South African Medical Journal

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On-site screening for syphilis at an antenatal clinic

S D Delport, J H Y van den Berg


Objective. To determine the validity, predictive value and accuracy of the rapid plasma reagin card test performed on site to diagnose active syphilis in pregnant women so that immediate treatment can be offered to prevent congenital syphilis.
Design. Open, descriptive study.
Setting. Antenatal clinic, Mamelodi Hospital, Pretoria.
Patients. Four hundred and seventy-four pregnant women attending the antenatal clinic for the first time were entered into the study.
Methods. A rapid plasma reagin test was performed on site with no specialised equipment and the results were compared with those of the reference laboratory.
Results. In the event of rapid plasma reagin titres of 1:8 and higher, indicative of active syphilis, the on-site rapid plasma reagin test had a sensitivity of 90.5%. The test had a sensitivity of 100% if the rapid plasma reagin titres were 1:16 and higher.
Conclusion. The on-site rapid plasma reagin test identified all women with rapid plasma reagin titres higher than 1:8. This implies that all women whose fetuses were in danger of acquiring congenital syphilis were identified at the clinic and could be treated immediately.

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