Syphilis screening: Difference between revisions

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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>
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>
*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:

Revision as of 14:15, 19 September 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, 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.[4][1]
  • 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 population which require frequent screening includes: [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

  • Anually for sexually active MSM[5]
  • Every 3 to 6 months if increased risk

Women who have sex with women

  • Routine screening is recommended[2]

Persons with HIV

  • At first HIV evaluation for sexually active individuals[5][6][7]
  • Annually after first evaluation
  • More frequent testing for individuals who are at increased risk or are residing in highly prevalent area for syphilis

Screening tests

Screening tests recommended for syphilis include the following:[8]

Screening Non treponemal tests

  • Venereal Disease Research Laboratory (VDRL)
  • Rapid Plasma Reagin (RPR)

Confirmatory treponemal tests

  • Fluorescent treponemal antibody absorbed (FTA-ABS)
  • Treponema pallidum particle agglutination (TPPA)


  • The requirement to test for syphilis has been challenged due to the vast improvements in HIV testing.

US Preventive Services Task Force (USPSTF) Recommendation [9]

Grade A recommendation

1. Screen all pregnant women for syphilis infection.

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. More, Read. "Guidelines and recommendations." (1999).
  7. http://hivprevent.thelancet.com/content/guidelines-and-recommendations Accesed on September 19, 2016
  8. https://www.uspreventiveservicestaskforce.org/Page/Document/ClinicalSummaryFinal/syphilis-infection-in-pregnancy-screening Accessed on September 19, 2016
  9. "National Guideline Clearinghouse | Screening for syphilis infection in pregnancy: U.S. Preventive Services Task Force reaffirmation recommendation statement". Retrieved 2012-12-18.


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