[The value of prophylactic serological tests for syphilis in the region of Białystok in years 1994-2004 (before and after the introducing the health care system reform in Poland)].

The prophylactic serological tests for syphilis (psts), belong to the principal methods of controling the spread of the disease. The aim of the study was to to analyze the epidemiological efficacy of psts performed in Bialystok region before and after the health care system reform. The results of psts performed in 1994-1998 (N = 752.787) and in 1999-2004 (N = 407.366) were analyzed. The average annual number of psts declined from 150.557 to 68.687 in two periods analyzed, respectively. The lowest number of tests performed (51.654) was noticed in 2004. Sixty-one of 117 (52.14%) and 30 of 52 (57.97%) syphilis cases have been detected owing to psts in two periods analyzed, respectively. The efficacy index of psts was highest in convicts or prisoners and in pregnant women in both periods (172,1 and 134,6 and 67,9 and 50,7, respectively). The significant decline in efficacy index was noticed for tests performed as periodic prophylactic examinations of employees and prior to employment. The results indicate that psts remain one of the most efficient methods of diagnosis and prevention of syphilis despite the decline in the number of the tests and the formal renouncement of the screening among convicts and prisoners since 2003. Low syphilis incidence rate in Poland can be, in part, own to diminished number of performed tests. There is a need for the parallel studies in other regions of Poland.