PERCEPTION, EFFICACY, AND TREATMENT OUTCOMES OF POINT-OF-CARE SYPHILIS TESTING IN CANADA AND THE UNITED STATES: A LITERATURE REVIEW
Date
2024-05-15
Authors
Guenther, Sarah
Journal Title
Journal ISSN
Volume Title
Publisher
Abstract
Introduction: Syphilis is a preventable sexually transmitted infection that causes systemic manifestations in the absence of appropriate treatment. The rise in infectious syphilis cases across Canada over the past several years has brought forth accessibility concerns for traditional serological laboratory testing. Despite the recent approval of rapid syphilis testing for use in professional settings by Health Canada, point-of-care syphilis testing remains underutilized.
Objectives: This study investigates current literature on rapid point-of-care testing as an initial screening measure for infectious syphilis. The aim of this review is to explore the perception, field performance, and treatment outcomes of rapid syphilis testing in Canada and the United States to determine the utility of shifting toward point-of-care screening in Canada.
Methods: A literature search using Google Scholar and PubMed databases identified articles examining the field performance of rapid syphilis testing in Canada and the United States in the last 24 years (2000-2024). Five primary research articles satisfied the inclusion criteria and were included in this review.
Results: Five observational studies found rapid syphilis testing was generally well-accepted, highly specific with few false positives and negatives, and significantly reduced time to treatment compared to serological laboratory standards. Sensitivity and predictive value were variable; however, sensitivity improved with rising RPR titers.
Conclusion: This review suggests that point-of-care testing is adequate as an initial screening measure for infectious syphilis but should be supplemented by traditional serological laboratory testing. The inability of treponemal tests to discern infectious syphilis from a previously treated infection is a key limitation of currently available rapid tests. Given the ease of test administration and the low burden of overtreatment with benzathine penicillin G, future studies should investigate the utility of point-of-care syphilis screening in resource-limited communities in rural and northern Canada.