Efektivitas Pemeriksaan Serologis Sifilis

High prevalence of syphilis can be reduced by doing screening. Tests used for screening and diagnosis of syphilis are serological tests of syphilis consisting of nontreponemal tests and treponemal tests. Nontreponemal tests consist of Rapid Plasma Reagin (RPR) and Venereal Disease Research Laboratory (VDRL) meanwhile Treponemal tests consist of Treponema Pallidum Haemagglutination Assay (TPHA) and Treponema Pallidum Rapid (TP Rapid). This study was aimed to determine the effectiveness of syphilis serological tests. This was a literature review study using the keywords namely serology OR serological OR serologic AND syphilis in PubMed and ClinicalKey. The literatures were written in English and/or Indonesian, published in the last 10 years (2011-2020), and can be accessed in full text. The results obtained 25 literatures. High sensitivity was found in RPR of 9.1%-100%, VDRL of 44.4% -100%, and TP Rapid of 50.0%-100%. High specificity was found in TPHA of 99.7% and TP Rapid of 85.3% -100%. In conclusion, effective syphilis screening is performed with RPR and VDRL, while effective syphilis diagnostic is performed with TP Rapid and TPHA.Keywords: syphilis, serology tests, effectiveness of tests Abstrak: Prevalensi kasus sifilis yang tinggi dapat diturunkan dengan adanya skrining. Pemeriksaan yang digunakan untuk skrining dan diagnosis sifilis ialah pemeriksaan serologis sifilis, terdiri atas pemeriksaan serologis non spesifik treponema dan pemeriksaan serologis spesifik treponema. Pemeriksaan serologis non spesifik treponema antara lain Rapid Plasma Reagin (RPR) dan Venereal Disease Research Laboratory (VDRL). Pemeriksaan serologis spesifik treponema antara lain Treponema Pallidum Haemagglutination Assay (TPHA) dan Treponema Pallidum Rapid (TP Rapid). Penelitian ini bertujuan untuk mengetahui efektivitas pemeriksaan serologis sifilis. Jenis penelitian ialah literature review menggunakan kata kunci serology OR serological OR serologic AND syphilis di PubMed dan ClinicalKey. Literatur yang digunakan memiliki bahasa Inggris dan/atau bahasa Indonesia, terbitan 10 tahun terakhir (2011-2020), dan dapat diakses teks lengkap. Sensitivitas tinggi ditemukan pada RPR sebesar 9,1%-100%, VDRL sebesar 44,4%-100%, dan TP Rapid sebesar 50,0%-100%. Spesifisitas tinggi ditemukan pada TPHA sebesar 99,7% dan TP Rapid sebesar 85,3%-100%. Simpulan penelitian ini ialah skrining sifilis efektif dilakukan dengan RPR dan VDRL, sedangkan diagnostik sifilis efektif dilakukan dengan TP Rapid dan TPHA.Kata kunci: sifilis, pmeriksaan serologis, efektivitas pemeriksaan

Comparison of Syphilis Rapid Diagnostic Test to Rapid Plasma Reagin, Treponema pallidum Haemagglutination Assay and Fluorescent Treponemal Antibody-Absorption for Syphilis and Yaws Diagnostics

BACKGROUND: Syphilis and yaws are the treponemal infections which have become serious public health problems, and both are serologically indistinguishable. Developed serological tests for syphilis may also be used to diagnose yaws. In remote area, test modality with minimal requirements were needed. This study investigated the diagnostic value of syphilis rapid diagnostic test (RDT) in diagnosing syphilis and yaws.METHODS: For syphilis diagnostic test, serum samples were obtained from patients of outpatient clinic in Dr. Cipto Mangunkusumo National Central General Hospital who were sent for rapid plasma reagin (RPR) and Treponema pallidum haemagglutination assay (TPHA) to clinical laboratory of the hospital. The serum samples were collected and stored at -80°C until the day of testing for syphilis RDT and fluorescent treponemal antibody-absorption (FTA-Abs). For yaws diagnostic test, serum samples were obtained as a part of surveillance study of yaws among children 1-15 years old in West Halmahera. Venous blood samples were used for syphilis RDT and the sera were separated and were sent to Dr. Cipto Mangunkusumo National Central General Hospital for RPR, TPHA, and FTA-Abs tests.RESULTS: For syphilis diagnostic test, among 156 samples, 39 samples were positive with syphilis RDT. The sensitivity of syphilis RDT was similar to RPR and TPHA (100.0%), the specificity was same as TPHA (77.5%), but lower than RPR (84.8%) when compared to FTA-Abs IgM. The sensitivity of syphilis RDT was 62.5% and the specificity was 96.0% when compare to FTA-Abs IgG. For yaws diagnostic test, among 176 samples, 13 samples were positive with syphilis RDT. By using FTA-Abs IgM as gold standard for diagnosing yaws, the RDT have similar sensitivity (50.0%) with RPR and TPHA and syphilis RDT have similar specificity to TPHA (93.1%). If compared to FTA-Abs IgG, the sensitivity of syphilis RDT was 40.0% and the specificity was 98.0%.CONCLUSION: Syphilis RDT gives similar results with TPHA in syphilis and yaws cases. It may be used as a first line screening test latent or untreated syphilis and yaws because of good sensitivity. For yaws diagnosis Syphilis RDT, RPR, and TPHA have low sensitivity, however all those tests have an excellent agreement.KEYWORDS: FTA-Abs, rapid diagnostic test, syphilis, yaws

Prevalence of antibodies to Chlamydiaceae in pet dogs in Shenzhen, Guangdong Province, China

The prevalence of chlamydiosis in pet dogs was surveyed in Shenzhen, Guangdong Province, China. A total of 442 serum samples were collected from three districts of Shenzhen, namely the Futian, Nanshan, and Luohu Districts, and assayed for Chlamydiaceae antibodies by indirect haemagglutination assay. The results showed that the mean positive rate was 6.11%, and the positive rate for the Futian District was the highest (9.52%), followed by the Nanshan District (7.08%), and the Luohu District (4.02%). The positive rate for male dogs was 6.08%, and for female dogs 6.16%. Out of all the 38 breeds of dogs examined, 14 breeds were positive. The positive rate for the Cocker Spaniel dog was the highest (14.2%), followed by the Pekinese dog (10.71%), and the Border Collie dog (10.34%). This is the first time that the seroprevalence of Chlamydiaceae infection in pet dogs in Shenzhen, Guangdong province, China was reported, and the results indicated that pet dogs may be an important source for human infection by Chlamydiaceae in Shenzhen and other areas of China.