Is routine antenatal venereal disease research laboratory test still justified? Nigerian experience
- PMID: 25610000
- PMCID: PMC4294656
- DOI: 10.2147/IJWH.S70442
Is routine antenatal venereal disease research laboratory test still justified? Nigerian experience
Abstract
Objective: To determine the seroreactivity of pregnant women to syphilis in order to justify the need for routine antenatal syphilis screening.
Methods: A multicenter retrospective analysis of routine antenatal venereal disease research laboratory (VDRL) test results between 1 September 2010 and 31 August 2012 at three specialist care hospitals in south-east Nigeria was done. A reactive VDRL result is subjected for confirmation using Treponema pallidum hemagglutination assay test. Analysis was by Epi Info 2008 version 3.5.1 and Stata/IC version 10.
Results: Adequate records were available regarding 2,156 patients and were thus reviewed. The mean age of the women was 27.4 years (±3.34), and mean gestational age was 26.4 weeks (±6.36). Only 15 cases (0.70%) were seropositive to VDRL. Confirmatory T. pallidum hemagglutination assay was positive in 4 of the 15 cases, giving an overall prevalence of 0.19% and a false-positive rate of 73.3%. There was no significant difference in the prevalence of syphilis in relation to maternal age and parity (P>0.05).
Conclusion: While the prevalence of syphilis is extremely low in the antenatal care population at the three specialist care hospitals in south-east Nigeria, false-positive rate is high and prevalence did not significantly vary with maternal age or parity. Because syphilis is still a serious but preventable and curable disease, screening with VDRL alone, without confirmatory tests may not be justified. Because of the increase in the demand for evidence-based medicine and litigation encountered in medical practice, we may advocate that confirmatory test for syphilis is introduced in routine antenatal testing to reduce the problem of false positives. The government should increase the health budget that will include free routine antenatal testing including the T. pallidum hemagglutination assay.
Keywords: VDRL tests; antenatal care; congenital syphilis management; treponema screening.
Similar articles
-
Syphilis in pregnant women in Mozambique.Genitourin Med. 1985 Dec;61(6):355-8. doi: 10.1136/sti.61.6.355. Genitourin Med. 1985. PMID: 3910543 Free PMC article.
-
Evaluation of the usefulness of Treponema pallidum hemagglutination test in the diagnosis of syphilis in weak reactive Venereal Disease Research Laboratory sera.Indian J Sex Transm Dis AIDS. 2012 Jul;33(2):102-6. doi: 10.4103/0253-7184.102117. Indian J Sex Transm Dis AIDS. 2012. PMID: 23188934 Free PMC article.
-
Seroprevalence of venereal disease among pregnant women attending antenatal care (ANC) in Onitsha, Anambra State, Southeast, Nigeria.Niger J Med. 2011 Jan-Mar;20(1):57-60. Niger J Med. 2011. PMID: 21970261
-
Utility of immunochromatographic assay as a rapid point of care test for screening of antenatal syphilis.Indian J Sex Transm Dis AIDS. 2015 Jul-Dec;36(2):162-5. doi: 10.4103/0253-7184.167159. Indian J Sex Transm Dis AIDS. 2015. PMID: 26692609 Free PMC article.
-
Syphilis in women of reproductive age in Mogadishu, Somalia: serological survey.Genitourin Med. 1987 Oct;63(5):326-8. doi: 10.1136/sti.63.5.326. Genitourin Med. 1987. PMID: 3500110 Free PMC article.
References
-
- Frickmann H, Schwarz NG, Girmann M, et al. Serological survey of HIV and syphilis in pregnant women in Madagascar. Trop Med Int Health. 2013;18:35–39. - PubMed
-
- Binnicker MJ. Which algorithm should be used to screen for syphilis? Curr Opin Infect Dis. 2012;25:79–85. - PubMed
-
- Stray-Pederson B. Economic evaluation of maternal screening to prevent congenital syphilis. Sex Transm Dis. 1983;10:167–172. - PubMed
-
- Osoba AO. Serological test for syphilis among hospital patients in Ibadan, 1968–1970; Proceedings of the first medical research seminar, Fifty years of medical research in Nigeria; 1–4 February 1972; Yaba, Lagos: Academic Press; 1972. pp. 49–52.
LinkOut - more resources
Full Text Sources