Syphilis point-of-care tests: an Australian perspective
Gladymar Pérez Chacón A # , Amit Saha A # , Emily Phillips A , Rebecca Guy A , Tanya L. Applegate A , Louise Causer A , Skye McGregor A and Belinda Hengel A *A
Dr Gladymar Pérez Chacón is an early career researcher in public health and a medical epidemiologist based at The Kirby Institute, UNSW. Gladymar has professional experience in point-of-care (POC) testing and mass-treatment strategies for yaws in resource-constrained settings in the Asia–Pacific Region. Her research interests are broad and include pertussis and other vaccine preventable diseases as well as sexually and vertically transmitted infections. |
Dr Amit Saha is a medical epidemiologist and lecturer at The Kirby Institute, UNSW. His current work focuses on POC diagnostics for sexually transmitted infections (STIs) and respiratory infections and their impact in high-prevalence remote settings. He has professional experience in various fields of infectious disease epidemiology and large field-based clinical studies on enteric vaccines. |
Emily Phillips, BMedSci(Hons) is completing a Masters of Applied Epidemiology. Emily manages a large-scale research programme that aims to scale up infectious disease POC testing in remote Indigenous communities to enable person-centred care and improve health outcomes for Aboriginal and Torres Strait Islander peoples. Previously, Emily held the position of director of communicable diseases at the National Aboriginal Community Controlled Health Organisation, where she played a pivotal role in the Aboriginal and Torres Strait Islander response to the COVID-19 pandemic. |
Prof. Rebecca Guy is the head of the Surveillance Evaluation and Research Programme at The Kirby Institute, UNSW. She is a member of the Institute’s Executive and Aboriginal and Torres Strait Islander Committees. Prof. Guy specialises in epidemiology, implementation research, health services and translational research. Her public health research aims to reduce the impact of infectious diseases in vulnerable populations, evaluating the effectiveness, acceptability and cost effectiveness of novel strategies, including POC testing. |
Assoc. Prof. Tanya Applegate leads the Diagnostics Innovations Group at The Kirby Institute and manages the RAPID Point of Care Research Consortium for infectious diseases in the Asia–Pacific. She oversees a multidisciplinary diagnostics research program, successfully engaging industry partners. With over 20 years of experience in regulatory, hospital, private industry and academic environments, her research aims to provide equitable healthcare access for marginalised populations and people living in remote or resource limited settings. |
Dr Louise Causer is a medical epidemiologist and senior lecturer at The Kirby Institute, UNSW, leading the Decentralised Diagnostics Implementation Research Group. Her research focuses on evaluating and scaling up POC diagnostic tests for infectious diseases. She has worked on molecular POC testing in rural and remote Australian health services. She co-leads the national implementation of STI molecular POC testing with Flinders University and contributes to the First Nations Infectious Diseases POC Testing Programme and the National HCV POC Testing Programme. |
Dr Skye McGregor is an epidemiologist and lead of the Surveillance Innovation Group at The Kirby Institute, UNSW. Her research focuses on surveillance and prevention of sexually transmissible infections and blood borne viruses, and aims to understand and address persistent disparities in the burden of infection and disease among key populations in Australia. |
Dr Belinda Hengel is an infectious diseases researcher based with The Kirby Institute, UNSW. Her focus is on reducing the impact of infectious diseases, including STIs and respiratory infections in populations at risk. Belinda has experience in public health interventions, including molecular POC testing in remote communities and optimising health service delivery. |
Abstract
Syphilis is a sexually and vertically transmitted infection caused by Treponema pallidum. Although preventable and curable, syphilis remains a public health challenge worldwide, disproportionately affecting communities who experience marginalisation, stigma, and discrimination. Syphilis point-of-care (POC) tests may provide a tool to enhance patient access and timely treatment. In Australia, syphilis POC tests have been incorporated into various public health screening strategies and implemented across different jurisdictions as part of the nationwide response to an expanding syphilis epidemic. These programmes use a highly sensitive and specific POC lateral flow immunoassay test that detects antibodies to T. pallidum, and have largely focused on outbreaks areas, where the burden of infectious syphilis is highest and the distance to centralised laboratories remains significant. The COVID-19 pandemic has resulted in substantial advancements in diagnostic development capabilities with many companies now pivoting to development of POC tests for sexually transmitted infections (STIs). Here we summarise types of syphilis POC tests available, their role in clinical and public health strategies in Australia, and frameworks for selection of POC tests in screening programmes.
Keywords: Australia, nontreponemal test, point-of-care, POC, syphilis, Treponema pallidum, treponemal test.
Dr Gladymar Pérez Chacón is an early career researcher in public health and a medical epidemiologist based at The Kirby Institute, UNSW. Gladymar has professional experience in point-of-care (POC) testing and mass-treatment strategies for yaws in resource-constrained settings in the Asia–Pacific Region. Her research interests are broad and include pertussis and other vaccine preventable diseases as well as sexually and vertically transmitted infections. |
Dr Amit Saha is a medical epidemiologist and lecturer at The Kirby Institute, UNSW. His current work focuses on POC diagnostics for sexually transmitted infections (STIs) and respiratory infections and their impact in high-prevalence remote settings. He has professional experience in various fields of infectious disease epidemiology and large field-based clinical studies on enteric vaccines. |
Emily Phillips, BMedSci(Hons) is completing a Masters of Applied Epidemiology. Emily manages a large-scale research programme that aims to scale up infectious disease POC testing in remote Indigenous communities to enable person-centred care and improve health outcomes for Aboriginal and Torres Strait Islander peoples. Previously, Emily held the position of director of communicable diseases at the National Aboriginal Community Controlled Health Organisation, where she played a pivotal role in the Aboriginal and Torres Strait Islander response to the COVID-19 pandemic. |
Prof. Rebecca Guy is the head of the Surveillance Evaluation and Research Programme at The Kirby Institute, UNSW. She is a member of the Institute’s Executive and Aboriginal and Torres Strait Islander Committees. Prof. Guy specialises in epidemiology, implementation research, health services and translational research. Her public health research aims to reduce the impact of infectious diseases in vulnerable populations, evaluating the effectiveness, acceptability and cost effectiveness of novel strategies, including POC testing. |
Assoc. Prof. Tanya Applegate leads the Diagnostics Innovations Group at The Kirby Institute and manages the RAPID Point of Care Research Consortium for infectious diseases in the Asia–Pacific. She oversees a multidisciplinary diagnostics research program, successfully engaging industry partners. With over 20 years of experience in regulatory, hospital, private industry and academic environments, her research aims to provide equitable healthcare access for marginalised populations and people living in remote or resource limited settings. |
Dr Louise Causer is a medical epidemiologist and senior lecturer at The Kirby Institute, UNSW, leading the Decentralised Diagnostics Implementation Research Group. Her research focuses on evaluating and scaling up POC diagnostic tests for infectious diseases. She has worked on molecular POC testing in rural and remote Australian health services. She co-leads the national implementation of STI molecular POC testing with Flinders University and contributes to the First Nations Infectious Diseases POC Testing Programme and the National HCV POC Testing Programme. |
Dr Skye McGregor is an epidemiologist and lead of the Surveillance Innovation Group at The Kirby Institute, UNSW. Her research focuses on surveillance and prevention of sexually transmissible infections and blood borne viruses, and aims to understand and address persistent disparities in the burden of infection and disease among key populations in Australia. |
Dr Belinda Hengel is an infectious diseases researcher based with The Kirby Institute, UNSW. Her focus is on reducing the impact of infectious diseases, including STIs and respiratory infections in populations at risk. Belinda has experience in public health interventions, including molecular POC testing in remote communities and optimising health service delivery. |
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