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APHA Scientific Session and Event Listing

Freddy Tinajeros, MPH¹, Matthew Steele, PhD², Dan Grossman³, Sandra Garcia, ScD, ScM⁴, Kara Richmond, MPH⁵, Lourdes Zegarra⁶, and Rita Revollo, MD¹. (1) Population Council, Calle 18 de Calacoto No. 8082, La Paz, Bolivia, 591 2-2792545, ftinajeros@popcouncil.org.bo, (2) PATH, 1455 NW Leary Way, Seattle, WA 98107, (3) Ibis Reproductive Health, UCSF 3333 California Street, Suite 335, San Francisco, CA 94143-0744, (4) Population Council Regional Office for Latin America and the Caribbean, One Dag Hammarskjold Plaza, New York, NY 01070, (5) Independent consultant, 712 La Veta Dr. NE, Albuquerque, NM 87108, (6) INLASA, Ministry of Health, Av. Saavedra, pasaje Rafael Zubieta No. 1889, Miraflores, La Paz, Bolivia

Background: Traditional syphilis screening covers just 19.8% of pregnant Bolivian women. Using a syphilis rapid strip test in rural areas that lack adequate laboratory facilities could improve capacity to diagnose syphilis. We investigated the sensitivity and specificity of the syphilis rapid strip test Abbott Determine TP among pregnant women attending prenatal care at four urban hospitals in Bolivia. We compared the test's performance with that of a Rapid Plasma Reagin (RPR) test confirmed with Treponema pallidum particle agglutination assay (TPPA).

Methods: We recruited 8,900 pregnant women receiving prenatal care in the four largest hospitals in Bolivia. Eligible women underwent the rapid strip test with a finger-stick blood test. A second blood sample was taken to perform the RPR/TPPA. We used 2x2 tables to determine test sensitivity, specificity, positive predictive value, and negative predictive value, using the RPR/TPPA result as the gold standard.

Results: Maternal syphilis prevalence detected with the RPR/TPPA was 3.84% (95% CI: 3.5 – 4.3). However, the rapid strip test Abbott Determine TP without TPPA identified a prevalence of 5.0% (95% CI: 4.8 – 5.2). The rapid test's sensitivity was 91.8% (95% CI: 88.4 - 94.5), specificity was 98.5% (95% CI: 98.2 - 98.8), negative predictive value was 71.0% (95% CI: 66.6 - 75.2), and positive predictive value was 99.7% (95% CI: 99.5 - 99.8).

Conclusions: The Abbott Determine TP is highly sensitive and specific. This rapid strip test would improve coverage of syphilis diagnosis, especially in health services in rural or peri-urban areas that lack traditional tests.

Learning Objectives:

• To describe the challenges of prenatal syphilis screening in Bolivia
• To describe syphilis prevalence among pregnant Bolivian women in the country's four largest hospitals
• To describe the sensitivity and specificity of the rapid syphilis strip test Abbott Determine TP

Keywords: Syphilis Screening, International MCH

Presenting author's disclosure statement:

Not Answered