Syphilis: The confusion on the difference kind of blood tests

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Soarawee Weerasopone, MD

Royal Phnom Penh hospital, Kingdom of Cambodia

Syphilis is one type of sexual transmitted disease which is commonly seeing in my office. The clinical that presents it was varied from a painless genital ulcer compared to a rash at palm and sole, depend on the stage of the syphilis infections. The blood test is the only way to confirm diagnosis for the disease, but the problem is, each blood test has pros and con. Most of patients more likely confusing on it, especially, when their test confirmed positive on syphilis.  And the other thing while they didn’t have a full explanation from physicians it will mislead them to seek out another second opinions or advices. In this topic, we will figure out about the difference type of syphilis tests and how to use them wisely.

Blood test
The only way for making syphilis diagnosis is blood test

Nontreponemal tests – it would be named as a “Screening test” for syphilis suspicious infections. More often, we use this test as a primary investigation. The pros, is the ability of the detective for an active syphilis infection which either used to trace the possibility of the treatment whether it works or not.

Common nontreponemal tests in Cambodia

  1. VDRL (Venereal disease research laboratory)
  2. RPR (Rapid plasma reagin)

Treponemal tests – it would be named as a “Confirmation tests”. If anyone got positive test from VDRL or RPR, it must do the reconfirming diagnosis with treponemal tests. The pro of this test is, it was very accuracy but unfortunately, we don’t know that the syphilis is currently in the active stage or not, that is the weak point of it.  Additionally, the treponemal test will always positive in whole your life even a completely cured were done. Therefore, we cannot rely on the tracing’s treatment outcome via the treponemal tests only. This is why the patient must be carefully and pay attention more on the explanation about this information.

Common treponemal tests in Cambodia

  1. TP-PA (Treponemal Pallidum particle agglutination)
  2. FTA-ABS (Fluorescent Treponemal antibody absorbed)
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Good understanding about the tests bring the best outcome and strengthen Doctor-Patient relationship

Syphilis is a common disease that very easy to get treated, but the important thing is, how to make your treatment correctly and get educated your patient properly. When the patients educated and fully understanding  about their problems and they can actually knowing how to trace the disease that currently they are in, then they will never and ever experience in the panic condition any more. So the point is, you need probably binding a good communication and relations a little stronger than before in order to get a high success treatment and cure on this kind of disease – syphilis. Have a good day.

Any questions, you can feel free to discuss with me.

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