Syphilis screening: Difference between revisions
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Screening guidelines for syphilis are: | Screening guidelines for syphilis are: | ||
===Non pregnant adults and adolescents (Age 15-65)=== | ===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]].<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 }} | *All individuals who are at increased risk for syphilis should be screened for syphilis [[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> | *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> | ||
Revision as of 14:16, 19 September 2016
Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1] Associate Editor(s)-in-Chief: Aysha Anwar, M.B.B.S[2]
Syphilis Microchapters | |
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Syphilis screening On the Web | |
American Roentgen Ray Society Images of Syphilis screening | |
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, 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 population which require frequent screening includes: [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
- Anually for sexually active MSM[5]
- Every 3 to 6 months if increased risk
Women who have sex with women
- Routine screening is recommended[2]
Persons with HIV
- At first HIV evaluation for sexually active individuals[5][6][7]
- Annually after first evaluation
- More frequent testing for individuals who are at increased risk or are residing in highly prevalent area for syphilis
Screening tests
Screening tests recommended for syphilis include the following:[8]
Screening Non treponemal tests
- Venereal Disease Research Laboratory (VDRL)
- Rapid Plasma Reagin (RPR)
Confirmatory treponemal tests
- Fluorescent treponemal antibody absorbed (FTA-ABS)
- Treponema pallidum particle agglutination (TPPA)
- The requirement to test for syphilis has been challenged due to the vast improvements in HIV testing.
- False positives on the rapid tests can be seen in viral infections (Epstein-Barr, hepatitis, varicella, measles), lymphoma, tuberculosis, malaria, endocarditis, connective tissue disease, pregnancy, intravenous drug abuse, or contamination. As a result, these two screening tests should always be followed up by a more specific treponemal test.
US Preventive Services Task Force (USPSTF) Recommendation [9]
“ |
Grade A recommendation1. Screen all pregnant women for syphilis infection. |
” |
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
- ↑ More, Read. "Guidelines and recommendations." (1999).
- ↑ 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
- ↑ "National Guideline Clearinghouse | Screening for syphilis infection in pregnancy: U.S. Preventive Services Task Force reaffirmation recommendation statement". Retrieved 2012-12-18.