title: Improving global estimates of syphilis in pregnancy by diagnostic test type: A systematic review and meta-analysis.
abstract: BACKGROUND
  "Probable active syphilis," is defined as seroreactivity in both non-treponemal and treponemal tests. A correction factor of 65%, namely the proportion of pregnant women reactive in one syphilis test type that were likely reactive in the second, was applied to reported syphilis seropositivity data reported to WHO for global estimates of syphilis during pregnancy.
  
  
  OBJECTIVE
  To identify more accurate correction factors based on test type reported.
  
  
  METHODS
  Medline search using: "Syphilis [Mesh] and Pregnancy [Mesh]," "Syphilis [Mesh] and Prenatal Diagnosis [Mesh]," and "Syphilis [Mesh] and Antenatal [Keyword].
  
  
  METHODS
  Eligible studies must have reported results for pregnant or puerperal women for both non-treponemal and treponemal serology.
  
  
  METHODS
  We manually calculated the crude percent estimates of subjects with both reactive treponemal and reactive non-treponemal tests among subjects with reactive treponemal and among subjects with reactive non-treponemal tests. We summarized the percent estimates using random effects models.
  
  
  RESULTS
  Countries reporting both reactive non-treponemal and reactive treponemal testing required no correction factor. Countries reporting non-treponemal testing or treponemal testing alone required a correction factor of 52.2% and 53.6%, respectively. Countries not reporting test type required a correction factor of 68.6%.
  
  
  CONCLUSIONS
  Future estimates should adjust reported maternal syphilis seropositivity by test type to ensure accuracy.
authors.affiliation: Centers for Disease Control and Prevention, Atlanta, GA, USA. Electronic address: Ink4@cdc.gov.
authors.forename: D Cal
authors.initials: DC
authors.lastname: Ham
authors.affiliation: Centers for Disease Control and Prevention, Atlanta, GA, USA.
authors.forename: Carol
authors.initials: C
authors.lastname: Lin
authors.affiliation: World Health Organization, Geneva, Switzerland.
authors.forename: Lori
authors.initials: L
authors.lastname: Newman
authors.affiliation: Centers for Disease Control and Prevention, Atlanta, GA, USA.
authors.forename: N Saman
authors.initials: NS
authors.lastname: Wijesooriya
authors.affiliation: Centers for Disease Control and Prevention, Atlanta, GA, USA.
authors.forename: Mary
authors.initials: M
authors.lastname: Kamb
mesh_terms: D000068598:Data Accuracy; D005260:Female; D006801:Humans; D011247:Pregnancy; D011251:Pregnancy Complications, Infectious / Q000175:diagnosis / Q000453:epidemiology*; D011296:Prenatal Diagnosis / Q000379:methods / Q000706:statistics & numerical data*; D013587:Syphilis / Q000175:diagnosis / Q000453:epidemiology*; D013588:Syphilis Serodiagnosis / Q000379:methods / Q000706:statistics & numerical data*
keywords: Congenital syphilis; Diagnostics; Pregnancy; Prenatal diagnosis; Syphilis