Using a dual antibody point-of-care test with visual and digital reads to diagnose syphilis among people living with HIV in Botswana
Open Access
- 11 February 2021
- journal article
- research article
- Published by SAGE Publications in International Journal of STD & AIDS
- Vol. 32 (5), 453-461
- https://doi.org/10.1177/0956462420975639
Abstract
Syphilis data from low- and middle-income countries are lacking due to limited testing. Point-of-care tests (POCTs) have been promoted to expand testing but previously only included treponemal tests, which cannot distinguish active from past infection. We aimed to assess the feasibility of using a combined treponemal and non-treponemal POCT in HIV clinic patients in Gaborone, Botswana, and estimate syphilis prevalence in our clinic sample using this approach. We recruited 390 non-pregnant patients. Participants underwent a combined treponemal and non-treponemal POCT (Dual Path Platform (DPP®) Syphilis Screen and Confirm Assay (Chembio Diagnostic Systems)) on finger-prick blood sample and a questionnaire. Median age 45 years, 30% men, median CD4 count 565 cells/μL, and 91% had an HIV viral load <400 copies/mL. Five participants had active syphilis (1.3%, 95% CI 0.5–3.0%) and 64 had previous syphilis (16.4%, 95% CI 13.0–20.4%) using the DPP POCT. There was a reasonable level of agreement between digital and visual reading of the POCT (kappa statistic of 0.81); however, visual reading missed three active infections (60%). The level of active syphilis was similar to local antenatal data. The DPP POCT led to five participants with active syphilis being diagnosed and starting same-day treatment. The digital reader should be used.Keywords
This publication has 22 references indexed in Scilit:
- Syphilis among people with HIV infection in southern Ethiopia: sero-prevalence and risk factorsBMC Infectious Diseases, 2015
- HIV/Sexually Transmitted Infection Prevalence and Sexual Behavior of Men Who Have Sex With Men in 3 Districts of BotswanaSexually Transmitted Diseases, 2014
- HIV Prevalence and Risk Behaviors Among Female Sex Workers in Botswana: Results from the 2012 HIV/STI Bio-Behavioral StudyAIDS and Behavior, 2014
- A Laboratory-Based Evaluation of Four Rapid Point-of-Care Tests for SyphilisPLOS ONE, 2014
- Untreated maternal syphilis and adverse outcomes of pregnancy: a systematic review and meta-analysisBulletin of the World Health Organization, 2013
- Novel Point-of-Care Test for Simultaneous Detection of Nontreponemal and Treponemal Antibodies in Patients with SyphilisJournal of Clinical Microbiology, 2010
- Serological Evidence of HIV-Associated Infection among HIV-1--Infected Adults in BotswanaClinical Infectious Diseases, 2006
- Syphilis and HIV: a dangerous combinationThe Lancet Infectious Diseases, 2004
- Approaches to the control of sexually transmitted infections in developing countries: old problems and modern challengesSexually Transmitted Infections, 2004
- Syndromic management of sexually transmitted diseases in Botswana's primary health care: quality of care aspectsTropical Medicine & International Health, 2003