◽  
Syphilis Screening ◽  
Antenatal Clinics

Abstract Background: Untreated male partners are a critical source of maternal re-infection. Contact tracing is a good way to identify infection among partners and reduce risk of mother-to-child transmission related to maternal re-infection. This study aimed to analyze the current situation and related factors of contact tracing of syphilis-seropositive pregnant women and syphilis-infection among their male partners.Method: Data of syphilis-seropositive pregnant women and their male partners attending clinic for syphilis-screening were obtained from the Shenzhen Program for Prevention of Congenital Syphilis. Contact tracing rate of syphilis-seropositive pregnant women and syphilis prevalence among male partners were counted, and related factors were also analyzed using a random-effects logistic regression model.Result: Of the 1299 syphilis-seropositive pregnant women, 74.1% (963/1299) had their male partners receiving syphilis-screening and 19.1% (184/963) of male partners were syphilis-infected. For pregnant women, being divorced (adjusted odds ratio [AOR] =0.39; 95%CI: 0.17-0.87), seeking for emergency services at their first antenatal clinics visits (AOR=0.58; 95%CI: 0.44-0.77), reporting willingness to notify partner(AOR=7.65; 95%CI: 4.69-12.49), multi-partners (AOR= 1.38; 95%CI:1.03-1.86) and having a history of drug abuse (AOR=0.37; 95%CI: 0.14-1.00)were independently associated with successful contact tracing. For male partners, of minority ethnicity (AOR=4.15; 95%CI: 1.66-10.34), age at first sex＞20(AOR=0.57; 95%CI: 0.37-0.87), reporting multi-partners (AOR = 1.60; 95%CI: 1.04-2.46), having a history of drug abuse (AOR=4.07; 95%CI: 1.31-12.64) were independently associated with syphilis-infection. In addition, pregnant women with TRUST titer ≥1:8 (AOR=2.81; 95%CI: 1.87-4.21), having a history of adverse pregnancy outcomes (AOR=1.70; 95%CI: 1.14-2.53), reporting multi-partners (AOR=0.43; 95%CI: 0.29-0.64) and reporting the current partner as the source of syphilis (AOR=5.05; 95%CI: 2.82-9.03) were independently associated with partners' syphilis-infection.Conclusion: Contact tracing is feasible and effective in identifying syphilis-infected partners among syphilis-seropositive pregnant women. Contact tracing is associated with many factors such as women's marital status, services at their first antenatal clinics visit and willingness of partner notification. Partners' ethnicity, age at first sex, multi-partners and history of drug abuse as well as women's levels of TRUST titer were associated with partners' syphilis-infection.

scholarly journals Tinjauan Karakteristik Ibu Hamil Dengan Preklamsi Dan Anemia Di Kota Bandung, Kabupaten Cirebon, Kabupaten Kuningan

2021 ◽  
Vol 3 (4) ◽  
pp. 636-642
Author(s):  
Liliek Pratiwi ◽  
Harnanik Nawangsari
Keyword(s):  
Pregnant Women ◽  
Sleep Disturbances ◽  
Health Workers ◽  
Descriptive Analysis ◽  
Sampling Technique ◽  
Cross Sectional ◽  
Detection And Identification ◽  
History Of ◽  
Quota Sampling ◽  
And Control

ABSTRACT : REVIEW OF THE CHARACTERISTICS OF PREGNANT MOTHERS WITH PRECLAMATION AND ANEMIA IN BANDUNG CITY CIREBON REGENCY, KUNINGAN REGENCY Background: Preeclampsia and anemia in pregnant women are still common and cause maternal mortality to increase. Late help is still found because pregnant women are not detected early. Anemia can cause shortness of breath, fatigue, palpitations, bleeding disorders during labor, sleep disturbances and sepsis. Pre-eclampsia is one of the direct causes of maternal death, the incidence of pre-eclampsia initially does not provide symptoms and signs, but at one time it can deteriorate rapidly, so it takes a series of examinations, detection, and identification of risk factors and control them so as to enable complex primary prevention.Objective: This study will provide an overview of the characteristics of pregnant women with preeclampsia and anemia in Bandung City, Cirebon Regency and Kuningan Regency.Research Methods: This study uses descriptive analysis, with a cross sectional approach, is retrospective in nature, observing the results of medical records. The population is pregnant women with preeclampsia and anemia in Bandung City, Cirebon Regency and Kuningan Regency, the pregnancy period from October 2020 to February 2021 is 489. The inclusion criteria for this study were pregnant women from trimester 1 to trimester 3 who experienced preeclampsia and anemia. The sampling technique is using quota sampling. The number of samples is 110 respondents. Exclusion criteria in this study were pregnant women with a history of congenital disease, being infected and other pregnancy complications besides anemia and preeclampsia.Results: Characteristics of pregnant women with preeclampsia and anemia in Bandung City, Cirebon Regency and Kuningan Regency, the majority of pregnant women experiencing preeclampsia, preceded by a history of preeclampsia in a previous pregnancy of 34.6%, primiparous status 18.1% and having hypertension. ,3%. The majority of pregnant women who experience anemia are with multiparous status of 28.1% and often occur when stepping on the 3rd trimester, as well as mothers who do not consume Fe tablets.Conclusion: So, by looking at these results, the outcome for the future is a proactive effort to screen pregnant women at risk in several areas by involving health workers, the community and other researchers as well as volunteers, for the sake of maternal and child health. Keywords: Preeclampsia, Anemia, Bandung City, Cirebon Regency, Kuningan RegencyINTISARI: TINJAUAN KARAKTERISTIK IBU HAMIL DENGAN PREKLAMSI DAN ANEMIA DI KOTA BANDUNG, KABUPATEN CIREBON, DAN KABUPATEN KUNINGAN Latar Belakang: Preklamsia dan anemia ibu hamil masih sering terjadi dan menyebabkan Angka Kematian Ibu meningkat. Pertolongan yang terlambat masih ditemukan karena ibu hamil tidak terdeteksi lebih awal. Anemia dapat mengakibatkan sesak nafas, fatigue, palpitasi, gangguan pendarahan selama persalinan, sampai gangguan tidur dan sepsis. Pre Eklamsi merupakan salah satu penyebab langsung kematian ibu, kejadian pre eklamsi pada awalnya tidak memberikan gejala dan tanda, namun pada suatu ketika dapat memburuk dengan cepat, sehingga butuh serangkaian pemeriksaan, deteksi, dan identifikasi faktor risiko serta mengontrolnya sehingga memungkinkan dilakukan pencegahan primer yang kompleksTujuan: Dalam penelitian ini akan memberikan gambaran tinjauan karakteristik ibu hamil dengan preklamsia dan anemia di Kota Bandung, Kabupaten Cirebon dan Kabupaten Kuningan.Metode Penelitian: Pada penelitian ini menggunakan analisis deskriptif, dengan pendekatan cross sectional, bersifat retrospektif, observasi dari hasil rekam medis. Populasi yaitu ibu hamil dengan preklamsia dan anemia di Kota Bandung, Kabupaten Cirebon dan Kabupaten Kuningan, periode kehamilan dari bulan Oktober tahun 2020 sampai Februari tahun 2021 yaitu 489. Kriteria inklusi penelitian ini adalah ibu hamil trimester 1 sampai trimester 3 yang mengalami preklamsia dan anemia. Teknik sampling yaitu menggunakan kuota sampling. Jumlah sampel adalah 110 responden. Kriteria eksklusi dalam penelitian ini yaitu ibu hamil dengan riwayat penyakit bawaan, sedang terinfeksi dan komplikasi kehamilan lainnya selain anemia dan preklamsia.Hasil: Karakteristik ibu hamil dengan preklamsia dan anemia di Kota Bandung, Kabupaten Cirebon dan Kabupaten Kuningan., mayoritas ibu hamil yang mengalami preklamsia, didahului dengan riwayat preklamsia pada kehamilan sebelumnya sebesar 34,6%, status primipara 18,1% serta memiliki hipertensi 16,3%. Mayoritas ibu hamil yang mengalami anemia yaitu dengan status multipara sebesar 28,1% dan sering terjadi Ketika menginjak trimester 3, serta ibu yang tidak mengkonsumsi tablet Fe.Kesimpulan: Jadi, dengan melihat hasil ini, outcome untuk ke depannya yaitu adanya upaya pro aktif penjaringan wanita hamil dengan risiko di beberapa daerah dengan melibatkan tenaga Kesehatan, masyarakat dan penelitia lain serta relawan, demi Kesehatan ibu dan anak. Kata Kunci:  Preklamsia, Anemia, Kota Bandung, Kabupaten Cirebon, Kabupaten Kuningan

scholarly journals Cognitive function, depressive symptoms and syphilis in HIV-positive and HIV-negative individuals

2019 ◽  
Vol 30 (5) ◽  
pp. 440-446 ◽  
Author(s):  
Davide De Francesco ◽  
Alan Winston ◽  
Jonathan Underwood ◽  
Fiona V Cresswell ◽  
Jane Anderson ◽  
...  
Keyword(s):  
Depressive Symptoms ◽  
Cognitive Function ◽  
Cognitive Test ◽  
People Living With Hiv ◽  
Serological Tests ◽  
Syphilis Infection ◽  
Patient Health ◽  
History Of ◽  
Negative Controls ◽  
Hiv Negative

We evaluated associations between history of syphilis infection and both cognitive function and depressive symptoms in people living with HIV (PLHIV) and comparable HIV-negative controls. Syphilis serological tests, cognitive function and depression were assessed in PLHIV and controls participating in the Pharmacokinetic and Clinical Observations in People Over Fifty study. Cognitive test scores were converted to demographically adjusted T-scores (mean = 50, SD = 10) and then averaged to obtain a global T-score. Severity of depressive symptoms was assessed via the Patient Health Questionnaire-9. Associations of syphilis with global T-scores and depression were assessed using median regression. The 623 PLHIV and 246 HIV-negative controls were predominantly male (89.3% and 66.5%) with median age (interquartile range [IQR]) of 57 (53–63) and 58 (53–63) years, respectively. PLHIV had lower global cognitive T-scores (median [IQR] 48.7 [45.1, 52.1] versus 50.5 [47.0, 53.9], p < 0.001), more severe depressive symptoms (median [IQR] 4 [1, 10] versus 1 [0, 3], p < 0.001) and were more likely to report history of syphilis infection (22.0% versus 8.1%) than controls. There was no significant association between history of syphilis and global cognitive function in either PLHIV (p = 0.69) or controls (p = 0.10). Participants with a history of syphilis had more severe depressive symptoms (median [IQR] 4 [1, 9] versus 2 [0, 8], p = 0.03); however, the association became non-significant (p = 0.62) after adjusting for HIV status and potential confounders. Despite the higher prevalence of syphilis infection in PLHIV, there was no evidence of an association between history of syphilis infection and impaired cognitive function nor depressive symptoms after accounting for potential confounders.

scholarly journals Contact tracing of syphilis-seropositive pregnant women and syphilis-infection among their male partners in Bao'an district, Shenzhen, China

2020 ◽  
Vol 20 (1) ◽  
Author(s):  
Ruilin Yan ◽  
Baoqing Deng ◽  
Guichun Wen ◽  
Licheng Huang ◽  
Limei Li ◽  
...  
Keyword(s):  
Drug Abuse ◽  
Pregnant Women ◽  
Contact Tracing ◽  
Male Partners ◽  
Related Factors ◽  
Syphilis Infection ◽  
First Sex ◽  
History Of ◽  
Syphilis Screening ◽  
Antenatal Clinics

Abstract Background Untreated male partners are a critical source of maternal re-infection. Contact tracing is a good way to identify infection among partners and reduce risk of mother-to-child transmission related to maternal re-infection. This study aimed to analyze the current situation and related factors of contact tracing of syphilis-seropositive pregnant women and syphilis-infection among their male partners. Method Data of syphilis-seropositive pregnant women and their male partners attending clinic for syphilis-screening were obtained from the Shenzhen Program for Prevention of Congenital Syphilis. Contact tracing rate of syphilis-seropositive pregnant women and syphilis prevalence among male partners were counted, and related factors were also analyzed using a random-effects logistic regression model. Result Of the 1299 syphilis-seropositive pregnant women, 74.1% (963/1299) had their male partners receiving syphilis-screening and 19.1% (184/963) of male partners were syphilis-infected. For pregnant women, being divorced (adjusted odds ratio [AOR] =0.39; 95%CI: 0.17–0.87), seeking for emergency services at their first antenatal clinics visits (AOR = 0.58; 95%CI: 0.44–0.77), reporting willingness to notify partner(AOR = 7.65; 95%CI: 4.69–12.49), multi-partners (AOR = 1.38; 95%CI:1.03–1.86) and having a history of drug abuse (AOR = 0.37; 95%CI: 0.14–1.00)were independently associated with successful contact tracing. For male partners, of minority ethnicity (AOR = 4.15; 95%CI: 1.66–10.34), age at first sex>20(AOR = 0.57; 95%CI: 0.37–0.87), reporting multi-partners (AOR = 1.60; 95%CI: 1.04–2.46), having a history of drug abuse (AOR = 4.07; 95%CI: 1.31–12.64) were independently associated with syphilis-infection. In addition, pregnant women with TRUST titer ≥1:8 (AOR = 2.81; 95%CI: 1.87–4.21), having a history of adverse pregnancy outcomes (AOR = 1.70; 95%CI: 1.14–2.53), reporting multi-partners (AOR = 0.43; 95%CI: 0.29–0.64) and reporting the current partner as the source of syphilis (AOR = 5.05; 95%CI: 2.82–9.03) were independently associated with partners’ syphilis-infection. Conclusion Contact tracing is feasible and effective in identifying syphilis-infected partners among syphilis-seropositive pregnant women. Contact tracing is associated with many factors such as women’s marital status, services at their first antenatal clinics visit and willingness of partner notification. Partners’ ethnicity, age at first sex, multi-partners and history of drug abuse as well as women’s levels of TRUST titer were associated with partners’ syphilis-infection.

Treponema pallidum PCR testing for diagnosis of mucocutaneous ulcers suspicious for syphilis

2021 ◽  
pp. sextrans-2021-055192
Author(s):  
Muhammad Hyder Junejo ◽  
Mark Collery ◽  
Gary Whitlock ◽  
Alan McOwan ◽  
Victoria Tittle ◽  
...  
Keyword(s):  
Demographic Data ◽  
Treponema Pallidum ◽  
Added Value ◽  
Contact Tracing ◽  
Bisexual Men ◽  
Electronic Patient Records ◽  
Serological Tests ◽  
Syphilis Infection ◽  
Cross Sectional ◽  
History Of

BackgroundPrimary syphilis is characterised by the appearance of an ulcerated lesion (chancre) on the anogenital or oral mucosa from which Treponema pallidum DNA may be detectable by PCR. Serological tests for syphilis may be non-reactive in early infection, even after the appearance of a chancre. We reviewed the use of a multiplex-PCR (M-PCR) test to determine the added value of T. pallidum DNA detection in the management of individuals presenting with mucocutaneous ulceration at a sexual health service in central London.MethodsWe performed a cross-sectional analysis of all individuals with detectable T. pallidum DNA from September 2019 to April 2020. Electronic patient records were reviewed and concomitant results for treponemal serology and/or rapid plasma reagin (RPR) extracted, along with demographic data, history of syphilis and indices of sexual behaviour including number of sexual partners contacted. Any subsequent treponemal serology and RPR results were also reviewed.ResultsM-PCR swab specimens were performed in 450 individuals, of whom 63 (14%) had detectable T. pallidum DNA; 60 of 63 (95%) were gay or bisexual men and 11 of 63 (17%) were living with HIV. A history of treated syphilis was present in 17 of 63 (27%). Same-day treponemal serology/RPR testing was performed in 58 of 63 (92%) patients. Of the 58 who had same-day syphilis serology/RPR, 9 (16%) had their syphilis infection confirmed by treponemal DNA PCR alone. A total of 165 partners were traced as contacts of infection, of whom 25 (15%) were contacts of individuals diagnosed by M-PCR testing alone.ConclusionIn individuals with T. pallidum PCR-positive lesions, around one in six in our cohort were negative on standard diagnostic serological tests for syphilis. Treponemal DNA testing is an important addition to serological assays in individuals with mucocutaneous ulceration who are at risk of recent syphilis infection and facilitates early diagnosis and contact tracing.

scholarly journals Immunoblot Assay Using Recombinant Antigens as a Supplemental Test To Confirm the Presence of Antibodies to Trypanosoma cruzi

2007 ◽  
Vol 14 (4) ◽  
pp. 355-361 ◽  
Author(s):  
Kevin Y. Cheng ◽  
Chi-Deu Chang ◽  
Vince A. Salbilla ◽  
Louis V. Kirchhoff ◽  
David A. Leiby ◽  
...  
Keyword(s):  
Trypanosoma Cruzi ◽  
False Positive ◽  
Test Results ◽  
Serological Tests ◽  
Assay Sensitivity ◽  
Immunoblot Assay ◽  
Recombinant Antigens ◽  
Persistent Problem ◽  
Negative Results ◽  
Positive Results

ABSTRACT The diagnosis of chronic Chagas' disease is generally made by detecting antibodies to Trypanosoma cruzi. Most conventional serological tests are based on lysates of whole parasites or semipurified antigen fractions from T. cruzi epimastigotes grown in culture. The occurrence of inconclusive and false-positive results has been a persistent problem with the conventional assays, and there is no universally accepted gold standard for confirmation of positive test results. We describe here an immunoblot assay for detecting antibodies to T. cruzi in which four chimeric recombinant antigens (rAgs), designated FP3, FP6, FP10, and TcF, are used as target antigens. Each of these rAgs is composed of several antigenically distinct regions and includes repetitive as well as nonrepetitive sequences. Each rAg is coated as a discrete line on a nitrocellulose strip. Assay sensitivity was assessed by testing 345 specimens known to be positive for antibodies to T. cruzi. All 345 of these samples showed two to four reactive test bands in addition to the three on-board control bands that are on each strip. Assay specificity was determined by testing 500 specimens from random U.S. blood donors, all of which gave negative results. Based on the results obtained in this study, we propose the following scheme for interpretation of test results: (i) no bands or a single test band = a negative result; (ii) two or more test bands with at least one band showing intensity of 1+ or higher = a positive result; and (iii) multiple faint test bands (±) = indeterminate result. Based on this scheme, the prototype immunoblot assay showed sensitivity of 100% (n = 345) and specificity of 100% (n = 500). Additionally, all 269 potentially cross-reacting and T. cruzi antibody-negative specimens tested negative in our immunoblot assay. The rAg-based immunoblot assay has potential as a supplemental test for confirming the presence of antibodies to T. cruzi in blood specimens and for identifying false-positive results obtained with other assays.

scholarly journals Contact tracing of syphilis-seropositive pregnant women and syphilis-infection among their male partners in Bao'an District, Shenzhen, China

2020 ◽  
Author(s):  
Rui-lin Yan ◽  
Bao-Qing Deng ◽  
Gui-Chun Wen ◽  
Li-Cheng Huang ◽  
Li-Mei Li ◽  
...  
Keyword(s):  
Drug Abuse ◽  
Pregnant Women ◽  
Contact Tracing ◽  
Male Partners ◽  
Related Factors ◽  
Syphilis Infection ◽  
First Sex ◽  
History Of ◽  
Syphilis Screening ◽  
Antenatal Clinics

Abstract Background Untreated male partners are critical source of maternal re-infection. Contact tracing is a good way to identify infection among partners and reduce risk of mother-to-child transmission related to maternal re-infection. This study aimed to analyze the current situation and related factors of contact tracing of syphilis-seropositive pregnant women and syphilis-infection among their male partners.Method Data of syphilis-seropositive pregnant women and their male partners attending clinics for syphilis-screening were obtained from the Shenzhen Program for Prevention of Congenital Syphilis. Contact tracing rate of syphilis-seropositive pregnant women and syphilis prevalence among male partners were counted, and related factors were also analyzed using a random-effects logistic regression model.Result Of the 1299 syphilis-seropositive pregnant women, 74.1% (963/1299) had their male partners receiving syphilis-screening and 19.1% (184/963) of male partners were syphilis-infected. For pregnant women, being divorced (adjusted odds ratio [AOR] =0.39; 95%CI: 0.17-0.88), seeking for emergency services at their first antenatal clinics visit (AOR=0.59; 95%CI: 0.44-0.79), reporting willingness to notify partner (AOR=7.75; 95%CI: 4.73-12.70), and having a history of drug abuse (AOR=0.35; 95%CI: 0.13-0.93) were independently associated with successful contact tracing. For male partners, of minority nationality (AOR=4.15; 95%CI: 1.66-10.34), age of first sex>20(AOR=0.57; 95%CI: 0.37-0.87), reporting multi-partner (AOR = 1.60; 95%CI: 1.04-2.46), having a history of drug abuse (AOR=4.07; 95%CI: 1.31-12.64) were independently associated with syphilis-infection. In addition, pregnant women with TRUST titer ≥1:8 (AOR=2.81; 95%CI: 1.87-4.21), having a history of adverse pregnancy outcomes (AOR=1.70; 95%CI: 1.14-2.53), reporting multi-partners (AOR=0.43; 95%CI: 0.29-0.64) and reporting the current partner as the source of syphilis (AOR=5.05; 95%CI: 2.82-9.03) were independently associated with partners' syphilis-infection.Conclusion Contact tracing is feasible and effective in identifying syphilis-infected partners among syphilis-seropositive pregnant women. Contact tracing is associated with many factors such as women's marital status, services at their first antenatal clinics visit and willingness of partner notification. Partners' ethnicity, age of first sex, multi-partners and history of drug abuse as well as women's levels of TRUST titer were associated with partners' syphilis-infection.

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