{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,4]],"date-time":"2026-05-04T20:42:52Z","timestamp":1777927372391,"version":"3.51.4"},"reference-count":29,"publisher":"SAGE Publications","issue":"2","license":[{"start":{"date-parts":[[2021,11,1]],"date-time":"2021-11-01T00:00:00Z","timestamp":1635724800000},"content-version":"unspecified","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["Int J STD AIDS"],"published-print":{"date-parts":[[2022,2]]},"abstract":"<jats:p>In Ottawa, Canada, we initiated protocols to include non-serologic syphilis testing, as direct fluorescence antibody (DFA) for patients with syphilis symptoms. The purpose was to assess the ability of DFA to detect syphilis during acute infection and to determine if non-serologic testing could yield an increased number of syphilis diagnoses. We reviewed charts of patients of our local sexual health clinic for whom syphilis was suspected. A total of 69 clinical encounters were recorded for 67 unique patients, most of whom were male. The most common symptom was a painless genital lesion. Of the 67 patients, 29 were found to have a new syphilis diagnosis, among whom, 52% had positive syphilis serology and positive DFA, 34% had a positive syphilis serology and negative DFA, and 14% had negative syphilis serology and positive DFA. While DFA testing did not yield an abundance of new cases, it was useful to support findings from syphilis serology or confirm diagnosis where serology was negative. Where available, alternate non-serologic tests, such as nucleic acid amplification tests, should be considered above DFA due to its higher sensitivity for detecting syphilis in primary lesions; however, in clinical situations, when new syphilis infection is suspected, empiric treatment should not be delayed.<\/jats:p>","DOI":"10.1177\/09564624211048610","type":"journal-article","created":{"date-parts":[[2021,11,1]],"date-time":"2021-11-01T11:44:04Z","timestamp":1635767044000},"page":"123-128","update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":1,"title":["Direct fluorescence antibody testing augments syphilis diagnosis, compared to serology alone"],"prefix":"10.1177","volume":"33","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-7732-2866","authenticated-orcid":false,"given":"Lauren","family":"Orser","sequence":"first","affiliation":[{"name":"University of Ottawa, School of Nursing, Ottawa, ON, Canada"},{"name":"Ottawa Public Health, Sexual Health Clinic, Ottawa, ON, Canada"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0587-1409","authenticated-orcid":false,"given":"Patrick","family":"O\u2019Byrne","sequence":"additional","affiliation":[{"name":"University of Ottawa, School of Nursing, Ottawa, ON, Canada"},{"name":"Ottawa Public Health, Sexual Health Clinic, Ottawa, ON, Canada"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"179","published-online":{"date-parts":[[2021,11,1]]},"reference":[{"key":"bibr1-09564624211048610","volume-title":"Infectious disease trends in Ontario","author":"Public Health Ontario","year":"2021"},{"key":"bibr2-09564624211048610","doi-asserted-by":"publisher","DOI":"10.4103\/ijstd.IJSTD_86_19"},{"key":"bibr3-09564624211048610","volume-title":"Canadian guidelines on sexually transmitted infections: Management and treatment of specific syndromes","author":"Public Health Agency of Canada","year":"2013"},{"key":"bibr4-09564624211048610","volume-title":"Canadian guidelines on sexually transmitted infections: Syphilis screening and diagnostic testing","author":"Public Health Agency of Canada","year":"2020"},{"key":"bibr5-09564624211048610","doi-asserted-by":"publisher","DOI":"10.1128\/CMR.12.2.187"},{"key":"bibr6-09564624211048610","doi-asserted-by":"publisher","DOI":"10.1136\/bmj.l4159"},{"key":"bibr7-09564624211048610","volume-title":"Sexually Transmitted Diseases","author":"Holmes KK","year":"2007","edition":"4"},{"key":"bibr8-09564624211048610","volume-title":"Laboratory Services: Syphilis, Serology","author":"Public Health Ontario","year":"2020"},{"key":"bibr9-09564624211048610","doi-asserted-by":"publisher","DOI":"10.1155\/2015\/685603"},{"issue":"2","key":"bibr10-09564624211048610","first-page":"283","volume":"68","author":"Brown DL","year":"2003","journal-title":"AFP"},{"key":"bibr11-09564624211048610","doi-asserted-by":"publisher","DOI":"10.1093\/cid\/ciaa176"},{"key":"bibr12-09564624211048610","doi-asserted-by":"publisher","DOI":"10.3389\/fcimb.2020.574806"},{"key":"bibr13-09564624211048610","doi-asserted-by":"publisher","DOI":"10.1128\/JCM.00100-21"},{"issue":"03","key":"bibr14-09564624211048610","first-page":"38","volume":"64","author":"Centers for Disease Control and Prevention","year":"2015","journal-title":"MMWR Recomm Rep"},{"key":"bibr15-09564624211048610","volume-title":"Cases of Infectious Diseases of Public Health Significance in Ottawa","author":"Ottawa Public Health","year":"2020"},{"key":"bibr16-09564624211048610","doi-asserted-by":"publisher","DOI":"10.1016\/j.apnr.2015.06.003"},{"key":"bibr17-09564624211048610","volume-title":"Syphilis: Provincial Case Definitions for Diseases of Public Health Significance","author":"Ontario Ministry of Health","year":"2019"},{"key":"bibr18-09564624211048610","volume-title":"Infectious Diseases Protocol","author":"Ontario Ministry of Health","year":"2020"},{"key":"bibr19-09564624211048610","doi-asserted-by":"publisher","DOI":"10.1097\/JXX.0000000000000370"},{"key":"bibr20-09564624211048610","volume-title":"Sexually Transmitted Infection Treatment Guidelines","author":"Centers for Disease Control and Prevention","year":"2021"},{"key":"bibr21-09564624211048610","doi-asserted-by":"publisher","DOI":"10.14745\/ccdr.v42i02a04"},{"key":"bibr22-09564624211048610","volume-title":"Syphilis Strikes Back","author":"Centre for Disease Control and Prevention","year":"2021"},{"key":"bibr23-09564624211048610","doi-asserted-by":"publisher","DOI":"10.1071\/SH14156"},{"key":"bibr24-09564624211048610","doi-asserted-by":"publisher","DOI":"10.14745\/ccdr.v44i02a02"},{"key":"bibr25-09564624211048610","volume-title":"Canadian Guidelines on Sexually Transmitted Infections. 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