Abstract
This study examined the decentralization of syphilis screening for improved care in Jamaican public clinics. One of every five serum samples tested at the six peripheral sites was frozen and retested at the central laboratory in Kingston. Patient files and laboratory logbooks were compared over a 3-month period. Between May 1993 and December 1994, 15.5% of 32913 patients with sexually transmitted diseases and 8.3% of 8914 women seeking prenatal care were found syphilis seroreactive. Of 2001 samples evaluated, 1933 (96.6%) had been correctly reported at the peripheral sites. Of 129 syphilis seroreactors detected at the peripheral sites, 88 (68%) were treated the same day and 21 (16%) more within 3 days after testing. Syphilis seroreactors were accurately detected and quickly treated at the peripheral sites. If these efforts can be sustained, Jamaican syphilis rates should decrease.
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