Challenges of Rapid Plasma Reagin Interpretation in Syphilis Screening in Uganda: Variability in Nontreponemal Results Between Different Laboratories
| Autor: | Matthew M. Hamill, Agnes Kiragga, Mary Jett-Goheen, Anne Rompalo, Charlotte A. Gaydos, Rosalind Parkes-Ratanshi, Yukari C. Manabe, Edith Nakku-Joloba, Kimeze J. Mbazira |
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| Rok vydání: | 2018 |
| Předmět: |
Adult
Male 0301 basic medicine Microbiology (medical) medicine.medical_specialty 030106 microbiology Dermatology Reference laboratory urologic and male genital diseases Article Rapid plasma reagin Serology Immunoenzyme Techniques Young Adult 03 medical and health sciences 0302 clinical medicine stomatognathic system Internal medicine Humans Mass Screening Medicine Uganda Syphilis Treponema pallidum 030212 general & internal medicine Reagins medicine.diagnostic_test business.industry Extramural Significant difference Public Health Environmental and Occupational Health medicine.disease Antibodies Bacterial Syphilis Serodiagnosis Titer Infectious Diseases Female business Algorithms Student's t-test |
| Zdroj: | Sexually Transmitted Diseases. 45:829-833 |
| ISSN: | 1537-4521 0148-5717 |
| DOI: | 10.1097/olq.0000000000000883 |
| Popis: | BACKGROUND Syphilis is a cause of morbidity and mortality and is of particular concern in pregnancy in low-income countries because of the risks associated with maternal-fetal transmission. Ugandan national guidelines recommend a nontreponemal rapid plasma reagin (RPR) followed by treponemal testing for diagnosis of syphilis. The RPR test confirms a reactive specific treponemal test, or confirms serological "cure" with a 4-fold dilutional decrease; RPR is beset with technical and biological limitations, making accurate diagnosis and appropriate treatment problematic. The aim of this analysis was to compare performance of RPR testing in different laboratories. METHODS Stored, freeze-thawed sera from 215 participants were additionally tested for RPR and dilutional titer in 2 different reference laboratories. Discrepant results were tested at a third reference laboratory which served as a tie-breaker. Equivalence in RPR titer was defined as within 2-fold or less. All patients with reactive rapid tests were treated as per Ugandan National Guidelines. RESULTS Of 215 sera, 97 (45.1%) were RPR reactive in clinic laboratory A, 81 (37.7%) and 65 (30.2%) were RPR reactive in laboratories B and C, respectively. All reported positive in laboratory C were positive in laboratory B. Discrepant results were tested in laboratory D. χ Test was highly significant (P = |
| Databáze: | OpenAIRE |
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