Cover Image

The role of VDRL Testing in routine screening of antenatal women in the present decade.



Background - Prevalence of syphilis is decreasing in India, but it has been a part of routine antenatal screening. With the increasing number of laboratories varied                   recommendations and reverse screening algorithm , we           undertook this study to determine the present prevalence of syphilis in the antenatal women, cost effectiveness of routine screening with VDRL test and to identify the best method of screening for syphilis. Methods - Retrospective review of charts from January 2006 to June 2011. Results - Prevalence of syphilis was 0.1 among the antenatal women. Since            syphilis is a preventable cause perinatal mortality and                 morbidity, routine screening was identified as the defence against these problems. The present CDC recommendation of screening with VDRL followed by TPPA on VDRL reactive cases was found to be the best method of screening.                 Conclusion - Though the seroprevalence of syphilis is low and showing a downward trend in our population, still screening for syphilis is cost effective. The best method of screening is with VDRL and confirmation of reactive cases with TPPA. We need further studies before we could implement TPPA as screening test for antenatal women.

Full Text:



Errol R Norwitz. Syphilis in pregnancy. uptodate.

Edward Dassah, Baafuor Kofi Opoku and Yaw Adu-Sarkodie, School of Medical Sciences, Kwame Nkrumah University of Science and Technology, Kumasi, Ghana ED, Baafuor Kofi Opoku and Yaw Adu. Screening for syphilis during pregnancy in Ghana:the role of new rapid point-of-care diagnostic tests. 2010 Jan;

Sharaf Ali Shah,Ghazala Usman,Asifa Ghazi ( BIRDGE Consultants Foundation, Karachi, Pakistan. ) Sibylle Kristensen,Nalini Sathiakumar SAS, Ghazala Usman,Asifa Ghazi ( BIRDGE Consultants Foundation, Karachi, Pakistan. ) Sibylle Kristensen,Nalini Sathiakumar. Prevalence of syphilis among antenatal clinic attendees in Karachi: Imperative to begin universal screening in Pakistan. Journal of Pakistan medical association. 2011;61:993.

Kebede E, Chamiso B. Prevalence of syphilis in pregnancy in Addis Ababa. East Afr Med J. 2000 Apr;77(4):212–6.

Sethi S, Sharma K, Dhaliwal LK, Banga SS, Sharma M. Declining trends in syphilis prevalence among antenatal women in northern India: a 10-year analysis from a tertiary healthcare centre. Sex Transm Infect. 2007 Dec;83(7):592.

Mathai E, Mathai M, Prakash JA, Bergström S. Audit of management of pregnant women with positive VDRL tests. Natl Med J India. 2001 Aug;14(4):202–4.

Singh AE, Romanowski B. Syphilis: review with emphasis on clinical, epidemiologic, and some biologic features. Clin. Microbiol. Rev. 1999 Apr;12(2):187–209.

Larsen SA, Steiner BM, Rudolph AH. Laboratory diagnosis and interpretation of tests for syphilis. Clin. Microbiol. Rev. 1995 Jan;8(1):1–21.

Egglestone SI, Turner AJ. Serological diagnosis of syphilis. PHLS Syphilis Serology Working Group. Commun Dis Public Health. 2000 Sep;3(3):158–62.

Manavi K, Young H, McMillan A. The sensitivity of syphilis assays in detecting different stages of early syphilis. Int J STD AIDS. 2006 Nov;17(11):768–71.

D’Errico MM, Mariottini M, Tombolesi P, Di Rosa S, Prospero E, Raffo M, et al. Syphilis and blood donors: comparison of two different diagnostic strategies. Eur. J. Epidemiol. 1996


Young H, Henrichsen C, Robertson DH. Treponema pallidum haemagglutination test as a screening procedure for the diagnosis of syphilis. Br J Vener Dis. 1974 Oct;50(5):341–6.

Wiwanitkit V. A cost-utility analysis of Treponema pallidum haemagglutination (TPHA) testing for syphilis screening of blood donors: is the TPHA test useful for syphilis screening in a blood centre? Blood Transfus. 2009 Jan;7(1):65–6.

Genç M, Ledger WJ. Syphilis in pregnancy. Sex Transm Infect. 2000 Apr;76(2):73–9.

Syphilis Testing Algorithms Using Treponemal Tests for Initial Screening --- Four Laboratories, New York City, 2005--2006 [Internet]. [cited 2011 Dec 10];Available from:

Discordant Results from Reverse Sequence Syphilis Screening --- Five Laboratories, United States, 2006--2010 [Internet]. [cited 2011 Dec 10];Available from:


  • There are currently no refbacks.

Creative Commons License
This work is licensed under a Creative Commons Attribution-NoDerivatives 4.0 International License.

An initiative of The Tamil Nadu Dr M.G.R. Medical University