On-site screening for maternal syphilis in an antenatal clinic

Abstract

Study objective: To determine the sensitivity, specificity, negative predictive value and positive predictive value of the rapid plasma reagin (RPR) test as performed on site in an antenatal clinic to facilitate immediate diagnosis and treatment of maternal syphilis.

Design: Open, descriptive study.

Setting: Antenatal clinic, Kalafong Hospital, Pretoria.

Patients: One thousand two hundred and thirty-seven pregnant patients attending an antenatal clinic for the first time were entered into the study.

Methods: An RPR test was performed on site in the antenatal clinic and by the reference laboratory where a Treponema pallidum haemagglutination test was also performed.

Measurements and results: The results of the RPR test were compared with results reported by the laboratory for sensitivity, specificity, negative and positive predictive values. The RPR test performed on site had a sensitivity of 92.8%, a negative predictive value of 99.5%, a specificity of 96.3%, and a positive predictive value of 64.7%.

Conclusion: Maternal syphilis can be diagnosed in the majority of cases during the first visit to an antenatal clinic.