{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,2,14]],"date-time":"2026-02-14T04:06:43Z","timestamp":1771042003150,"version":"3.50.1"},"reference-count":44,"publisher":"American Society of Tropical Medicine and Hygiene","issue":"6","license":[{"start":{"date-parts":[[2024,6,5]],"date-time":"2024-06-05T00:00:00Z","timestamp":1717545600000},"content-version":"unspecified","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2024,6,5]]},"abstract":"<jats:title>ABSTRACT.<\/jats:title>\n<jats:p>There are a variety of nontreponemal test (NTT) and treponemal test (TT) kits for the serologic diagnosis of syphilis. Because of the complexity of the infection (multiple clinical stages) and the different antigens used in these kits, a systematic evaluation of the accuracy of the currently available commercial tests is warranted. Our objective was to evaluate the performance of commercially available tests for the diagnosis of syphilis infection. In this study, we analyzed one NTT (Venereal Disease Research Laboratory [VDRL] test, Wiener Laboratories, Rosario, Argentina) and two TTs (fluorescent treponemal antibody absorption [FTA-ABS] test, Euroimmun, L\u00fcbeck, Germany, and syphilis recombinant ELISA v. 4.0 test [ELISA], Wiener Laboratories, Rosario, Argentina) using a panel of 187 samples, including serum samples from 31 individuals with primary syphilis, 77 with secondary syphilis, and 79 with latent syphilis. An additional 192 samples from uninfected individuals and 323 serum samples from individuals with other diseases were included. The sensitivities of the VDRL, ELISA, and FTA-ABS tests were 97.9%, 100%, and 96.3%, respectively. The VDRL and ELISA tests showed a specificity of 100%, and the FTA-ABS test showed a specificity of 99.5%. Accuracy was 98.9% for the VDRL test, 100% for the ELISA, and 97.9% for the FTA-ABS test. For primary, secondary, and latent syphilis, the ELISA achieved a diagnostic performance of 100%, whereas the sensitivity for the VDRL and FTA-ABS tests ranged from 96.8% to 98.7% and 93.7% to 98.7%, respectively. No difference was observed when the tests were used as traditional or reverse algorithms. In general, all three tests are able to discriminate positive and negative samples for syphilis, regardless of the diagnostic algorithm.<\/jats:p>","DOI":"10.4269\/ajtmh.23-0238","type":"journal-article","created":{"date-parts":[[2024,4,9]],"date-time":"2024-04-09T17:47:21Z","timestamp":1712684841000},"page":"1237-1244","source":"Crossref","is-referenced-by-count":4,"title":["Performance Assessment of Treponemal and Nontreponemal Tests for the Diagnosis of Acquired Syphilis"],"prefix":"10.4269","volume":"110","author":[{"given":"\u00c2ngelo Ant\u00f4nio Oliveira","family":"Silva","sequence":"first","affiliation":[{"name":"Advanced Public Health Laboratory, Institute Gon\u00e7alo Moniz, Foundation Oswaldo Cruz (FIOCRUZ-BA), Salvador, Brazil;"},{"name":"Salvador University (UNIFACS), Salvador, Brazil;"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ayla Ara\u00fajo","family":"Lima","sequence":"additional","affiliation":[{"name":"Advanced Public Health Laboratory, Institute Gon\u00e7alo Moniz, Foundation Oswaldo Cruz (FIOCRUZ-BA), Salvador, Brazil;"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Larissa de Carvalho Medrado","family":"Vasconcelos","sequence":"additional","affiliation":[{"name":"Advanced Public Health Laboratory, Institute Gon\u00e7alo Moniz, Foundation Oswaldo Cruz (FIOCRUZ-BA), Salvador, Brazil;"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ros\u00e2ngela Andrade","family":"de Almeida","sequence":"additional","affiliation":[{"name":"Advanced Public Health Laboratory, Institute Gon\u00e7alo Moniz, Foundation Oswaldo Cruz (FIOCRUZ-BA), Salvador, Brazil;"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Nat\u00e1lia Erdens Maron","family":"de Freitas","sequence":"additional","affiliation":[{"name":"Advanced Public Health Laboratory, Institute Gon\u00e7alo Moniz, Foundation Oswaldo Cruz (FIOCRUZ-BA), Salvador, Brazil;"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Fernanda Lopes","family":"Habib","sequence":"additional","affiliation":[{"name":"Advanced Public Health Laboratory, Institute Gon\u00e7alo Moniz, Foundation Oswaldo Cruz (FIOCRUZ-BA), Salvador, Brazil;"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Talita Andrade","family":"Oliva","sequence":"additional","affiliation":[{"name":"State Center Specializing in Diagnosis, Assistance, and Research (CEDAP), Salvador, Brazil;"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Miralba Freire de Carvalho Ribeiro","family":"da Silva","sequence":"additional","affiliation":[{"name":"State Center Specializing in Diagnosis, Assistance, and Research (CEDAP), Salvador, Brazil;"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Isadora Cristina","family":"de Siqueira","sequence":"additional","affiliation":[{"name":"Laboratory of Experimental Pathology, Institute Gon\u00e7alo Moniz, Foundation Oswaldo Cruz (FIOCRUZ-BA), Salvador, Brazil;"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Fred Luciano Neves","family":"Santos","sequence":"additional","affiliation":[{"name":"Advanced Public Health Laboratory, Institute Gon\u00e7alo Moniz, Foundation Oswaldo Cruz (FIOCRUZ-BA), Salvador, Brazil;"},{"name":"Integrated Translational Program in Chagas Disease from Fiocruz (Fio-Chagas), Rio de Janeiro, Brazil"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"2795","reference":[{"key":"b1","series-title":"Bull World Health Organ","first-page":"548","article-title":"Chlamydia, gonorrhoea, trichomoniasis and syphilis: global prevalence and incidence estimates, 2016","volume":"97","author":"Rowley","year":"2019"},{"key":"b2","series-title":"Bull World Health Organ","first-page":"217","article-title":"Untreated maternal syphilis and adverse outcomes of pregnancy: a systematic review and 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Meta-analysis of eight external quality control surveys performed by the German infection serology proficiency testing program","volume":"44","author":"M\u00fcller","year":"2006"},{"key":"b24","series-title":"Clin Infect Dis","first-page":"S21","article-title":"Syphilis laboratory guidelines: performance characteristics of nontreponemal antibody tests","volume":"71","author":"Tuddenham","year":"2020"},{"key":"b25","series-title":"Sex Transm Dis","first-page":"285","article-title":"Evaluation of diagnostic serological results in cases of suspected primary syphilis infection","volume":"41","author":"Gratzer","year":"2014"},{"key":"b26","series-title":"J Clin Lab Anal","first-page":"204","article-title":"The diagnostic value and performance evaluation of five serological tests for the detection of Treponema pallidum.","volume":"28","author":"Liu","year":"2014"},{"key":"b27","series-title":"J Immunol Res","first-page":"2978419","article-title":"Comparison of RPR and ELISA with TPHA for the 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syphilis","volume":"75","author":"Evren","year":"2022"},{"key":"b44","series-title":"Am J Clin Pathol","first-page":"572","article-title":"Performance characteristics of the reverse syphilis screening algorithm in a population with a moderately high prevalence of syphilis","volume":"146","author":"Rourk","year":"2016"}],"container-title":["The American Journal of Tropical Medicine and 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