Aplicación del algoritmo inverso para diagnóstico de sífilis gestacional en el Instituto Nacional Materno Perinatal, Perú. 2011-2017

Abstract

Introduction and objectives: The purpose is to evaluate the results of the application of the inverse algorithm for the diagnosis of gestational syphilis in the Preventive Medicine Service of the National Maternal and Perinatal Institute of Lima, between 2011 and 2017. Method: Observational, descriptive and retrospective study. The results of the diagnostic tests applying the inverse algorithm gestational syphilis were reviewed. The Rapid Syphilis Test (PRS)) was used as a screening, its positivity required to perform the RPR, whose reactivity defined the activity of the disease when it was equal to or greater than 8 dilutions, minor titers required serological followup. Result: The incidence of active syphilis was 1.02 per thousand screened, the frequency of minor titres reached 29.33% of those positive for PRS and the discordance between PRS and RPR was 57.87%, serological follow-up was insufficient (7.27%), as well as the evaluation of sexual partners and / or contacts of pregnant women with active syphilis (4.17%). Conclusion: The algorithm allows a rapid diagnosis and the timely establishment of antibiotic therapy, but its reliability will be optimized with the systematization of internal and external quality controls, systematic serological monitoring, strategy planning to ensure the serological evaluation and treatment of couples and / or sexual contacts, and in cases of discordance, the algorithm must include another treponemal test.