Syphilis testing algorithms: A review

Table 1 Selected studies evaluating the reverse sequence syphilis screening and European Centre for Disease Prevention and control algorithms in comparison to the traditional algorithm for syphilis testing

Screening method	Confirmatory method	Third method	No. of samples screened	% reactive results in initial screen	% of screening results confirmed	% of discrepant results confirmed by third method	Ref.
EIA/CIA	RPR	TPPA, FTA-ABS	12774	14.5%	49%	86%	CDC[19]
TPPA	CIA	N/A	24124	11.4%	99%	N/A	Tong et al[28]
TPPA	RPR	CIA	24124	11.4%	76%	99%	Tong et al[28]
Multiple EIA methods	RPR	TPPA/FTA-ABS	116822	5.6%	44%	83%	CDC et al[26]
CIA	RPR	TPPA, FTA-ABS	28261	4.1%	31%	89%	Hunter et al[21]
EIA/CIA	RPR	TPPA, FTA-ABS	127402	2.3%	39%	59%	CDC[19]
CIA	RPR	TPPA	21623	2.2%	42%	78%	Park et al[33]
EIA	RPR	TPPA, FTA-ABS, TPHA	1037025	2.0%	30%	84%	Mishra et al[15]
CIA	RPR	TPPA	15713	1.7%	82%	82%	Lee et al[24]

RPR: Rapid plasma reagin; TPPA: Treponema pallidum particle agglutination test; EIA: Enzyme immunoassay; CIA: Chemiluminescence immunoassay; FTA-ABS: Fluorescent Treponemal Antibody Absorption test; CDC: Centers for Disease Control and Prevention.