Evaluation of a rapid diagnostic test to assess the prevalence of maternal syphilis in Bolivia

Abstract

Syphilis is still a public health problem in Latin America and the Caribbean. Therefore maternal screening is of great importance for public health. To estimate the prevalence of maternal syphilis and to evaluate a rapid diagnostic test for the disease among Bolivian women. A total of 489 women delivering in a Public Hospital in Cochabamba, Bolivia, answered a questionnaire about socioeconomic and reproductive characteristics and access to health care services. Syphilis was diagnosed by using RPR and FTA-ABS tests. The rapid test Determine syphilis TP was evaluated taking as reference FTA-ABS test. Twenty two women (4.5%) were positive both for RPR and FTA-ABS tests and fifty (10.2%) were positive for the rapid diagnostic test and FTA-ABS. Compared with FTA-ABS, the sensitivity and specificity of the rapid test were 98% and 99.8%, respectively Only 15% of women that had at least one antenatal care visit had a syphilis screening test and 40% of the women in whom the test was performed, did not receive its results. Increasing age, low socioeconomic level and a history of a sexually transmitted disease were independently associated with syphilis infection. The magnitude of syphilis infection among the studied women was still high in Cochabamba. The rapid test showed excellent overall performance for maternal syphilis screening. Few women of all attended in the hospital had a screening syphilis test and half of those screened were not aware of the results. Maternal syphilis affected older women of low socioeconomic level and with a history of a sexually transmitted disease.