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The syphilis reactor grid: help or hindrance for syphilis surveillance?
Sexually Transmitted Diseases 2003;30(8):650-653.
McLean CA, Kohl K, Baker MA, Sinclair MF, Ciesielski
CA, Markowitz
LE.
Abstract
BACKGROUND: Health departments use reactor grids (sex, age, and serologic test
for syphilis [STS] titer criteria) to determine which persons to evaluate
for untreated syphilis. GOAL: The goal of the study was to assess reactor
grid performance in Chicago and reactor grid use nationally in 1999 to 2000.
STUDY DESIGN: We reviewed Chicago health department records to identify characteristics
of persons with a reactive STS excluded from evaluation by reactor grid criteria
and syphilis cases not meeting evaluation criteria. We surveyed health departments
regarding reactor grid use. RESULTS: Of persons with a reactive STS, 46%
did not meet criteria for health department evaluation, including 62% of
men, 29% of women, and 21% with titers > or =1:8. The reactor grid would
have excluded 17% of primary syphilis cases. Overall, 82% of health departments
use reactor grids. CONCLUSIONS: Reactor grids are widely used and may exclude
persons with infectious syphilis from health department evaluation, especially
men. The impact of reactor grid use on syphilis control and surveillance
in the United States should be evaluated.