{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,2,21]],"date-time":"2025-02-21T11:02:31Z","timestamp":1740135751219,"version":"3.37.3"},"reference-count":23,"publisher":"Wiley","issue":"9","license":[{"start":{"date-parts":[[2017,7,19]],"date-time":"2017-07-19T00:00:00Z","timestamp":1500422400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"funder":[{"name":"Ministries of Health of the region"},{"DOI":"10.13039\/100011893","name":"Pan American Health Organization","doi-asserted-by":"crossref","id":[{"id":"10.13039\/100011893","id-type":"DOI","asserted-by":"crossref"}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Tropical Med Int Health"],"published-print":{"date-parts":[[2017,9]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Objective<\/jats:title><jats:p>To present the findings of the Pan American Health Organization's 2014 survey on syphilis testing policies and practices in the Americas.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>Representatives of national\/regional reference and large, lower\u2010level laboratories from 35 member states were invited to participate. A semi\u2010structured, electronically administered questionnaire collected data on syphilis tests, algorithms, equipment\/commodities, challenges faced and basic quality assurance (QA) strategies employed (i.e. daily controls, standard operating procedures, technician training, participating in external QA programmes, on\u2010site evaluations).<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>The 69 participating laboratories from 30 (86%) member states included 41 (59%) national\/regional reference and 28 (41%) lower\u2010level laboratories. Common syphilis tests conducted were the rapid plasma reagin (RPR) (62% of surveyed laboratories), venereal disease research laboratory (VDRL) (54%), fluorescent treponemal antibody absorption (FTA\u2010ABS) (41%) and <jats:italic>Treponema pallidum<\/jats:italic> haemagglutination assay (TPHA) (32%). Only three facilities reported using direct detection methods, and 28 (41% overall, 32% of lower\u2010level facilities) used rapid tests. Most laboratories (62%) used only traditional testing algorithms (non\u2010treponemal screening and treponemal confirmatory testing); however, 12% used only a reverse sequence algorithm (treponemal test first), and 14% employed both algorithms. Another nine (12%) laboratories conducted only one type of serologic test<jats:bold>.<\/jats:bold> Although most reference (97%) and lower\u2010level (89%) laboratories used at least one QA strategy, only 16% reported using all five basic strategies. Commonly reported challenges were stock\u2010outs of essential reagents or commodities (46%), limited staff training (73%) and insufficient equipment (39%)<jats:bold>.<\/jats:bold><\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>Many reference and clinical laboratories in the Americas face challenges in conducting appropriate syphilis testing and in ensuring quality of testing.<\/jats:p><\/jats:sec>","DOI":"10.1111\/tmi.12920","type":"journal-article","created":{"date-parts":[[2017,6,27]],"date-time":"2017-06-27T06:28:40Z","timestamp":1498544920000},"page":"1196-1203","source":"Crossref","is-referenced-by-count":3,"title":["Syphilis testing practices in the Americas"],"prefix":"10.1111","volume":"22","author":[{"given":"Thuy T.","family":"Trinh","sequence":"first","affiliation":[{"name":"Division of Sexually Transmitted Disease Prevention Centers for Disease Control and Prevention Atlanta GA USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Mary L.","family":"Kamb","sequence":"additional","affiliation":[{"name":"Division of Sexually Transmitted Disease Prevention Centers for Disease Control and Prevention Atlanta GA USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Minh","family":"Luu","sequence":"additional","affiliation":[{"name":"Emory University Atlanta GA USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"D. Cal","family":"Ham","sequence":"additional","affiliation":[{"name":"Division of Sexually Transmitted Disease Prevention Centers for Disease Control and Prevention Atlanta GA USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Freddy","family":"Perez","sequence":"additional","affiliation":[{"name":"HIV, Hepatitis, Tuberculosis and Sexually Transmitted Infections Unit\u2010Communicable Diseases and Health Analysis Department Pan American Health Organization Washington DC USA"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2017,7,19]]},"reference":[{"key":"e_1_2_6_2_1","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pone.0143304"},{"volume-title":"Investment Case for Eliminating Mother\u2010to\u2010Child Transmission of Syphilis: Promoting Better Maternal and Child Health and Stronger Health Systems","year":"2012","author":"World Health Organization (WHO)","key":"e_1_2_6_3_1"},{"key":"e_1_2_6_4_1","doi-asserted-by":"publisher","DOI":"10.1016\/S2214-109X(16)30135-8"},{"key":"e_1_2_6_5_1","doi-asserted-by":"publisher","DOI":"10.2471\/BLT.12.107623"},{"key":"e_1_2_6_6_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ijid.2012.07.021"},{"key":"e_1_2_6_7_1","doi-asserted-by":"publisher","DOI":"10.1186\/s12889-015-2002-0"},{"key":"e_1_2_6_8_1","first-page":"422","article-title":"Gestational syphilis and stillbirth in the Americas: a systematic review and meta\u2010analysis","volume":"37","author":"Arnesen L","year":"2015","journal-title":"Rev Panam Salud Publica"},{"volume-title":"Elimination of Mother\u2010to\u2010child Transmission of HIV and Syphilis: Update 2016","year":"2016","author":"Pan American Health Organization (PAHO)","key":"e_1_2_6_9_1"},{"volume-title":"Elimination of Mother\u2010to\u2010child Transmission of HIV and Syphilis: Update 2015 [Internet]","year":"2015","author":"Pan American Health Organization (PAHO)","key":"e_1_2_6_10_1"},{"key":"e_1_2_6_11_1","unstructured":"Pan American Health Organization (PAHO).Guidance on syphilis testing in Latin America and the Caribbean: improving uptake interpretation and quality of testing in different clinical settings 2015.http:\/\/iris.paho.org\/xmlui\/handle\/123456789\/7706[13 September 2016]."},{"key":"e_1_2_6_12_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ijgo.2015.04.011"},{"volume-title":"Syphilis Testing Practices in the Americas Region: Results of the 2014 Survey","year":"2016","author":"Pan American Health Organization (PAHO)","key":"e_1_2_6_13_1"},{"key":"e_1_2_6_14_1","unstructured":"Centers for Disease Control and Prevention (CDC).Laboratory standard 2014.https:\/\/www.cdc.gov\/labstandards\/[20 August 2016]."},{"key":"e_1_2_6_15_1","unstructured":"World Health Organization (WHO).Quality assurance.http:\/\/www.who.int\/diagnostics_laboratory\/quality\/en\/[13 July 2016]."},{"key":"e_1_2_6_16_1","unstructured":"Centers for Disease Control and Prevention (CDC).Venereal Disease Research Laboratory (VDRL) slide test.https:\/\/www.cdc.gov\/std\/syphilis\/manual-1998\/chapt8.pdf[30 September 2016]."},{"key":"e_1_2_6_17_1","unstructured":"Centers for Disease Control and Prevention (CDC).Rapid Plasma Reagin (RPR) 18\u2010MM Circle Card Test.https:\/\/www.cdc.gov\/std\/syphilis\/manual-1998\/chapt10.pdf[30 September 2016]."},{"key":"e_1_2_6_18_1","unstructured":"Centers for Disease Control and Prevention (CDC).Sexually transmitted diseases treatment guidelines 2015.http:\/\/www.cdc.gov\/mmwr\/preview\/mmwrhtml\/rr6403a1.htm[14 May 2016]."},{"key":"e_1_2_6_19_1","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pmed.1001233"},{"key":"e_1_2_6_20_1","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pone.0066905"},{"key":"e_1_2_6_21_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jviromet.2009.10.013"},{"key":"e_1_2_6_22_1","doi-asserted-by":"publisher","DOI":"10.1136\/sextrans-2013-051181"},{"key":"e_1_2_6_23_1","unstructured":"World Health Organization (WHO).Manual for procurement of diagnostics and related laboratory items and equipment 2013.http:\/\/www.who.int\/diagnostics_laboratory\/procurement\/130627_manual_for_procurement_of_diagnostics-001-june2013.pdf[16 August 2016]."},{"key":"e_1_2_6_24_1","unstructured":"Pan American Health Organization (PAHO).Concept Note: Regional consultation on algorithms for syphilis testing and diagnosis in Latin America and the Caribbean. 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