ABSTRACT
BACKGROUND: Dual point-of-care tests for antibodies to human immunodeficiency virus (HIV) and Treponema pallidum allow for same-day testing and treatment and have been demonstrated to be cost-effective in preventing the adverse outcomes of HIV infection and syphilis. By recording and transmitting data as they are collected, electronic readers address challenges related to the decentralization of point-of-care testing. METHODS: We evaluated a smartphone-based electronic reader using 201 sera tested with 2 dual rapid tests for detection of antibodies to HIV and T. pallidum in Los Angeles, USA, and Lima, Peru. Tests were read both visually and with the electronic reader. Enzyme immunoassay followed by Western blot and T. pallidum particle agglutination were the reference tests for HIV and T. pallidum, respectively. RESULTS: The sensitivities of the 2 rapid tests for detection of HIV were 94.1% and 97.0% for electronic readings. Both tests had a specificity of 100% for detection of HIV by electronic reading. The sensitivities of the 2 rapid tests for detection of T. pallidum were 86.5% and 92.4% for electronic readings. The specificities for detection of T. pallidum were 99.1% and 99.0% by electronic reading. There were no significant differences between the accuracies of visual and electronic readings, and the performance did not differ between the 2 study sites. CONCLUSIONS: Our results show the electronic reader to be a promising option for increasing the use of point-of-care testing programs.
Subject(s)
HIV Antibodies/analysis , HIV Infections/immunology , Immunoenzyme Techniques/instrumentation , Point-of-Care Systems , Smartphone , Syphilis/immunology , Treponema pallidum/immunology , HIV Antibodies/immunology , HIV Infections/diagnosis , HIV Infections/economics , HIV Infections/virology , Humans , Immunoenzyme Techniques/economics , Immunoenzyme Techniques/standards , Los Angeles/epidemiology , Peru/epidemiology , Point-of-Care Systems/economics , Point-of-Care Systems/standards , Reproducibility of Results , Sensitivity and Specificity , Smartphone/instrumentation , Syphilis/diagnosis , Syphilis/economics , Syphilis/microbiologyABSTRACT
We report the circulating genotypes and the frequency of macrolide-resistance patterns among Treponema pallidum pallidum DNA isolated from syphilitic lesions from patients who attended 2 sexual health clinics in Lima, Peru. We implemented and used a molecular typing scheme to describe local T. pallidum pallidum strains. Among 14 specimens, subtype 14d/f was the most prevalent strain in 7 fully typed T. pallidum DNA specimens obtained from men who have sex with men and transgender women presenting with chancre-like lesions. No macrolide-resistance mutations were found in T. pallidum DNA from 10 lesions.