Trinh Thuy T, Kamb Mary L, Luu Minh, Ham D Cal, Perez Freddy
Division of Sexually Transmitted Disease Prevention, Centers for Disease Control and Prevention, Atlanta, GA, USA.
Emory University, Atlanta, GA, USA.
Trop Med Int Health. 2017 Sep;22(9):1196-1203. doi: 10.1111/tmi.12920. Epub 2017 Jul 19.
To present the findings of the Pan American Health Organization's 2014 survey on syphilis testing policies and practices in the Americas.
Representatives of national/regional reference and large, lower-level laboratories from 35 member states were invited to participate. A semi-structured, electronically administered questionnaire collected data on syphilis tests, algorithms, equipment/commodities, challenges faced and basic quality assurance (QA) strategies employed (i.e. daily controls, standard operating procedures, technician training, participating in external QA programmes, on-site evaluations).
The 69 participating laboratories from 30 (86%) member states included 41 (59%) national/regional reference and 28 (41%) lower-level laboratories. Common syphilis tests conducted were the rapid plasma reagin (RPR) (62% of surveyed laboratories), venereal disease research laboratory (VDRL) (54%), fluorescent treponemal antibody absorption (FTA-ABS) (41%) and Treponema pallidum haemagglutination assay (TPHA) (32%). Only three facilities reported using direct detection methods, and 28 (41% overall, 32% of lower-level facilities) used rapid tests. Most laboratories (62%) used only traditional testing algorithms (non-treponemal screening and treponemal confirmatory testing); however, 12% used only a reverse sequence algorithm (treponemal test first), and 14% employed both algorithms. Another nine (12%) laboratories conducted only one type of serologic test. Although most reference (97%) and lower-level (89%) laboratories used at least one QA strategy, only 16% reported using all five basic strategies. Commonly reported challenges were stock-outs of essential reagents or commodities (46%), limited staff training (73%) and insufficient equipment (39%).
Many reference and clinical laboratories in the Americas face challenges in conducting appropriate syphilis testing and in ensuring quality of testing.
介绍泛美卫生组织2014年关于美洲梅毒检测政策和实践的调查结果。
邀请了来自35个成员国的国家/区域参考实验室和大型基层实验室的代表参与。通过一份半结构化的电子调查问卷收集有关梅毒检测、算法、设备/用品、面临的挑战以及所采用的基本质量保证（QA）策略（即日常对照、标准操作规程、技术人员培训、参加外部QA计划、现场评估）的数据。
来自30个（86%）成员国的69个参与实验室包括41个（59%）国家/区域参考实验室和28个（41%）基层实验室。常见的梅毒检测方法有快速血浆反应素试验（RPR）（62%的受调查实验室）、性病研究实验室试验（VDRL）（54%）、荧光密螺旋体抗体吸收试验（FTA-ABS）（41%）和梅毒螺旋体血凝试验（TPHA）（32%）。只有三家机构报告使用直接检测方法，28家（总体占41%，基层机构占32%）使用快速检测。大多数实验室（62%）仅使用传统检测算法（非梅毒螺旋体筛查和梅毒螺旋体确证检测）；然而，12%仅使用反向序列算法（先进行梅毒螺旋体检测），14%同时使用两种算法。另外九个（12%）实验室仅进行一种血清学检测。尽管大多数参考实验室（97%）和基层实验室（89%）至少使用了一种QA策略，但只有16%报告使用了所有五种基本策略。常见的挑战包括基本试剂或用品缺货（46%）、工作人员培训有限（73%）和设备不足（39%）。
美洲的许多参考实验室和临床实验室在进行适当的梅毒检测及确保检测质量方面面临挑战。
