title: An Audit of VDRL Testing from an STI Clinic in India: Analysing the Present Scenario with Focus on Estimating and Optimizing the Turnaround Time.
abstract: BACKGROUND
  Timeliness of reporting is of utmost importance to limit the spread of syphilis. The present analysis was undertaken to evaluate the turnaround time of syphilis testing (mainly Venereal disease research laboratory /VDRL test) in a sexually transmitted infections (STI) clinic in India; to find out the possible reasons for delay; to describe the trends of clinical indications for syphilis testing from an STI clinic; to assess the frequency of a positive syphilis serology among STI clinic attendees; and to analyse the follow-up rates of VDRL report collection.
  
  
  METHODS
  Two hundred consecutive VDRL requests received at the serology laboratory of a tertiary care health facility from the STI clinic of the linked hospital were prospectively analysed to evaluate the above parameters.
  
  
  RESULTS
  For the 200 requests audited, the mean absolute turnaround time of VDRL test was 7.46±2.81 days. The mean duration of the pre-laboratory, laboratory and post laboratory phases was 0, 4.69±2.13 and 2.77±2.51 days respectively. The interval from specimen receipt to performance of tests (mean duration=4.25±1.96 days) was the major reason for long VDRL turnaround time. The common indications for syphilis testing in STI clinic attendees were lower abdominal pain (33%), vaginal discharge (26.5%) and genital ulcer disease (9%); and the follow-up rate for report collection was 71%.
  
  
  CONCLUSIONS
  Our study highlights the strong need to shift to alternative testing methods, mainly rapid point of care procedures for serodiagnosis of syphilis in order to circumvent the problems of long turnaround time and low patient follow-up rates.
authors.affiliation: Senior Resident, Department of Microbiology, Maulana Azad Medical College , New Delhi, India .
authors.forename: Bhanu
authors.initials: B
authors.lastname: Mehra
authors.affiliation: Director Professor, Department of Microbiology, Maulana Azad Medical College , New Delhi, India .
authors.forename: Preena
authors.initials: P
authors.lastname: Bhalla
authors.affiliation: Assistant Professor, Department of Microbiology, Maulana Azad Medical College , New Delhi, India .
authors.forename: Deepti
authors.initials: D
authors.lastname: Rawat
authors.affiliation: Junior Resident, Department of Microbiology, Maulana Azad Medical College , New Delhi, India .
authors.forename: Shikhar
authors.initials: S
authors.lastname: Saxena
keywords: Serology laboratory; Syphilis; Timeliness