Study objective: To evaluate targeted screening for syphilis among a high-risk group of emergency department patients. STUDY DESIGN AND TYPE OF PARTICIPANTS: During a four-month period, 260 patients with suspected sexually transmitted diseases other than syphilis had rapid plasma reagins drawn to determine the incidence of otherwise unsuspected syphilis.
Results: Twenty-two patients (8%) had a reactive rapid plasma reagin. Of these, 16 (6%) also had a reactive FTA-ABS and were determined to have syphilis. The cost for screening was $104.90 for each patient with syphilis. Using Poisson regression to control for changing rates over time and for prior differences in rates of syphilis detection in the three hospitals involved in the study, it was determined that our intervention led to 2.4-fold as many cases identified as would have been expected considering prior rates and the increasing incidence of syphilis.
Conclusion: Syphilis screening of this high-risk population in the ED is warranted.