Evaluation of Rapid Syphilis Testing Using the Syphilis Health Check in Florida, 2015–2016
The Syphilis Health Check (SHC) had low estimated specificity (91.5%) in one Florida county. We investigated use of SHC by a range of Florida publicly-funded programs between 2015 and 2016 to estimate specificity, positive predictive value (PPV), field staff acceptance, and impacts on programmatic o...
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2019-08-01
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doaj-7d707993a5d242ac919d366e03dca96d2020-11-24T21:56:05ZengUniversity of North FloridaFlorida Public Health Review2643-62482019-08-0116106119Evaluation of Rapid Syphilis Testing Using the Syphilis Health Check in Florida, 2015–2016Jennifer Richards0James Matthias1Charlotte Baker2Craig Wilson3Thomas A Peterman4C Perry Brown5Matthew Dutton6Yussif Dokurugu7Florida Agricultural and Mechnical University, Institute of Public HealthSTD and Viral Hepatitis Section, Florida Department of HealthDepartment of Population Health Sciences, Virginia Polytech Institute and State UniversitySTD and Viral Hepatitis Section, Florida Department of HealthDivision of STD Prevention, National Center for HIV/AIDS, Viral Hepatitis, STD, and TB Prevention, Centers for Disease Control and PreventionFlorida Agricultural and Mechnical University, Institute of Public HealthEconomic, Social, and Administrative Pharmacy, Florida Agricultural and Mechnical UniversityFlorida Agricultural and Mechnical University, Institute of Public HealthThe Syphilis Health Check (SHC) had low estimated specificity (91.5%) in one Florida county. We investigated use of SHC by a range of Florida publicly-funded programs between 2015 and 2016 to estimate specificity, positive predictive value (PPV), field staff acceptance, and impacts on programmatic outcomes. All reported SHC results were extracted from routinely collected program data. Field staff were surveyed about SHC’s utility. Analyses investigated differences between SHC and traditional syphilis testing outcomes. Of 3,630 SHC results reported, 442 were reactive; 92 (20.8%) had prior diagnoses of syphilis; 7 (1.6%) had no further testing. Of the remaining 343; 158 (46.0%) were confirmed cases, 168 (49.0%) were considered false-positive, and 17 (5.0%) were not cases but not clearly false-positive. Estimated specificity of SHC was 95.0%. Overall, 48.5% of positives became confirmed cases (PPV). PPV varied according to prevalence of syphilis in populations tested. Staff (90%) thought SHC helped identify new cases but expressed concern regarding discordance between reactive SHC and lab-based testing. Programmatic outcomes assessment showed shorter time to treatment and increased numbers of partners tested for the SHC group; these enhanced outcomes may better mitigate the spread of syphilis compared to traditional syphilis testing alone, but more research is needed.https://digitalcommons.unf.edu/cgi/viewcontent.cgi?article=1235&context=fphr |
collection |
DOAJ |
language |
English |
format |
Article |
sources |
DOAJ |
author |
Jennifer Richards James Matthias Charlotte Baker Craig Wilson Thomas A Peterman C Perry Brown Matthew Dutton Yussif Dokurugu |
spellingShingle |
Jennifer Richards James Matthias Charlotte Baker Craig Wilson Thomas A Peterman C Perry Brown Matthew Dutton Yussif Dokurugu Evaluation of Rapid Syphilis Testing Using the Syphilis Health Check in Florida, 2015–2016 Florida Public Health Review |
author_facet |
Jennifer Richards James Matthias Charlotte Baker Craig Wilson Thomas A Peterman C Perry Brown Matthew Dutton Yussif Dokurugu |
author_sort |
Jennifer Richards |
title |
Evaluation of Rapid Syphilis Testing Using the Syphilis Health Check in Florida, 2015–2016 |
title_short |
Evaluation of Rapid Syphilis Testing Using the Syphilis Health Check in Florida, 2015–2016 |
title_full |
Evaluation of Rapid Syphilis Testing Using the Syphilis Health Check in Florida, 2015–2016 |
title_fullStr |
Evaluation of Rapid Syphilis Testing Using the Syphilis Health Check in Florida, 2015–2016 |
title_full_unstemmed |
Evaluation of Rapid Syphilis Testing Using the Syphilis Health Check in Florida, 2015–2016 |
title_sort |
evaluation of rapid syphilis testing using the syphilis health check in florida, 2015–2016 |
publisher |
University of North Florida |
series |
Florida Public Health Review |
issn |
2643-6248 |
publishDate |
2019-08-01 |
description |
The Syphilis Health Check (SHC) had low estimated specificity (91.5%) in one Florida county. We investigated use of SHC by a range of Florida publicly-funded programs between 2015 and 2016 to estimate specificity, positive predictive value (PPV), field staff acceptance, and impacts on programmatic outcomes. All reported SHC results were extracted from routinely collected program data. Field staff were surveyed about SHC’s utility. Analyses investigated differences between SHC and traditional syphilis testing outcomes. Of 3,630 SHC results reported, 442 were reactive; 92 (20.8%) had prior diagnoses of syphilis; 7 (1.6%) had no further testing. Of the remaining 343; 158 (46.0%) were confirmed cases, 168 (49.0%) were considered false-positive, and 17 (5.0%) were not cases but not clearly false-positive. Estimated specificity of SHC was 95.0%. Overall, 48.5% of positives became confirmed cases (PPV). PPV varied according to prevalence of syphilis in populations tested. Staff (90%) thought SHC helped identify new cases but expressed concern regarding discordance between reactive SHC and lab-based testing. Programmatic outcomes assessment showed shorter time to treatment and increased numbers of partners tested for the SHC group; these enhanced outcomes may better mitigate the spread of syphilis compared to traditional syphilis testing alone, but more research is needed. |
url |
https://digitalcommons.unf.edu/cgi/viewcontent.cgi?article=1235&context=fphr |
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