{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2024,7,27]],"date-time":"2024-07-27T07:04:57Z","timestamp":1722063897461},"reference-count":26,"publisher":"Wiley","issue":"1","license":[{"start":{"date-parts":[[2018,10,12]],"date-time":"2018-10-12T00:00:00Z","timestamp":1539302400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Acad Dermatol Venereol"],"published-print":{"date-parts":[[2019,1]]},"abstract":"Abstract<\/jats:title>Background<\/jats:title>Currently, many laboratories have switched the traditional screening algorithm (TSA<\/jats:styled-content>) to reverse screening algorithm (RSA<\/jats:styled-content>) for the efficiencies in high\u2010volume syphilis screening. However, confusions have been arisen regarding this paradigm shift.<\/jats:p><\/jats:sec>Objective<\/jats:title>To compare the performance of two algorithms with head\u2010to\u2010head mode.<\/jats:p><\/jats:sec>Methods<\/jats:title>Sera screening for syphilis were tested in parallel with chemiluminescence immunoassay (CIA<\/jats:styled-content>) and toluidine red unheated serum test (TRUST<\/jats:styled-content>). CIA<\/jats:styled-content>\u2010reactive sera from the RSA<\/jats:styled-content> were reflexively tested with TRUST<\/jats:styled-content> and confirmed with Treponema pallidum<\/jats:italic> particle agglutination assay (TPPA<\/jats:styled-content>), while the TRUST<\/jats:styled-content>\u2010reactive serology from the TSA<\/jats:styled-content> were afterwards tested with TPPA<\/jats:styled-content>.<\/jats:p><\/jats:sec>Results<\/jats:title>A total of 110 663 serum samples were screened. The RSA<\/jats:styled-content> identified 2259 (2.0%) CIA<\/jats:styled-content>\u2010reactive results, of which 377 (16.7%) showed TPPA nonreactive results, while the TSA<\/jats:styled-content> identified 934 (0.8%) TRUST<\/jats:styled-content>\u2010reactive results, of which 67 (7.2%) showed TPPA<\/jats:styled-content>\u2010nonreactive results. Among the 2259 CIA<\/jats:styled-content>\u2010reactive results, 1392 (61.6%) were TRUST<\/jats:styled-content>\u2010nonreactive, of which 350 (25.1%) were TPPA<\/jats:styled-content>\u2010nonreactive. A total of 182 sera from the 350 TPPA<\/jats:styled-content>\u2010nonreactive sera were further tested by a second CIA<\/jats:styled-content> (VITROS<\/jats:styled-content> Syphilis TPA<\/jats:styled-content>, VITROS TPA<\/jats:styled-content>), of which 155 (85.2%) were nonreactive and 27 (14.8%) were reactive. The 27 VITROS TPA<\/jats:styled-content>\u2010reactive sera were further tested with a treponemal Western blot assay (Euroimmun IgG Western Blot, EuroWB<\/jats:styled-content>), of which 11 (41%) were indeterminate, 6 (22%) were nonreactive and 10 (37%) were reactive. Among the 10 EuroWB<\/jats:styled-content>\u2010reactive sera, two seroconverted to TPPA<\/jats:styled-content> 1:80+\/\u2212 after 1\u2010year follow\u2010up. Of 867 CIA<\/jats:styled-content>\u2010reactive\/TRUST<\/jats:styled-content>\u2010reactive results, 27 (3.1%) were TPPA<\/jats:styled-content>\u2010nonreactive.<\/jats:p><\/jats:sec>Conclusions<\/jats:title>The RSA<\/jats:styled-content> identified more patients with reactive treponemal serology. However, it also yielded an increased likely false\u2010reactive rate compared with the TSA<\/jats:styled-content>, especially those results with low index values and TRUST<\/jats:styled-content>\u2010nonreactive serology, were necessary to retest with a second treponemal test. Further testing results with TPPA<\/jats:styled-content>, VITROS TPA<\/jats:styled-content> and EuroWB<\/jats:styled-content> suggested the false\u2010reactive CIA<\/jats:styled-content> screening results and the likely false\u2010nonreactive TPPA<\/jats:styled-content> results when the reactive treponemal results screened with RSA<\/jats:styled-content> were to be identified.<\/jats:p><\/jats:sec>","DOI":"10.1111\/jdv.15251","type":"journal-article","created":{"date-parts":[[2018,9,17]],"date-time":"2018-09-17T22:59:10Z","timestamp":1537225150000},"page":"178-184","update-policy":"http:\/\/dx.doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":4,"title":["Screening for syphilis with dual algorithms: analysis of discordant and concordant serology results in a population with a low prevalence of syphilis"],"prefix":"10.1111","volume":"33","author":[{"given":"Y.\u2010H.","family":"Zhuang","sequence":"first","affiliation":[{"name":"Department of Clinical 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