Rapid tests for syphilis

Appropriate use

Since syphilis rapid tests detect antibodies that can remain in a patient’s system long after infection is cleared, there are limitations in how these tests should be used. In areas of low disease prevalence, it may be possible to use these tests (or a combination of them) as screening tests to identify patients for presumptive treatment. In settings where the prevalence of treated syphilis is high or where the response to therapy is being assessed, the rapid test will be less helpful to clinicians.
Specific applications may include:

  • Use to screen patients in remote clinics that are unable to perform more complicated or instrument intensive diagnosis.
  • Use to screen patients who would otherwise be lost to follow-up.
  • Use as a screening or diagnostic test in populations with a low rate of past, treated syphilis infection.
  • Use as an on-site outbreak investigation and treatment tool (mining barracks, field military sites, brothels, etc.).
  • Field use in mass testing and treatment protocols (inmates, military recruits, returning migrant workers, etc.).
  • Use in refugee settings and other complex emergency situations that interrupt access to routine testing.
  • Use to confirm diagnoses in hospital laboratories or medical clinics.
  • Use to enhance clinical protocols for genital ulcer disease and to identify or rule out syphilis. These tests can decrease over treatment, especially in areas with increased rates of other ulcerative STIs such as herpes.
  • Use for epidemiological surveillance in prevalence studies.
  • Use in innovative settings such as antenatal/family planning clinics, pharmacies, private providers, premarital testing, and prison health clinics.
  • Use for self-diagnosis by travelers.

Links to more information