Rapid diagnostic testing for syphilis in Arctic communities (the STAR study): a multisite prospective field diagnostic accuracy study in an intended-use setting

The study assessed the accuracy of a syphilis rapid test (RDT) used by non-laboratorians in two Canadian Arctic communities, comparing its performance with serum and whole blood samples against standard lab tests. Over two years, 161 participants were tested, showing the RDT had high sensitivity and specificity, especially for recent infections, with consistent results for both sample types. The results indicate that non-experts can effectively use the RDT in the field, potentially reducing treatment delays and improving syphilis control in remote areas.

Fig. 1. Study flowchart. The study flowchart of patients attending sexual health clinics in communities A and B is shown in panel (a), whereas panel (b) depicts that of individuals identified in a separate door-to-door mass screening campaign for syphilis in community A between July and October 2021. ∗In a total of 111 participant encounters, both venous whole blood and serum specimens were concurrently collected (i.e. 111 paired specimens; 222 specimens total) for rapid testing with the index test. EIA, enzyme immunoassay; RPR, rapid plasma reagin.

https://www.sciencedirect.com/science/article/pii/S1198743X23002914