Screening for syphilis in pregnancy: which is the proper method?
BACKGROUND
Consequences of syphilis in mother, pregnancy, fetus and child are considerable, but preventable. Serological screening must be offered at the first prenatal visit. Presently, the diagnosis of syphilis is dependent mainly on serological tests. The most widely used screening tests for syphilis are the VDRL and the rapid plasma reagin (RPR) and for confirmation the fluorescent treponemal antibody (FTA) and the treponema pallidum hemagglutination (TPHA) tests.


METHODS
The four alternative nodes for diagnosis of can be a) VDRL + FTA, b) VDRL + TPHA, c) RPR + FTA and d) RPR + TPHA. Here the author reports an evaluation of cost utility of those tests in obstetrical practice. According to this study, it can be shown that the cost per accurate diagnosis for VDRL + TPHA is the least expensive choice and for RPR + FTA is the most expensive choice.


CONCLUSIONS
Therefore, this alternative is the best method for serological diagnosis of syphilis, based on medical laboratory economics principles.
Wiwanitkit
Viroj
V
Department of Laboratory Medicine, Faculty of Medicine, Chulalongkorn University, Bangkok, 10330, Thailand. wviroj@yahoo.com
D003362:Cost-Benefit Analysis; D005260:Female; D006801:Humans; D011247:Pregnancy; D011251:Pregnancy Complications, Infectious / Q000175:diagnosis*; D013587:Syphilis / Q000175:diagnosis*; D013588:Syphilis Serodiagnosis / Q000191:economics* / Q000379:methods*