An epidemiological study of syphilis and predictors of treatment failure in University Malaya Medical Center

@#Introduction: There are limited studies on the epidemiology of syphilis in Malaysia. In this study we describe the clinical features and treatment outcomes of patients with syphilis attending a tertiary referral university hospital. Methods: We retrospectively reviewed the case records of patients with positive serology findings for syphilis in University Malaya Medical Center (UMMC) from January 2010 to December 2015. Serological positivity was defined as having a positive rapid plasma reagin (RPR) or Venereal Disease Research Laboratory (VDRL) with a confirmatory positive Treponema pallidum particle agglutination assay (TPPA). Treatment outcomes were divided into two, success or failure. Demographic and clinical characteristics associated with predictors of treatment failure were assessed using statistical package for the social science (SPSS). This study also included a neurosyphilis descriptive sub-study. Results: There were 637 patients identified with positive syphilis serology, but 258 patients were excluded as they did not meet the inclusion criteria. 379 patients were then taken for the demographic study; 14 patients (3.7%) were treated for neurosyphilis; 170 patients with complete data were included. In all 42/170 (24.7%) failed treatment, 12/170 (7.1%) had reinfection and 116/170 (68.2%) had treatment success. A final number of 158 patients were then taken and analyzed for predictors of treatment failure after excluding the 12 reinfection patients. Only low baseline RPR (<1:16) was found to be significant on multivariate logistic regression analysis (p value: 0.007, 95% CI: 1.42, 9.21). Conclusion: Most of the patients were HIV positive and from the MSM (Men who have sex with Men) population. Low baseline RPR titre is a predictor of treatment failure.

Application analysis of three syphilis antibody detection methods for the clinical diagnosis / 国际检验医学杂志

Objective To explore the clinical application of treponema pallidum enzyme-linked immunosorbent assay (TP-ELISA),syphilis toluidine red unheated serum regain test (TRUST) and treponema pallidum particle agglutination assay (TPPA) for the diagnosis of syphilis,improvement of the process of sequence syphilis screening program and thus assisting clinical diagnosis and treatment of syphilis.Methods The serum samples were both screened by TP-ELISA and TRUST simultaneously.The positive was confirmed by TPPA test.Syphilis serological test results of patients were collected and retrospectively analyzed.Results The 3 618 cases out of total 82 026 serum samples were reactive by TP-ELISA,453 were reactive to TRUST,and 1 684 were confirmed positive on TPPA;thepositive rate were 4.41%,0.55%and 2.05%;The TP-ELISA,TRUST and TPPA positive conformity rate or titer were rising with the TP-ELISA S/CO and TRUST titer increasing.Conclusion There is a positive correlation of TP-ELISA S/CO among the TPPA,TRUST of positive conformity rate and titer.Using TP-ELISA and TRUST as screening,TPPA as confirmed test,the diagnostic efficiency of the process of sequence syphilis screening program can be improved.