Mehra Bhanu, Bhalla Preena, Rawat Deepti, Saxena Shikhar
Senior Resident, Department of Microbiology, Maulana Azad Medical College , New Delhi, India .
Director Professor, Department of Microbiology, Maulana Azad Medical College , New Delhi, India .
J Clin Diagn Res. 2015 Aug;9(8):IC01-IC04. doi: 10.7860/JCDR/2015/14179.6302. Epub 2015 Aug 1.
Timeliness of reporting is of utmost importance to limit the spread of syphilis. The present analysis was undertaken to evaluate the turnaround time of syphilis testing (mainly Venereal disease research laboratory /VDRL test) in a sexually transmitted infections (STI) clinic in India; to find out the possible reasons for delay; to describe the trends of clinical indications for syphilis testing from an STI clinic; to assess the frequency of a positive syphilis serology among STI clinic attendees; and to analyse the follow-up rates of VDRL report collection.
Two hundred consecutive VDRL requests received at the serology laboratory of a tertiary care health facility from the STI clinic of the linked hospital were prospectively analysed to evaluate the above parameters.
For the 200 requests audited, the mean absolute turnaround time of VDRL test was 7.46±2.81 days. The mean duration of the pre-laboratory, laboratory and post laboratory phases was 0, 4.69±2.13 and 2.77±2.51 days respectively. The interval from specimen receipt to performance of tests (mean duration=4.25±1.96 days) was the major reason for long VDRL turnaround time. The common indications for syphilis testing in STI clinic attendees were lower abdominal pain (33%), vaginal discharge (26.5%) and genital ulcer disease (9%); and the follow-up rate for report collection was 71%.
Our study highlights the strong need to shift to alternative testing methods, mainly rapid point of care procedures for serodiagnosis of syphilis in order to circumvent the problems of long turnaround time and low patient follow-up rates.
报告的及时性对于限制梅毒传播至关重要。本分析旨在评估印度一家性传播感染（STI）诊所梅毒检测（主要是性病研究实验室/VDRL检测）的周转时间；找出延迟的可能原因；描述STI诊所梅毒检测的临床指征趋势；评估STI诊所就诊者中梅毒血清学阳性的频率；并分析VDRL报告收集的随访率。
前瞻性分析了一家三级医疗保健机构血清学实验室从关联医院的STI诊所收到的200份连续VDRL检测申请，以评估上述参数。
对于审核的200份申请，VDRL检测的平均绝对周转时间为7.46±2.81天。实验室前、实验室和实验室后阶段的平均持续时间分别为0天、4.69±2.13天和2.77±2.51天。从标本接收到检测执行的间隔时间（平均持续时间=4.25±1.96天）是VDRL周转时间长的主要原因。STI诊所就诊者梅毒检测的常见指征是下腹痛（33%）、阴道分泌物异常（26.5%）和生殖器溃疡疾病（9%）；报告收集的随访率为71%。
我们的研究强调迫切需要转向替代检测方法，主要是梅毒血清学诊断的即时快速检测程序，以规避周转时间长和患者随访率低的问题。
