Syphilis screening: Difference between revisions
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__NOTOC__ | __NOTOC__ | ||
{{CMG}} | {{CMG}} {{AE}}{{AA}} | ||
{{Syphilis}} | {{Syphilis}} | ||
==Overview== | ==Overview== | ||
Screening guidelines for syphilis include all high risk non-pregnant individuals aged 15-65, all pregnant females, men who have sex with men, women who have sex with women, and [[Human Immunodeficiency Virus (HIV)|HIV]] positive individuals.<ref name= sypilis>https://www.uspreventiveservicestaskforce.org/Page/Document/UpdateSummaryFinal/syphilis-infection-in-nonpregnant-adults-and-adolescents?ds=1&s=syphilis Accessed on September 19, 2016</ref> Routine screening of adolescents who are asymptomatic for syphilis is not recommended.<ref name=cdc5>http://www.cdc.gov/std/treatment/2010/specialpops.htm Accessed on September 19, 2016</ref><ref name=USPTF4> https://www.uspreventiveservicestaskforce.org/Page/Document/UpdateSummaryFinal/syphilis-infection-in-pregnancy-screening?ds=1&s=syphilis Accessed on September 19, 2016</ref> | |||
==Screening== | ==Screening== | ||
[[Screening]] guidelines for syphilis are: | |||
===Non-pregnant adults and adolescents (age 15-65)=== | |||
*All individuals who are at increased risk for syphilis should be screened for syphilis [[United states preventive services task force recommendations scheme#USPSTF Grade Definitions|Grade A recommendation]].<ref name= sypilis>https://www.uspreventiveservicestaskforce.org/Page/Document/UpdateSummaryFinal/syphilis-infection-in-nonpregnant-adults-and-adolescents?ds=1&s=syphilis Accessed on September 19, 2016</ref><ref name="pmid27272583">{{cite journal| author=US Preventive Services Task Force (USPSTF). Bibbins-Domingo K, Grossman DC, Curry SJ, Davidson KW, Epling JW et al.| title=Screening for Syphilis Infection in Nonpregnant Adults and Adolescents: US Preventive Services Task Force Recommendation Statement. | journal=JAMA | year= 2016 | volume= 315 | issue= 21 | pages= 2321-7 | pmid=27272583 | doi=10.1001/jama.2016.5824 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=27272583 }} </ref> | |||
*Routine screening of adolescents who are asymptomatic for syphilis is not recommended.<ref name=cdc5>http://www.cdc.gov/std/treatment/2010/specialpops.htm Accessed on September 19, 2016</ref> | |||
* | ===Pregnant women=== | ||
*At first [[Prenatal|prenatal visit]]<ref name=CDC4>http://www.cdc.gov/std/tg2015/screening-recommendations.htm#modalIdString_CDCTable_2 Accessed on September 19, 2016</ref> | |||
*Retest at early [[third trimester]] and delivery if high risk<ref name=USPTF4> https://www.uspreventiveservicestaskforce.org/Page/Document/UpdateSummaryFinal/syphilis-infection-in-pregnancy-screening?ds=1&s=syphilis Accessed on September 19, 2016</ref> | |||
*High risk populations which require frequent screening include:<ref name=USPTF4> https://www.uspreventiveservicestaskforce.org/Page/Document/UpdateSummaryFinal/syphilis-infection-in-pregnancy-screening?ds=1&s=syphilis Accessed on September 19, 2016</ref> | |||
:*Uninsured women | |||
:*Women living in poverty | |||
:*Sex workers | |||
:*[[Drug abuse|Illicit drug users]] | |||
:*Presence of other sexually transmitted diseases ([[Sexually transmitted disease|STDs]]) | |||
:*Other women living in communities with high syphilis morbidity | |||
* | ===Men who have sex with men=== | ||
*Annually for sexually active men who have sex with men<ref name=CDC4>http://www.cdc.gov/std/tg2015/screening-recommendations.htm#modalIdString_CDCTable_2 Accessed on September 19, 2016</ref> | |||
*Every 3 to 6 months if increased risk | |||
* | ===Women who have sex with women=== | ||
*Routine screening is recommended<ref name=cdc5>http://www.cdc.gov/std/treatment/2010/specialpops.htm Accessed on September 19, 2016</ref> | |||
== | ===HIV positive individuals=== | ||
{{ | *At first [[HIV]] evaluation for sexually active individuals<ref name=CDC4>http://www.cdc.gov/std/tg2015/screening-recommendations.htm#modalIdString_CDCTable_2 Accessed on September 19, 2016</ref><ref name=lancet> http://hivprevent.thelancet.com/content/guidelines-and-recommendations Accesed on September 19, 2016</ref> | ||
=====[[ | *Annually after first evaluation | ||
1. | *More frequent testing for individuals who are at increased risk or are residing in highly prevalent areas of syphilis | ||
==Screening tests== | |||
Screening tests recommended for syphilis include the following:<ref name= UPTFS2>https://www.uspreventiveservicestaskforce.org/Page/Document/ClinicalSummaryFinal/syphilis-infection-in-pregnancy-screening Accessed on September 19, 2016</ref> | |||
===Screening non-treponemal tests=== | |||
*[[Venereal Disease Research Laboratory]] ([[VDRL]])<ref name="pmid18159528">{{cite journal| author=Ratnam S| title=The laboratory diagnosis of syphilis. | journal=Can J Infect Dis Med Microbiol | year= 2005 | volume= 16 | issue= 1 | pages= 45-51 | pmid=18159528 | doi= | pmc=2095002 | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=18159528 }} </ref> | |||
*[[Rapid Plasma Reagin]]([[RPR]])<ref name="pmid7704889">{{cite journal| author=Larsen SA, Steiner BM, Rudolph AH| title=Laboratory diagnosis and interpretation of tests for syphilis. | journal=Clin Microbiol Rev | year= 1995 | volume= 8 | issue= 1 | pages= 1-21 | pmid=7704889 | doi= | pmc=172846 | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=7704889 }} </ref> | |||
===Confirmatory treponemal tests=== | |||
*[[Fluorescent treponemal antibody absorbed]] ([[FTA-ABS]])<ref name="pmid18159528">{{cite journal| author=Ratnam S| title=The laboratory diagnosis of syphilis. | journal=Can J Infect Dis Med Microbiol | year= 2005 | volume= 16 | issue= 1 | pages= 45-51 | pmid=18159528 | doi= | pmc=2095002 | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=18159528 }} </ref> | |||
*''[[Treponema pallidum]]'' particle agglutination ([[Treponema pallidum hemagglutination assay (TPHA) test|TPPA]])<ref name="pmid7704889">{{cite journal| author=Larsen SA, Steiner BM, Rudolph AH| title=Laboratory diagnosis and interpretation of tests for syphilis. | journal=Clin Microbiol Rev | year= 1995 | volume= 8 | issue= 1 | pages= 1-21 | pmid=7704889 | doi= | pmc=172846 | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=7704889 }} </ref> | |||
==References== | ==References== | ||
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[[Category: | [[Category:Up-To-Date]] | ||
[[Category:Infectious disease]] | [[Category:Infectious disease]] | ||
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[[Category: | [[Category:Neurology]] | ||
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Latest revision as of 00:23, 30 July 2020
Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1] Associate Editor(s)-in-Chief: Aysha Anwar, M.B.B.S[2]
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Overview
Screening guidelines for syphilis include all high risk non-pregnant individuals aged 15-65, all pregnant females, men who have sex with men, women who have sex with women, and HIV positive individuals.[1] Routine screening of adolescents who are asymptomatic for syphilis is not recommended.[2][3]
Screening
Screening guidelines for syphilis are:
Non-pregnant adults and adolescents (age 15-65)
- All individuals who are at increased risk for syphilis should be screened for syphilis Grade A recommendation.[1][4]
- Routine screening of adolescents who are asymptomatic for syphilis is not recommended.[2]
Pregnant women
- At first prenatal visit[5]
- Retest at early third trimester and delivery if high risk[3]
- High risk populations which require frequent screening include:[3]
- Uninsured women
- Women living in poverty
- Sex workers
- Illicit drug users
- Presence of other sexually transmitted diseases (STDs)
- Other women living in communities with high syphilis morbidity
Men who have sex with men
- Annually for sexually active men who have sex with men[5]
- Every 3 to 6 months if increased risk
Women who have sex with women
- Routine screening is recommended[2]
HIV positive individuals
- At first HIV evaluation for sexually active individuals[5][6]
- Annually after first evaluation
- More frequent testing for individuals who are at increased risk or are residing in highly prevalent areas of syphilis
Screening tests
Screening tests recommended for syphilis include the following:[7]
Screening non-treponemal tests
Confirmatory treponemal tests
- Fluorescent treponemal antibody absorbed (FTA-ABS)[8]
- Treponema pallidum particle agglutination (TPPA)[9]
References
- ↑ 1.0 1.1 https://www.uspreventiveservicestaskforce.org/Page/Document/UpdateSummaryFinal/syphilis-infection-in-nonpregnant-adults-and-adolescents?ds=1&s=syphilis Accessed on September 19, 2016
- ↑ 2.0 2.1 2.2 http://www.cdc.gov/std/treatment/2010/specialpops.htm Accessed on September 19, 2016
- ↑ 3.0 3.1 3.2 https://www.uspreventiveservicestaskforce.org/Page/Document/UpdateSummaryFinal/syphilis-infection-in-pregnancy-screening?ds=1&s=syphilis Accessed on September 19, 2016
- ↑ US Preventive Services Task Force (USPSTF). Bibbins-Domingo K, Grossman DC, Curry SJ, Davidson KW, Epling JW; et al. (2016). "Screening for Syphilis Infection in Nonpregnant Adults and Adolescents: US Preventive Services Task Force Recommendation Statement". JAMA. 315 (21): 2321–7. doi:10.1001/jama.2016.5824. PMID 27272583.
- ↑ 5.0 5.1 5.2 http://www.cdc.gov/std/tg2015/screening-recommendations.htm#modalIdString_CDCTable_2 Accessed on September 19, 2016
- ↑ http://hivprevent.thelancet.com/content/guidelines-and-recommendations Accesed on September 19, 2016
- ↑ https://www.uspreventiveservicestaskforce.org/Page/Document/ClinicalSummaryFinal/syphilis-infection-in-pregnancy-screening Accessed on September 19, 2016
- ↑ 8.0 8.1 Ratnam S (2005). "The laboratory diagnosis of syphilis". Can J Infect Dis Med Microbiol. 16 (1): 45–51. PMC 2095002. PMID 18159528.
- ↑ 9.0 9.1 Larsen SA, Steiner BM, Rudolph AH (1995). "Laboratory diagnosis and interpretation of tests for syphilis". Clin Microbiol Rev. 8 (1): 1–21. PMC 172846. PMID 7704889.