IS ROUTINE ANTENATAL SCREENINGTEST FOR SYPHYLIS USING VDRL STILL RELEVANT?

Antenatal clinics perform routine serological tests for syphilis as a screening procedure. Syphilis is still a serious but treatable disease with maternal and fetal complications. There are two categories of serological tests for syphilis, the cardiolopin; venereal disease research laboratory (VDRL) test and the specific tests treponema Pallidum haemagglutination (TPHA) test. Pregnancy is a recognised cause of false-positive VDRL test result. The aim of the study was todetermine the seroprevalence and cost-effectiveness of antenatal syphilis screening at Aminu Kano Teaching Hospital (AKTH), Kano, Nigeria. The method includes a retrospective analysis of venereal disease research laboratory (VDRL) test results among pregnant women in AKTH during a 4 year period (January 2007-December 2010) was undertaken. The resulst include: a) fourteen –thousand, eight hundred and seventy-one pregnant women were screened for syphilis, using VDRL test; 95women were positive. Only eighty- two (82) folders were retrieved and analyzed given a seroprevalence rate of 0.55%.The peak age specific incidence was in the 20-24 years age group, b) the median gestational age at booking was 22 weeks, c) the cost of VDRL testper patient in AKTH is $2.5. To detect the 95 seropositive cases the sum of $38,106 was spent. It was concluded that the seroprevalence rate of syphilis in this study was low (0.55%). Initial screening using VDRL alone is neither justified nor cost effective. Selective screening base on risk factors and confirmatory test with FTA-AB is recommended.