Rapid diagnostic tests may offer same-day therapy and eliminate needless treatment of infections: BMJ

Rapid diagnostic tests (RDTs) that can distinguish between current and previously treated illnesses might optimize care by offering same-day therapy and eliminating needless treatment, says an article published in BMJ Sexually Transmitted Infections.

Treponemal and non-treponemal antibodies can be found with current fast testing for syphilis and yaws. Thus, Ying Zhang and colleagues undertook this study with the intention of critically evaluating the literature for quick diagnostic techniques that may more effectively differentiate an active syphilis infection from yaws.

In order to conduct a systematic review and meta-analysis, five datasets between January 2010 and October 2021 were accessed (with an update in July 2022). The pooled sensitivity and specificity were subjected to a bivariate meta-analysis using a generalized linear mixed model. The I2 statistic was used to evaluate heterogeneity. Grading of Recommendations, Assessment, Development and Evaluations (GRADE) was used to assess the certainty of the evidence, and Quality Assessment of Diagnostic Accuracy Studies (QUADAS) was used to examine the likelihood of bias.

The key findings of this study were;

1. For this investigation, 17 papers for meta-analyses were included.

2. The treponemal component's combined sensitivity and specificity for syphilis were 0.93 (95% confidence interval: 0.86 to 0.97) and 0.98 (95% confidence interval: 0.96 to 0.99), respectively.

3. The pooled sensitivity and specificity for the non-treponemal component were 0.90 (95% CI: 0.82 to 0.95) and 0.97 (95% CI: 0.92 to 0.99), respectively.

4. The treponemal component's combined sensitivity and specificity for yaws were 0.86 (95% confidence interval: 0.66 to 0.95) and 0.97 (95% confidence interval: 0.94 to 0.99), respectively.

5. The pooled sensitivity and specificity for the non-treponemal component were as such 0.80 (95% CI: 0.55 to 0.93) and 0.96 (95% CI: 0.92 to 0.98).

In conclusion, when compared to laboratory reference tests, rapid diagnostic techniques have lower sensitivity but overall higher specificity for identifying yaws and syphilis infections.

Reference: 

Zhang, Y., Goh, S. M., Mello, M. B., Baggaley, R. C., Wi, T., Johnson, C. C., Asiedu, K. B., Marks, M., Pham, M. D., Fairley, C. K., Chow, E. P. F., Mitjà, O., Toskin, I., Ballard, R. C., & Ong, J. J. (2022). Improved rapid diagnostic tests to detect syphilis and yaws: a systematic review and meta-analysis. In Sexually Transmitted Infections (p. sextrans-2022-055546). BMJ. https://doi.org/10.1136/sextrans-2022-055546