title: Assessment of reactivity of three treponemal tests in non-treponemal non-reactive cases from sexually transmitted diseases clinic, antenatal clinic, integrated counselling and testing centre, other different outdoor patient departments/indoor patients of a tertiary care centre and peripheral health clinic attendees.
abstract: In India, many state reference centres for sexually transmitted infections perform only a single screening assay for syphilis diagnosis. In this study, Treponema pallidum haemagglutination (TPHA) was performed on 1115 Venereal Disease Research Laboratory (VDRL)/rapid plasma regain (RPR) non-reactive and 107 reactive sera out of 10,489 tested by VDRL/RPR according to the National AIDS Control Organisation syphilis testing protocol. A total of 47 Specimens reactive in TPHA and non-reactive with VDRL test were subjected to fluorescent treponemal antibody absorption and enzyme-immunoassay. Seroprevalence considering both VDRL and TPHA positivity was highest (4.4%) in sexually transmitted diseases clinic attendees than in other subject groups. Positivity by two treponemal tests in 24 (2.2%) cases non-reactive by VDRL/RPR was representative of the fully treated patients or latent or late syphilis cases. The findings highlight that a suitable treponemal confirmatory test should be performed in all the diagnostic laboratories.
authors.affiliation: Apex Regional STD Teaching, Training and Research Centre, Vardhman Mahavir Medical College and Safdarjung Hospital, New Delhi, India.
authors.forename: M
authors.initials: M
authors.lastname: Bala
authors.forename: V
authors.initials: V
authors.lastname: Singh
authors.forename: S
authors.initials: S
authors.lastname: Muralidhar
authors.forename: V
authors.initials: V
authors.lastname: Ramesh
mesh_terms: D005260:Female; D006801:Humans; D007194:India; D008297:Male; D012680:Sensitivity and Specificity; D016036:Seroepidemiologic Studies; D012698:Serologic Tests / Q000379:methods; D013587:Syphilis / Q000175:diagnosis*