Serological assays remain the most common diagnostic method for all treponemal infections.
Michael Marks, Tommy Esau, Rowena Asugeni, Relmah Harrington, Jason Diau, Hilary Toloka,James Asugeni, Eimhin Ansbro, Anthony W Solomon, David Maclaren, Michelle Redman-Maclaren,David C W Mabey 2018, 'Point-of-care tests for syphilis and yaws in a low-income setting - A qualitativestudy of healthcare worker and patient experiences.', PLoS Neglected Tropical Diseaseshttp://europepmc.org/articles/PMC5908063?pdf=render. Retrieved from PLOS CC BY 4.0 (https://creativecommons.org/licenses/by-sa/4.0/legalcode)
Yaws testing requires both treponemal (trep) and non-treponemal (non-trep) assays fordiagnosis of current infection.
Christopher Fitzpatrick, Kingsley Asiedu, Anita Sands, Tita Gonzalez Pena, MichaelMarks, Oriol Mitja, Filip Meheus, Patrick Van der Stuyft 2017, 'The cost and cost-effectiveness of rapid testing strategies for yaws diagnosis andsurveillance.', PLoS Neglected Tropical Diseaseshttp://europepmc.org/articles/PMC5658197?pdf=render. Retrieved from PLOS CC BY 4.0 (https://creativecommons.org/licenses/by-sa/4.0/legalcode)
However, treponemal tests cannot differentiate past infections from a current infection.
Golušin Zoran, Jovanović Marina, Matić Milan, Vujanović Ljuba, Roš Tatjana, JeremićBiljana 2016, 'Serological Tests for Acquired Syphilis in Immuno-competent Patients', Serbian Journal of Dermatology and Venereologyhttp://www.degruyter.com/view/j/sjdv.2016.8.issue-2/sjdv-2016-0007/sjdv-2016-0007.xml?format=INT. Retrieved from DOAJ CC BY 4.0 (https://creativecommons.org/licenses/by-sa/4.0/legalcode)
Repeated work-up revealed positivity of fluorescent treponemal antibody-absorption in serum and subsequently in cerebrospinal fluid.
Jong Hoon Park, Soo Geun Joe, Young Hee Yoon 2013, 'Delayed diagnosis of ocular syphilis that manifested as retinal vasculitis and acuteposterior multifocal placoid epitheliopathy', Indian Journal of Ophthalmologyhttp://www.ijo.in/article.asp?issn=0301-4738;year=2013;volume=61;issue=11;spage=676;epage=678;aulast=Park. Retrieved from DOAJ CC BY 4.0 (https://creativecommons.org/licenses/by-sa/4.0/legalcode)
Newer dual tests employing treponemal and nontreponemal antigens look promising.
Ameeta E Singh, Max A Chernesky, Muhammad Morshed, Tom Wong 2015, 'Canadian Public Health Laboratory Network laboratory Guidelines for the Use of Point-of-CareTests for the Diagnosis of Syphilis in Canada', Canadian Journal of Infectious Diseases and Medical Microbiologyhttp://dx.doi.org/10.1155/2015/152039. Retrieved from DOAJ CC BY 4.0 (https://creativecommons.org/licenses/by-sa/4.0/legalcode)
We used a serologic treponemal test to detect antibodies against the bacterium.
Idrissa S. Chuma, Emmanuel K. Batamuzi, D. Anthony Collins, Robert D. Fyumagwa, LuisaK. Hallmaier-Wacker, Rudovick R. Kazwala, Julius D. Keyyu, Inyasi A. Lejora, IddiF. Lipende, Simone Lüert, Filipa M.D. Paciência, Alexander Piel, Fiona A. Stewart,Dietmar Zinner, Christian Roos, Sascha Knauf 2018, 'Widespread Treponema pallidum Infection in Nonhuman Primates, Tanzania', Emerging Infectious Diseaseshttps://wwwnc.cdc.gov/eid/article/24/6/18-0037_article. Retrieved from DOAJ CC BY 4.0 (https://creativecommons.org/licenses/by-sa/4.0/legalcode)
We have developed an immunoassay for the detection of treponemal antibodies in human serum or plasma samples.
Sheikh M Talha, Jukka Hytönen, Adam Westhorpe, Sushil Kumar, Navin Khanna, Kim Pettersson 2013, 'Europium nanoparticle-based high performing immunoassay for the screening of treponemalantibodies.', PLoS ONEhttp://europepmc.org/articles/PMC3873409?pdf=render. Retrieved from PLOS CC BY 4.0 (https://creativecommons.org/licenses/by-sa/4.0/legalcode)
Even after successful treatment, approximately 85% of patients remain positive for treponemal antibodies for the rest of their lives.
Golušin Zoran, Jovanović Marina, Matić Milan, Vujanović Ljuba, Roš Tatjana, JeremićBiljana 2016, 'Serological Tests for Acquired Syphilis in Immuno-competent Patients', Serbian Journal of Dermatology and Venereologyhttp://www.degruyter.com/view/j/sjdv.2016.8.issue-2/sjdv-2016-0007/sjdv-2016-0007.xml?format=INT. Retrieved from DOAJ CC BY 4.0 (https://creativecommons.org/licenses/by-sa/4.0/legalcode)
The findings highlight that a suitable treponemal confirmatory test should be performed in all the diagnostic laboratories.
M Bala, V Singh, S Muralidhar, V Ramesh 2013, 'Assessment of reactivity of three treponemal tests in non-treponemal non-reactivecases from sexually transmitted diseases clinic, antenatal clinic, integrated counsellingand testing centre, other different outdoor patient departments/indoor patients ofa tertiary care centre and peripheral health clinic attendees', Indian Journal of Medical Microbiologyhttp://www.ijmm.org/article.asp?issn=0255-0857;year=2013;volume=31;issue=3;spage=275;epage=279;aulast=Bala. Retrieved from DOAJ CC BY 4.0 (https://creativecommons.org/licenses/by-sa/4.0/legalcode)
We also recommend using a non-treponemal test with the current treponemal tests being used to aid diagnosis.
Sepiso K. Masenga, Mercy Mweemba, Annie Kachele, Yahns Chalubemba, Paul Toloka, BensonM. Hamooya 2018, 'Lessons from a comparison of immuno-chromatographic and chemiluminescent micro-particleimmunoassay in the diagnosis of syphilis', BMC Research Noteshttp://link.springer.com/article/10.1186/s13104-018-3808-5. Retrieved from DOAJ CC BY 4.0 (https://creativecommons.org/licenses/by-sa/4.0/legalcode)