Title:
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Metaanalysis of the Performance of a Combined Treponemal and
Nontreponemal Rapid Diagnostic Test for Syphilis and Yaws
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Author:
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Marks, Michael; Yin, Yue-Ping; Chen, Xiang-Sheng; Castro, Arnold; Causer, Louise; Guy, Rebecca; Wangnapi, Regina A.; Mitjà Villar, Oriol; Aziz, Abdul; Castro, Rita; Luz Martins Pereira, Filomena da; Taleo, Fasihah; Guinard, Jérôme; Belec, Laurent; Tun, Ye; Bottomley, Christian; Ballard, Ronald C.; Mabey, David C. W.
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Abstract:
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BACKGROUND: The human treponematoses are important causes of
disease. Mother-to-child transmission of syphilis remains a
major cause of stillbirth and neonatal death. There are also
almost 100 000 cases of endemic treponemal disease reported
annually, predominantly yaws. Rapid diagnostic tests (RDTs)
would improve access to screening for these diseases. Most RDTs
cannot distinguish current and previous infection. The Dual Path
Platform (DPP) Syphilis Screen & Confirm test includes both
a treponemal (T1) and nontreponemal (T2) component and may
improve the accuracy of diagnosis. METHODS: We conducted a
metaanalysis of published and unpublished evaluations of the
DPP-RDT for the diagnosis of syphilis and yaws. We calculated
the sensitivity, specificity, and overall agreement of the test
compared with reference laboratory tests. RESULTS: Nine
evaluations, including 7267 tests, were included. Sensitivity
was higher in patients with higher titer rapid plasma reagin
(>/=1:16) for both the T1 (98.2% vs 90.1%, P < .0001) and
the T2 component (98.2% vs 80.6%, P < .0001). Overall
agreement between the DPP test and reference serology was 85.2%
(84.4%-86.1%). Agreement was highest for high-titer active
infection and lowest for past infection. CONCLUSIONS: The RDT
has good sensitivity and specificity of the treponemal and
nontreponemal components both in cases of suspected syphilis and
yaws, although the sensitivity is decreased at lower antibody
titers. |
Subject(s):
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-Sífilis -Malalties de transmissió sexual -Syphilis -Sexually transmitted diseases |
Rights:
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cc by (c) Marks et al., 2016
http://creativecommons.org/licenses/by/3.0/es/ |
Document type:
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Article Article - Published version |
Published by:
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Oxford University Press
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