Analysis of the neurosyphilis incidence rate and quality oflaboratory diagnostics in the russian federation

Abstract

According to the analysis of the state statistical reporting, the rate of new neurosyphilis cases was growing in the Russian Federation in 1999-2009. Substantial differences in the number of detected neurosyphilis cases by different federal districts were established. Low-quality laboratory diagnostics was proved to be one of the factors promoting the neurosyphilis incidence rate. The quality of the neurosyphilis laboratory diagnostics was studied by means of questionnaires distributed among dedicated dermatovenerological medical institutions. Substantial shortcomings in the neurosyphilis laboratory diagnostics were established including absence of spinal fluid diagnostics in 17%-33% of the institutions and inadequate compliance with the regulatory study methods (immunofluorescence test with whole spinal fluid, microprecipitation test, cytosis and protein determination in the spinal fluid). For the purposes of optimizing the neurosyphilis diagnostics in the Russian Federation, we suggest to provide for all-round and complex examination of patients with suspected neurosyphilis based on the regulatory laboratory and functional diagnostics methods; it is also required to make the spinal fluid examination based on the passive hemagglutination test being highly sensitive and specific as well as having a high diagnostic efficacy for neurosyphilis a part of the standards aimed at rendering medical aid to neurosyphilis patients.