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{{Syphilis}}
{{Syphilis}}
==Overview==  
==Overview==  
Screening guidelines for syphilis include all high risk non pregnant individuals aged 15-65, all pregnant females, men who have sex with men, women who have sex with women, HIV positive individuals.<ref name= sypilis>https://www.uspreventiveservicestaskforce.org/Page/Document/UpdateSummaryFinal/syphilis-infection-in-nonpregnant-adults-and-adolescents?ds=1&s=syphilis Accessed on September 19, 2016</ref> Routine screening of adolescents who are asymptomatic for syphilis is not recommended <ref name=cdc5>http://www.cdc.gov/std/treatment/2010/specialpops.htm Accessed on September 19, 2016</ref><ref name=USPTF4> https://www.uspreventiveservicestaskforce.org/Page/Document/UpdateSummaryFinal/syphilis-infection-in-pregnancy-screening?ds=1&s=syphilis Accessed on September 19, 2016</ref>
Screening guidelines for syphilis include all high risk non-pregnant individuals aged 15-65, all pregnant females, men who have sex with men, women who have sex with women, and [[Human Immunodeficiency Virus (HIV)|HIV]] positive individuals.<ref name= sypilis>https://www.uspreventiveservicestaskforce.org/Page/Document/UpdateSummaryFinal/syphilis-infection-in-nonpregnant-adults-and-adolescents?ds=1&s=syphilis Accessed on September 19, 2016</ref> Routine screening of adolescents who are asymptomatic for syphilis is not recommended.<ref name=cdc5>http://www.cdc.gov/std/treatment/2010/specialpops.htm Accessed on September 19, 2016</ref><ref name=USPTF4> https://www.uspreventiveservicestaskforce.org/Page/Document/UpdateSummaryFinal/syphilis-infection-in-pregnancy-screening?ds=1&s=syphilis Accessed on September 19, 2016</ref>


==Screening==
==Screening==
[[Screening]] guidelines for syphilis are:
[[Screening]] guidelines for syphilis are:
===Non pregnant adults and adolescents (Age 15-65)===
===Non-pregnant adults and adolescents (age 15-65)===
*All individuals who are at increased risk for [[syphilis]] should be screened for syphilis [[United states preventive services task force recommendations scheme#USPSTF Grade Definitions|Grade A recommendation]].<ref name= sypilis>https://www.uspreventiveservicestaskforce.org/Page/Document/UpdateSummaryFinal/syphilis-infection-in-nonpregnant-adults-and-adolescents?ds=1&s=syphilis Accessed on September 19, 2016</ref><ref name="pmid27272583">{{cite journal| author=US Preventive Services Task Force (USPSTF). Bibbins-Domingo K, Grossman DC, Curry SJ, Davidson KW, Epling JW et al.| title=Screening for Syphilis Infection in Nonpregnant Adults and Adolescents: US Preventive Services Task Force Recommendation Statement. | journal=JAMA | year= 2016 | volume= 315 | issue= 21 | pages= 2321-7 | pmid=27272583 | doi=10.1001/jama.2016.5824 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=27272583  }} </ref>
*All individuals who are at increased risk for syphilis should be screened for syphilis [[United states preventive services task force recommendations scheme#USPSTF Grade Definitions|Grade A recommendation]].<ref name= sypilis>https://www.uspreventiveservicestaskforce.org/Page/Document/UpdateSummaryFinal/syphilis-infection-in-nonpregnant-adults-and-adolescents?ds=1&s=syphilis Accessed on September 19, 2016</ref><ref name="pmid27272583">{{cite journal| author=US Preventive Services Task Force (USPSTF). Bibbins-Domingo K, Grossman DC, Curry SJ, Davidson KW, Epling JW et al.| title=Screening for Syphilis Infection in Nonpregnant Adults and Adolescents: US Preventive Services Task Force Recommendation Statement. | journal=JAMA | year= 2016 | volume= 315 | issue= 21 | pages= 2321-7 | pmid=27272583 | doi=10.1001/jama.2016.5824 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=27272583  }} </ref>
*Routine screening of adolescents who are asymptomatic for syphilis is not recommended <ref name=cdc5>http://www.cdc.gov/std/treatment/2010/specialpops.htm Accessed on September 19, 2016</ref>
*Routine screening of adolescents who are asymptomatic for syphilis is not recommended <ref name=cdc5>http://www.cdc.gov/std/treatment/2010/specialpops.htm Accessed on September 19, 2016</ref>


===Pregnant women===
===Pregnant women===
*At first prenatal visit<ref name=CDC4>http://www.cdc.gov/std/tg2015/screening-recommendations.htm#modalIdString_CDCTable_2 Accessed on September 19, 2016</ref>
*At first prenatal visit<ref name=CDC4>http://www.cdc.gov/std/tg2015/screening-recommendations.htm#modalIdString_CDCTable_2 Accessed on September 19, 2016</ref>
*Retest at early third trimester and delivery if high risk <ref name=USPTF4> https://www.uspreventiveservicestaskforce.org/Page/Document/UpdateSummaryFinal/syphilis-infection-in-pregnancy-screening?ds=1&s=syphilis Accessed on September 19, 2016</ref>
*Retest at early third trimester and delivery if high risk<ref name=USPTF4> https://www.uspreventiveservicestaskforce.org/Page/Document/UpdateSummaryFinal/syphilis-infection-in-pregnancy-screening?ds=1&s=syphilis Accessed on September 19, 2016</ref>
*High risk population which require frequent screening includes: <ref name=USPTF4> https://www.uspreventiveservicestaskforce.org/Page/Document/UpdateSummaryFinal/syphilis-infection-in-pregnancy-screening?ds=1&s=syphilis Accessed on September 19, 2016</ref>
*High risk populations which require frequent screening include: <ref name=USPTF4> https://www.uspreventiveservicestaskforce.org/Page/Document/UpdateSummaryFinal/syphilis-infection-in-pregnancy-screening?ds=1&s=syphilis Accessed on September 19, 2016</ref>
:*Uninsured women
:*Uninsured women
:*Women living in poverty
:*Women living in poverty
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===Men who have sex with men===
===Men who have sex with men===
*Anually for sexually active men who have sex with men<ref name=CDC4>http://www.cdc.gov/std/tg2015/screening-recommendations.htm#modalIdString_CDCTable_2 Accessed on September 19, 2016</ref>
*Annually for sexually active men who have sex with men<ref name=CDC4>http://www.cdc.gov/std/tg2015/screening-recommendations.htm#modalIdString_CDCTable_2 Accessed on September 19, 2016</ref>
*Every 3 to 6 months if increased risk
*Every 3 to 6 months if increased risk


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*Routine screening is recommended<ref name=cdc5>http://www.cdc.gov/std/treatment/2010/specialpops.htm Accessed on September 19, 2016</ref>
*Routine screening is recommended<ref name=cdc5>http://www.cdc.gov/std/treatment/2010/specialpops.htm Accessed on September 19, 2016</ref>


===Persons with HIV===  
===HIV positive individuals===  
*At first HIV evaluation for sexually active individuals<ref name=CDC4>http://www.cdc.gov/std/tg2015/screening-recommendations.htm#modalIdString_CDCTable_2 Accessed on September 19, 2016</ref><ref name=lancet> http://hivprevent.thelancet.com/content/guidelines-and-recommendations Accesed on September 19, 2016</ref>
*At first HIV evaluation for sexually active individuals<ref name=CDC4>http://www.cdc.gov/std/tg2015/screening-recommendations.htm#modalIdString_CDCTable_2 Accessed on September 19, 2016</ref><ref name=lancet> http://hivprevent.thelancet.com/content/guidelines-and-recommendations Accesed on September 19, 2016</ref>
*Annually after first evaluation
*Annually after first evaluation
*More frequent testing for individuals who are at increased risk or are residing in highly prevalent area for syphilis
*More frequent testing for individuals who are at increased risk or are residing in highly prevalent areas of syphilis


==Screening tests==
==Screening tests==
Screening tests recommended for syphilis include the following:<ref name= UPTFS2>https://www.uspreventiveservicestaskforce.org/Page/Document/ClinicalSummaryFinal/syphilis-infection-in-pregnancy-screening Accessed on September 19, 2016</ref>
Screening tests recommended for syphilis include the following:<ref name= UPTFS2>https://www.uspreventiveservicestaskforce.org/Page/Document/ClinicalSummaryFinal/syphilis-infection-in-pregnancy-screening Accessed on September 19, 2016</ref>


===Screening Non treponemal tests===
===Screening non-treponemal tests===
*[[Venereal Disease Research Laboratory]] (VDRL)<ref name="pmid18159528">{{cite journal| author=Ratnam S| title=The laboratory diagnosis of syphilis. | journal=Can J Infect Dis Med Microbiol | year= 2005 | volume= 16 | issue= 1 | pages= 45-51 | pmid=18159528 | doi= | pmc=2095002 | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=18159528  }} </ref>
*[[Venereal Disease Research Laboratory]] (VDRL)<ref name="pmid18159528">{{cite journal| author=Ratnam S| title=The laboratory diagnosis of syphilis. | journal=Can J Infect Dis Med Microbiol | year= 2005 | volume= 16 | issue= 1 | pages= 45-51 | pmid=18159528 | doi= | pmc=2095002 | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=18159528  }} </ref>
*[[Rapid Plasma Reagin]](RPR)<ref name="pmid7704889">{{cite journal| author=Larsen SA, Steiner BM, Rudolph AH| title=Laboratory diagnosis and interpretation of tests for syphilis. | journal=Clin Microbiol Rev | year= 1995 | volume= 8 | issue= 1 | pages= 1-21 | pmid=7704889 | doi= | pmc=172846 | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=7704889  }} </ref>
*[[Rapid Plasma Reagin]](RPR)<ref name="pmid7704889">{{cite journal| author=Larsen SA, Steiner BM, Rudolph AH| title=Laboratory diagnosis and interpretation of tests for syphilis. | journal=Clin Microbiol Rev | year= 1995 | volume= 8 | issue= 1 | pages= 1-21 | pmid=7704889 | doi= | pmc=172846 | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=7704889  }} </ref>
Line 43: Line 43:
===Confirmatory treponemal tests===
===Confirmatory treponemal tests===
*[[Fluorescent treponemal antibody absorbed]] (FTA-ABS)<ref name="pmid18159528">{{cite journal| author=Ratnam S| title=The laboratory diagnosis of syphilis. | journal=Can J Infect Dis Med Microbiol | year= 2005 | volume= 16 | issue= 1 | pages= 45-51 | pmid=18159528 | doi= | pmc=2095002 | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=18159528  }} </ref>
*[[Fluorescent treponemal antibody absorbed]] (FTA-ABS)<ref name="pmid18159528">{{cite journal| author=Ratnam S| title=The laboratory diagnosis of syphilis. | journal=Can J Infect Dis Med Microbiol | year= 2005 | volume= 16 | issue= 1 | pages= 45-51 | pmid=18159528 | doi= | pmc=2095002 | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=18159528  }} </ref>
*Treponema pallidum particle agglutination (TPPA)<ref name="pmid7704889">{{cite journal| author=Larsen SA, Steiner BM, Rudolph AH| title=Laboratory diagnosis and interpretation of tests for syphilis. | journal=Clin Microbiol Rev | year= 1995 | volume= 8 | issue= 1 | pages= 1-21 | pmid=7704889 | doi= | pmc=172846 | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=7704889  }} </ref>
*''Treponema pallidum'' particle agglutination (TPPA)<ref name="pmid7704889">{{cite journal| author=Larsen SA, Steiner BM, Rudolph AH| title=Laboratory diagnosis and interpretation of tests for syphilis. | journal=Clin Microbiol Rev | year= 1995 | volume= 8 | issue= 1 | pages= 1-21 | pmid=7704889 | doi= | pmc=172846 | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=7704889  }} </ref>


==References==
==References==

Revision as of 18:53, 13 October 2016

Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1] Associate Editor(s)-in-Chief: Aysha Anwar, M.B.B.S[2]

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Overview

Screening guidelines for syphilis include all high risk non-pregnant individuals aged 15-65, all pregnant females, men who have sex with men, women who have sex with women, and HIV positive individuals.[1] Routine screening of adolescents who are asymptomatic for syphilis is not recommended.[2][3]

Screening

Screening guidelines for syphilis are:

Non-pregnant adults and adolescents (age 15-65)

  • All individuals who are at increased risk for syphilis should be screened for syphilis Grade A recommendation.[1][4]
  • Routine screening of adolescents who are asymptomatic for syphilis is not recommended [2]

Pregnant women

  • At first prenatal visit[5]
  • Retest at early third trimester and delivery if high risk[3]
  • High risk populations which require frequent screening include: [3]
  • Uninsured women
  • Women living in poverty
  • Sex workers
  • Illicit drug users
  • Presence of other sexually transmitted diseases (STDs)
  • Other women living in communities with high syphilis morbidity

Men who have sex with men

  • Annually for sexually active men who have sex with men[5]
  • Every 3 to 6 months if increased risk

Women who have sex with women

  • Routine screening is recommended[2]

HIV positive individuals

  • At first HIV evaluation for sexually active individuals[5][6]
  • Annually after first evaluation
  • More frequent testing for individuals who are at increased risk or are residing in highly prevalent areas of syphilis

Screening tests

Screening tests recommended for syphilis include the following:[7]

Screening non-treponemal tests

Confirmatory treponemal tests

References

  1. 1.0 1.1 https://www.uspreventiveservicestaskforce.org/Page/Document/UpdateSummaryFinal/syphilis-infection-in-nonpregnant-adults-and-adolescents?ds=1&s=syphilis Accessed on September 19, 2016
  2. 2.0 2.1 2.2 http://www.cdc.gov/std/treatment/2010/specialpops.htm Accessed on September 19, 2016
  3. 3.0 3.1 3.2 https://www.uspreventiveservicestaskforce.org/Page/Document/UpdateSummaryFinal/syphilis-infection-in-pregnancy-screening?ds=1&s=syphilis Accessed on September 19, 2016
  4. US Preventive Services Task Force (USPSTF). Bibbins-Domingo K, Grossman DC, Curry SJ, Davidson KW, Epling JW; et al. (2016). "Screening for Syphilis Infection in Nonpregnant Adults and Adolescents: US Preventive Services Task Force Recommendation Statement". JAMA. 315 (21): 2321–7. doi:10.1001/jama.2016.5824. PMID 27272583.
  5. 5.0 5.1 5.2 http://www.cdc.gov/std/tg2015/screening-recommendations.htm#modalIdString_CDCTable_2 Accessed on September 19, 2016
  6. http://hivprevent.thelancet.com/content/guidelines-and-recommendations Accesed on September 19, 2016
  7. https://www.uspreventiveservicestaskforce.org/Page/Document/ClinicalSummaryFinal/syphilis-infection-in-pregnancy-screening Accessed on September 19, 2016
  8. 8.0 8.1 Ratnam S (2005). "The laboratory diagnosis of syphilis". Can J Infect Dis Med Microbiol. 16 (1): 45–51. PMC 2095002. PMID 18159528.
  9. 9.0 9.1 Larsen SA, Steiner BM, Rudolph AH (1995). "Laboratory diagnosis and interpretation of tests for syphilis". Clin Microbiol Rev. 8 (1): 1–21. PMC 172846. PMID 7704889.


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