Review Article

Use of rapid point-of-care diagnostic tests for the elimination of congenital syphilis: what is the evidence?

Ranmini Kularatne
Southern African Journal of Infectious Diseases | Vol 33, No 5 | a143 | DOI: | © 2019 Ranmini Kularatne | This work is licensed under CC Attribution 4.0
Submitted: 30 May 2019 | Published: 31 August 2018

About the author(s)

Ranmini Kularatne, Centre for HIV & STI, National Institute for Communicable Diseases, Johannesburg; Department of Clinical Microbiology & Infectious Diseases, University of the Witwatersrand, Johannesburg, South Africa

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Congenital syphilis constitutes a major preventable public health problem, that has been targeted for elimination by the World Health Organisation. Adverse pregnancy outcomes occur in upto 80% of untreated maternal syphilis. National impact targets for elimination include 95% syphilis testing and treatment coverage for pregnant women. Screening and treatment of maternal syphilis should ideally happen at the first ante-natal clinic visit. This may be facilitated by the use of rapid point-of-care tests (POCTs), especially for healthcare centres with limited laboratory access. There are several commercial syphilis POCTs, some of which also screen for HIV infection. These have different technical specifications, and their performance characteristics vary when capillary fingerprick whole blood is used for testing in a clinic setting. Syphilis POCT implementation in ante-natal care is affordable and rational in resource-constrained settings; however, managers and policy makers should be aware of the various programmatic issues that need to be addressed in the preimplementation phase and monitored over time.


Congenital syphilis; syphilis screening in pregnant women; syphilis point-of-care tests


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