Bibliographic Info
Recommendation
Recommended in favor
Conditional
Certainty of evidence
Low
In settings with a high prevalence of syphilis (5% or greater), the WHO STI guideline suggests an on-site rapid syphilis test (RST) and, if positive, provision of a first dose of treatment and a rapid plasma reagin (RPR) test, and then, if the RPR test is positive, provision of treatment according to duration of syphilis (Strategy C). The WHO STI guideline suggests this sequence of tests and treatment rather than a single on-site RST (Strategy A) or a single on-site RPR test (Strategy B).
Notes and Remarks
- 1.Refer to section 5.3 in the full guideline for the explanations and flowcharts for the various screening and treatment strategies mentioned (Strategies A-D)
- 2.This recommendations do not apply to countries that can provide appropriate/high-quality laboratory-based screening and treatment strategies. However, in some settings there may be challenges providing such strategies and/or a sequence of tests. When resources do not permit the use of a sequence of tests, a single on-site rapid syphilis test (RST) (Strategy A) is suggested to ensure greater screening coverage despite the number of pregnant women who will be over-treated due to the high rate of false-positive results. Treatment is based on duration of syphilis, according to the WHO guidelines for the treatment of Treponema pallidum (syphilis)
Also Featured In
This recommendation also appears in the following guidelines:
WHO recommendations on maternal health: guidelines approved by the WHO Guidelines Review Committee, second edition. Geneva: World Health Organization; 2025