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梅毒诊断快速检测:在巴西亚马逊地区一家性传播感染诊所的验证

Rapid tests for diagnosing syphilis: validation in an STD clinic in the Amazon Region, Brazil.

作者信息

Benzaken Adele Schwartz, Galbán García Enrique, Sardinha José Carlos Gomes, Dutra Junior João Catarino, Peeling Rosanna

机构信息

Fundação de Dermatologia Tropical e Venereologia Alfredo da Matta, Manaus, Brazil.

出版信息

Cad Saude Publica. 2007;23 Suppl 3:S456-64. doi: 10.1590/s0102-311x2007001500013.

Abstract

Correct, early diagnosis and treatment of syphilis are essential for its control. Traditional diagnostic tests depend on specialized equipment, installations, and human resources. In the search for quick, simple tests, a project was conducted on the validation and reproducibility of four different tests, previously assessed by WHO reference laboratories. The study also verified the operational characteristics and acceptance by patients and health professionals. Samples obtained at an STD clinic were from 541 and 248 patients with 51 and 52 positive results according to FTA-Abs (gold standard) in studies 1 and 2, respectively. The sensitivity varied from 84 to 96%, specificity was greater than 98%, and PPV was >90%. Reproducibility was >97% and kappa index 0.94, comparing the results obtained by different health workers. The tests took less than 20 minutes to perform, and more than 90% of patients agreed to wait up to two hours for the results. The tests presented the necessary requirements for use in diagnosis of syphilis, thus providing an additional option for controlling this disease.

摘要

梅毒的正确早期诊断和治疗对其控制至关重要。传统诊断测试依赖于专业设备、设施和人力资源。为了寻找快速、简便的测试方法,开展了一个项目,对世界卫生组织参考实验室先前评估过的四种不同测试的有效性和可重复性进行研究。该研究还验证了这些测试的操作特性以及患者和卫生专业人员的接受程度。在一项性传播疾病诊所进行的研究中,研究1和研究2分别从541名和248名患者中采集了样本,根据荧光螺旋体抗体吸收试验(金标准),分别有51例和52例呈阳性结果。敏感性在84%至96%之间,特异性大于98%,阳性预测值大于90%。不同卫生工作者所得结果的可重复性大于97%,kappa指数为0.94。这些测试执行时间不到20分钟,超过90%的患者同意等待长达两小时获取结果。这些测试具备用于梅毒诊断的必要条件,从而为控制该疾病提供了额外的选择。

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