Improved rapid diagnostic tests to detect syphilis and yaws: A systematic review and meta-analysis

Ying Zhang, Su Mei Goh, Maeve B. Mello, Rachel C. Baggaley, Teodora Wi, Cheryl C. Johnson, Kingsley B. Asiedu, Michael Marks, Minh D. Pham, Christopher K. Fairley, Eric P.F. Chow, Oriol Mitjà, Igor Toskin, Ronald C. Ballard, Jason J. Ong

Research output: Contribution to journalReview ArticleResearchpeer-review

2 Citations (Scopus)

Abstract

Background: Current rapid tests for syphilis and yaws can detect treponemal and non-treponemal antibodies. We aimed to critically appraise the literature for rapid diagnostic tests (RDTs) which can better distinguish an active infection of syphilis or yaws. Methods: We conducted a systematic review and meta-analysis, searching five databases between January 2010 and October 2021 (with an update in July 2022). A generalised linear mixed model was used to conduct a bivariate meta-analysis for the pooled sensitivity and specificity. Heterogeneity was assessed using the I2 statistic. We used the Quality Assessment of Diagnostic Accuracy Studies (QUADAS) to assess the risk of bias and Grading of Recommendations, Assessment, Development and Evaluations (GRADE) to evaluate the certainty of evidence. Results: We included 17 studies for meta-analyses. For syphilis, the pooled sensitivity and specificity of the treponemal component were 0.93 (95% CI: 0.86 to 0.97) and 0.98 (95% CI: 0.96 to 0.99), respectively. For the non-treponemal component, the pooled sensitivity and specificity were 0.90 (95% CI: 0.82 to 0.95) and 0.97 (95% CI: 0.92 to 0.99), respectively. For yaws, the pooled sensitivity and specificity of the treponemal component were 0.86 (95% CI: 0.66 to 0.95) and 0.97 (95% CI: 0.94 to 0.99), respectively. For the non-treponemal component, the pooled sensitivity and specificity were 0.80 (95% CI: 0.55 to 0.93) and 0.96 (95% CI: 0.92 to 0.98), respectively. Conclusions: RDTs that can differentiate between active and previously treated infections could optimise management by providing same-day treatment and reducing unnecessary treatment. PROSPERO registration number: CRD42021279587.

Original languageEnglish
Article number055546
Pages (from-to)608-616
Number of pages9
JournalSexually Transmitted Infections
Volume98
Issue number8
DOIs
Publication statusPublished - Dec 2022

Keywords

  • DIAGNOSIS
  • SYPHILIS
  • YAWS

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