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Meta-Analysis
. 2022 Dec;98(8):608-616.
doi: 10.1136/sextrans-2022-055546. Epub 2022 Sep 30.

Improved rapid diagnostic tests to detect syphilis and yaws: a systematic review and meta-analysis

Ying Zhang  1 , Su Mei Goh  2 , Maeve B Mello  3 , Rachel C Baggaley  3 , Teodora Wi  3 , Cheryl C Johnson  3 , Kingsley B Asiedu  3 , Michael Marks  4   5   6 , Minh D Pham  7   8 , Christopher K Fairley  2   9 , Eric P F Chow  2   9   10 , Oriol Mitjà  11 , Igor Toskin  12 , Ronald C Ballard  12 , Jason J Ong  13   4   9
Affiliations
Meta-Analysis

Improved rapid diagnostic tests to detect syphilis and yaws: a systematic review and meta-analysis

Ying Zhang et al. Sex Transm Infect. 2022 Dec.

Abstract

Background: Current rapid tests for syphilis and yaws can detect treponemal and non-treponemal antibodies. We aimed to critically appraise the literature for rapid diagnostic tests (RDTs) which can better distinguish an active infection of syphilis or yaws.

Methods: We conducted a systematic review and meta-analysis, searching five databases between January 2010 and October 2021 (with an update in July 2022). A generalised linear mixed model was used to conduct a bivariate meta-analysis for the pooled sensitivity and specificity. Heterogeneity was assessed using the I2 statistic. We used the Quality Assessment of Diagnostic Accuracy Studies (QUADAS) to assess the risk of bias and Grading of Recommendations, Assessment, Development and Evaluations (GRADE) to evaluate the certainty of evidence.

Results: We included 17 studies for meta-analyses. For syphilis, the pooled sensitivity and specificity of the treponemal component were 0.93 (95% CI: 0.86 to 0.97) and 0.98 (95% CI: 0.96 to 0.99), respectively. For the non-treponemal component, the pooled sensitivity and specificity were 0.90 (95% CI: 0.82 to 0.95) and 0.97 (95% CI: 0.92 to 0.99), respectively. For yaws, the pooled sensitivity and specificity of the treponemal component were 0.86 (95% CI: 0.66 to 0.95) and 0.97 (95% CI: 0.94 to 0.99), respectively. For the non-treponemal component, the pooled sensitivity and specificity were 0.80 (95% CI: 0.55 to 0.93) and 0.96 (95% CI: 0.92 to 0.98), respectively.

Conclusions: RDTs that can differentiate between active and previously treated infections could optimise management by providing same-day treatment and reducing unnecessary treatment.

Prospero registration number: CRD42021279587.

Keywords: DIAGNOSIS; SYPHILIS; YAWS.

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Conflict of interest statement

Competing interests: None declared.

Figures

Figure 1
Figure 1
Preferred Reporting Items for Systematic Reviews and Meta-Analyses flow diagram.
Figure 2
Figure 2
Forest plot of treponemal sensitivity and specificity for syphilis.
Figure 3
Figure 3
Forest plot of non-treponemal sensitivity and specificity for syphilis.
Figure 4
Figure 4
Forest plot of treponemal sensitivity and specificity for yaws. *Unpublished studies.
Figure 5
Figure 5
Forest plot of non-treponemal sensitivity and specificity for yaws. *Unpublished studies.
See this image and copyright information in PMC

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References

    1. World Health Organization . Yaws Geneva; 2021. https://www.who.int/news-room/fact-sheets/detail/yaws [Accessed 30 Oct 2021].
    1. World Health Organization . Global progress report on HIV, viral hepatitis and sexually transmitted infections, 2021, 2021. Available: https://www.who.int/publications/i/item/9789240027077 [Accessed 30 Dec 2021].
    1. Gomez GB, Kamb ML, Newman LM, et al. . Untreated maternal syphilis and adverse outcomes of pregnancy: a systematic review and meta-analysis. Bull World Health Organ 2013;91:217–26. 10.2471/BLT.12.107623 - DOI - PMC - PubMed
    1. Tsuboi M, Evans J, Davies EP, et al. . Prevalence of syphilis among men who have sex with men: a global systematic review and meta-analysis from 2000-20. Lancet Glob Health 2021;9:e1110–8. 10.1016/S2214-109X(21)00221-7 - DOI - PMC - PubMed
    1. World Health Organization . Ending the neglect to attain the sustainable development goals: a road map for neglected tropical diseases 2021–2030; 2021. https://www.who.int/publications/i/item/9789240010352 [Accessed 10 Nov 2021].

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