Screening Veterans for Syphilis: Implementation of the Reverse Sequence Algorithm

Clin Infect Dis. 2017 Nov 13;65(11):1930-1933. doi: 10.1093/cid/cix679.

Abstract

We evaluated the syphilis reverse sequence algorithm (RSA) in a Veteran Affairs facility, finding 5.5% reactive Treponema pallidum enzyme immunoassay (EIA) tests. In a subset of EIA+/VDRL-/TP-PA+ cases, 48% were previously treated. Of veterans with unknown/no prior therapy, only 45% had documentation of subsequent treatment, suggesting suboptimal interpretation of RSA results.

Keywords: reverse sequence algorithm; syphilis screening; veterans.

MeSH terms

  • Algorithms*
  • Anti-Bacterial Agents / administration & dosage
  • Anti-Bacterial Agents / therapeutic use
  • Antibodies, Bacterial
  • Humans
  • Immunoenzyme Techniques / methods
  • Immunoglobulin G / blood
  • Male
  • Mass Screening
  • Retrospective Studies
  • Sensitivity and Specificity
  • Syphilis / diagnosis*
  • Syphilis / drug therapy
  • Syphilis / prevention & control
  • Syphilis Serodiagnosis / methods*
  • Treponema pallidum / immunology*
  • Treponema pallidum / isolation & purification
  • Veterans / statistics & numerical data*

Substances

  • Anti-Bacterial Agents
  • Antibodies, Bacterial
  • Immunoglobulin G