Are Treponema pallidum specific rapid and point-of-care tests for syphilis accurate enough for screening in resource limited settings? Evidence from a meta-analysis. PLoS ONE 2013;8:e54695

Background: Rapid and point-of-care (POC) tests for syphilis are an invaluable screening tool, yet inadequate evaluation of their diagnostic accuracy against best reference standards limits their widespread global uptake. To fill this gap, a systematic review and meta-analysis was conducted to evaluate the sensitivity and specificity of rapid and POC tests in blood and serum samples against Treponema pallidum (TP) specific reference standards. Methods: Five electronic databases (1980–2012) were searched, data was extracted from 33 articles, and Bayesian hierarchical models were fit. Results: In serum samples, against a TP specific reference standard point estimates with 95 % credible intervals (CrI) for the sensitivities of popular tests were: i) Determine, 90.04 % (80.45, 95.21), ii) SD Bioline, 87.06 % (75.67, 94.50), iii) VisiTect, 85.13 % (72.83, 92.57), and iv) Syphicheck, 74.48 % (56.85, 88.44), while specificities were: i) Syphicheck, 99.14 % (96.37, 100)