<?xml version="1.0" encoding="ISO-8859-1"?><article xmlns:mml="http://www.w3.org/1998/Math/MathML" xmlns:xlink="http://www.w3.org/1999/xlink" xmlns:xsi="http://www.w3.org/2001/XMLSchema-instance">
<front>
<journal-meta>
<journal-id>1679-4974</journal-id>
<journal-title><![CDATA[Epidemiologia e Serviços de Saúde]]></journal-title>
<abbrev-journal-title><![CDATA[Epidemiol. Serv. Saúde]]></abbrev-journal-title>
<issn>1679-4974</issn>
<publisher>
<publisher-name><![CDATA[Secretaria de Vigilância em Saúde e Ambiente - Ministério da Saúde do Brasil]]></publisher-name>
</publisher>
</journal-meta>
<article-meta>
<article-id>S1679-49742021000500006</article-id>
<article-id pub-id-type="doi">10.1590/s1679-4974202100006.esp1</article-id>
<title-group>
<article-title xml:lang="pt"><![CDATA[Protocolo Brasileiro para Infecções Sexualmente Transmissíveis 2020: testes diagnósticos para sífilis]]></article-title>
<article-title xml:lang="en"><![CDATA[Brazilian Protocol for Sexually Transmitted Infections 2020: syphilis diagnostic tests]]></article-title>
<article-title xml:lang="es"><![CDATA[Protocolo Brasileño para Infecciones de Transmisión Sexual 2020: pruebas de diagnóstico de sífilis]]></article-title>
</title-group>
<contrib-group>
<contrib contrib-type="author">
<name>
<surname><![CDATA[Gaspar]]></surname>
<given-names><![CDATA[Pâmela Cristina]]></given-names>
</name>
<xref ref-type="aff" rid="Aff"/>
</contrib>
<contrib contrib-type="author">
<name>
<surname><![CDATA[Bigolin]]></surname>
<given-names><![CDATA[Álisson]]></given-names>
</name>
<xref ref-type="aff" rid="Aff"/>
</contrib>
<contrib contrib-type="author">
<name>
<surname><![CDATA[Alonso Neto]]></surname>
<given-names><![CDATA[José Boullosa]]></given-names>
</name>
<xref ref-type="aff" rid="Aff"/>
</contrib>
<contrib contrib-type="author">
<name>
<surname><![CDATA[Pereira]]></surname>
<given-names><![CDATA[Esdras Daniel dos Santos]]></given-names>
</name>
<xref ref-type="aff" rid="Aff"/>
</contrib>
<contrib contrib-type="author">
<name>
<surname><![CDATA[Bazzo]]></surname>
<given-names><![CDATA[Maria Luiza]]></given-names>
</name>
<xref ref-type="aff" rid="Aff"/>
</contrib>
</contrib-group>
<aff id="Af1">
<institution><![CDATA[,Ministério da Saúde Secretaria de Vigilância em Saúde ]]></institution>
<addr-line><![CDATA[Brasília DF]]></addr-line>
<country>Brazil</country>
</aff>
<aff id="Af2">
<institution><![CDATA[,Universidade Federal de Santa Catarina Programa de Pós-Graduação em Farmácia ]]></institution>
<addr-line><![CDATA[Florianópolis SC]]></addr-line>
<country>Brazil</country>
</aff>
<pub-date pub-type="pub">
<day>00</day>
<month>00</month>
<year>2021</year>
</pub-date>
<pub-date pub-type="epub">
<day>00</day>
<month>00</month>
<year>2021</year>
</pub-date>
<volume>30</volume>
<numero>esp1</numero>
<copyright-statement/>
<copyright-year/>
<self-uri xlink:href="http://scielo.iec.gov.br/scielo.php?script=sci_arttext&amp;pid=S1679-49742021000500006&amp;lng=en&amp;nrm=iso"></self-uri><self-uri xlink:href="http://scielo.iec.gov.br/scielo.php?script=sci_abstract&amp;pid=S1679-49742021000500006&amp;lng=en&amp;nrm=iso"></self-uri><self-uri xlink:href="http://scielo.iec.gov.br/scielo.php?script=sci_pdf&amp;pid=S1679-49742021000500006&amp;lng=en&amp;nrm=iso"></self-uri><abstract abstract-type="short" xml:lang="pt"><p><![CDATA[Resumo As recomendações de testes diagnósticos para investigação da sífilis compõem o Protocolo Clínico e Diretrizes Terapêuticas para Atenção Integral às Pessoas com Infecções Sexualmente Transmissíveis e o Manual Técnico para Diagnóstico de Sífilis, publicados pelo Ministério da Saúde do Brasil. Tais recomendações foram elaboradas com base em evidências científicas e discussões com painel de especialistas. Visando contribuir com gestores e profissionais de saúde na qualificação da assistência, este artigo apresenta o uso dos exames diretos para detecção de Treponema pallidum em lesões, assim como algoritmos que combinam testes imunológicos treponêmicos e não treponêmicos para auxiliar no diagnóstico da sífilis. O artigo também apresenta o uso dos testes não treponêmicos para investigação de neurossífilis e orientações para interpretação do título dos anticorpos não treponêmicos no monitoramento do tratamento e diagnóstico de sífilis congênita, bem como as perspectivas futuras de inovações em diagnóstico. Ressalta-se, além disso, o importante papel dos testes rápidos imunocromatográficos treponêmicos para a saúde pública e o enfrentamento da sífilis.]]></p></abstract>
<abstract abstract-type="short" xml:lang="en"><p><![CDATA[Abstract The recommendations for diagnostic tests for investigating syphilis are part of the Clinical Protocol and Therapeutic Guidelines for Comprehensive Care for People with Sexually Transmitted Infections and the Technical Manual for Syphilis Diagnosis, published by the Brazilian Ministry of Health. These recommendations were developed based on scientific evidence and discussions with a panel of experts. Aiming to contribute to the efforts of health service managers and health professionals in qualifying health care, this article presents the use of direct tests to detect Treponema pallidum in lesions, as well as algorithms that combine treponemal and non-treponemal antibody tests to assist in the diagnosis of syphilis. The article also covers use of non-treponemal tests to investigate neurosyphilis and guidelines for interpreting non-treponemal antibody titers in monitoring treatment and diagnosis of congenital syphilis, as well as prospects for innovations in diagnosis. The important role of rapid immunochromatographic treponemal tests for public health and for addressing syphilis is also highlighted.]]></p></abstract>
<abstract abstract-type="short" xml:lang="es"><p><![CDATA[Resumen Las recomendaciones de las pruebas de diagnóstico de sífilis forman parte del Protocolo Clínico y Directrices Terapéuticas para la Atención Integral a las Personas con Infecciones de Transmisión Sexual y del Manual Técnico para el Diagnóstico de Sífilis, publicados por el Ministerio de Salud de Brasil. Estos documentos fueron preparados en base a la evidencia científica y discusiones con especialistas. Con el objetivo de contribuir con los administradores y profesionales de la salud pública en la calificación de la atención, este artículo presenta el uso de pruebas directas para la detección de Treponema pallidum en lesiones, además de algoritmos que combinan pruebas treponémicas y no treponémicas para ayudar al diagnóstico. También se presentan las pruebas no treponémicas para investigar la neurosífilis y orientaciones para la interpretación de títulos de anticuerpos no treponémicos para monitorear la respuesta al tratamiento y diagnosticar la sífilis congénita, así como las perspectivas futuras para las innovaciones diagnósticas. También se enfatiza el uso de pruebas inmunocromatográficas treponémicas rápidas como una herramienta importante para la salud pública y para el enfrentamiento de la sífilis.]]></p></abstract>
<kwd-group>
<kwd lng="pt"><![CDATA[Sífilis]]></kwd>
<kwd lng="pt"><![CDATA[Neurossífilis]]></kwd>
<kwd lng="pt"><![CDATA[Sífilis Congênita]]></kwd>
<kwd lng="pt"><![CDATA[Diagnóstico]]></kwd>
<kwd lng="en"><![CDATA[Syphilis]]></kwd>
<kwd lng="en"><![CDATA[Neurosyphilis]]></kwd>
<kwd lng="en"><![CDATA[Congenital Syphilis]]></kwd>
<kwd lng="en"><![CDATA[Diagnosis]]></kwd>
<kwd lng="es"><![CDATA[Sífilis]]></kwd>
<kwd lng="es"><![CDATA[Neurossífilis]]></kwd>
<kwd lng="es"><![CDATA[Sífilis Congênita]]></kwd>
<kwd lng="es"><![CDATA[Diagnóstico]]></kwd>
</kwd-group>
</article-meta>
</front><back>
<ref-list>
<ref id="B1">
<label>1</label><nlm-citation citation-type="book">
<collab>Ministério da Saúde (BR). Secretaria de Vigilância em Saúde. Departamento de Doenças de Condições Crônicas e Infecções Sexualmente Transmissíveis</collab>
<source><![CDATA[Protocolo clínico e diretrizes terapêuticas para atenção integral às pessoas com infecções sexualmente transmissíveis (IST)]]></source>
<year>2020</year>
<publisher-loc><![CDATA[Brasília ]]></publisher-loc>
<publisher-name><![CDATA[Ministério da Saúde]]></publisher-name>
</nlm-citation>
</ref>
<ref id="B2">
<label>2</label><nlm-citation citation-type="book">
<collab>Ministério da Saúde (BR). Secretaria de Vigilância em Saúde. Departamento de Vigilância, Prevenção e Controle das Doenças Sexualmente Transmissíveis, Aids e Hepatites Virais</collab>
<source><![CDATA[Manual técnico para diagnóstico da sífilis]]></source>
<year>2016</year>
<publisher-loc><![CDATA[Brasília ]]></publisher-loc>
<publisher-name><![CDATA[Ministério da Saúde]]></publisher-name>
</nlm-citation>
</ref>
<ref id="B3">
<label>3</label><nlm-citation citation-type="journal">
<collab>Brasil. Ministério da Saúde</collab>
<article-title xml:lang=""><![CDATA[Portaria MS/GM nº 2.012, de 19 de outubro de 2016. Aprova o Manual Técnico para o Diagnóstico da Sífilis e dá outras providências]]></article-title>
<source><![CDATA[Diário Oficial da União]]></source>
<year>2016</year>
<publisher-loc><![CDATA[Brasília (DF) ]]></publisher-loc>
</nlm-citation>
</ref>
<ref id="B4">
<label>4</label><nlm-citation citation-type="journal">
<collab>Brasil. Ministério da Saúde</collab>
<article-title xml:lang=""><![CDATA[Portaria MS/GM nº 42, de 5 de outubro de 2018. Torna pública a decisão de aprovar o Protocolo Clínico e Diretrizes Terapêuticas para Atenção Integral às Pessoas com Infecções Sexualmente Transmissíveis (IST), no âmbito do Sistema Único de Saúde - SUS]]></article-title>
<source><![CDATA[Diário Oficial da União]]></source>
<year>2018</year>
<publisher-loc><![CDATA[Brasília (DF) ]]></publisher-loc>
</nlm-citation>
</ref>
<ref id="B5">
<label>5</label><nlm-citation citation-type="book">
<collab>World Health Organization - WHO</collab>
<source><![CDATA[Laboratory diagnosis of sexually transmitted infections, including human immunodeficiency virus]]></source>
<year>2013</year>
<publisher-loc><![CDATA[Geneva ]]></publisher-loc>
<publisher-name><![CDATA[World Health Organization]]></publisher-name>
</nlm-citation>
</ref>
<ref id="B6">
<label>6</label><nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Workowski]]></surname>
<given-names><![CDATA[KA]]></given-names>
</name>
<name>
<surname><![CDATA[Bolan]]></surname>
<given-names><![CDATA[GA]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[Sexually transmitted diseases treatment guidelines, 2015]]></article-title>
<collab>Centers for Disease Control and Prevention - CDC</collab>
<source><![CDATA[MMWR Recomm Rep]]></source>
<year>2015</year>
<volume>64</volume>
<numero>RR-03</numero>
<issue>RR-03</issue>
<page-range>1-137</page-range></nlm-citation>
</ref>
<ref id="B7">
<label>7</label><nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Hook]]></surname>
<given-names><![CDATA[EW]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[Syphilis]]></article-title>
<source><![CDATA[Lancet]]></source>
<year>2017</year>
<volume>389</volume>
<numero>10078</numero>
<issue>10078</issue>
<page-range>1550-7</page-range></nlm-citation>
</ref>
<ref id="B8">
<label>8</label><nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Peeling]]></surname>
<given-names><![CDATA[RW]]></given-names>
</name>
<name>
<surname><![CDATA[Mabey]]></surname>
<given-names><![CDATA[D]]></given-names>
</name>
<name>
<surname><![CDATA[Kamb]]></surname>
<given-names><![CDATA[ML]]></given-names>
</name>
<name>
<surname><![CDATA[Chen]]></surname>
<given-names><![CDATA[XS]]></given-names>
</name>
<name>
<surname><![CDATA[Radolf]]></surname>
<given-names><![CDATA[JD]]></given-names>
</name>
<name>
<surname><![CDATA[Benzaken]]></surname>
<given-names><![CDATA[AS]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[Syphilis]]></article-title>
<source><![CDATA[Nat Rev Dis Primers]]></source>
<year>2017</year>
<volume>3</volume>
<page-range>17073</page-range></nlm-citation>
</ref>
<ref id="B9">
<label>9</label><nlm-citation citation-type="book">
<collab>Ministério da Saúde (BR). Secretaria de Vigilância em Saúde. Departamento de Doenças de Condições Crônicas e Infecções Sexualmente Transmissíveis</collab>
<source><![CDATA[Protocolo clínico e diretrizes terapêuticas para prevenção da transmissão vertical de HIV, sífilis e hepatites virais]]></source>
<year>2019</year>
<publisher-loc><![CDATA[Brasília ]]></publisher-loc>
<publisher-name><![CDATA[Ministério da Saúde]]></publisher-name>
</nlm-citation>
</ref>
<ref id="B10">
<label>10</label><nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Rowley]]></surname>
<given-names><![CDATA[J]]></given-names>
</name>
<name>
<surname><![CDATA[Vander Hoorn]]></surname>
<given-names><![CDATA[S]]></given-names>
</name>
<name>
<surname><![CDATA[Korenromp]]></surname>
<given-names><![CDATA[E]]></given-names>
</name>
<name>
<surname><![CDATA[Low]]></surname>
<given-names><![CDATA[N]]></given-names>
</name>
<name>
<surname><![CDATA[Unemo]]></surname>
<given-names><![CDATA[M]]></given-names>
</name>
<name>
<surname><![CDATA[Abud-Raddad]]></surname>
<given-names><![CDATA[L]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[Chlamydia, gonorrhoea, trichomoniasis and syphilis: global prevalence and incidence estimates, 2016]]></article-title>
<source><![CDATA[Bull World Health Organ]]></source>
<year>2019</year>
<volume>97</volume>
<numero>8</numero>
<issue>8</issue>
<page-range>548-62</page-range></nlm-citation>
</ref>
<ref id="B11">
<label>11</label><nlm-citation citation-type="journal">
<collab>Ministério da Saúde (BR). Secretaria de Vigilância em Saúde. Departamento de Doenças de Condições Crônicas e Infecções Sexualmente Transmissíveis</collab>
<article-title xml:lang=""><![CDATA[Sífilis | 2019]]></article-title>
<source><![CDATA[Bol Epidemiol]]></source>
<year>2019</year>
<numero>especial</numero>
<issue>especial</issue>
</nlm-citation>
</ref>
<ref id="B12">
<label>12</label><nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Edmondson]]></surname>
<given-names><![CDATA[DG]]></given-names>
</name>
<name>
<surname><![CDATA[Hu]]></surname>
<given-names><![CDATA[B]]></given-names>
</name>
<name>
<surname><![CDATA[Norris]]></surname>
<given-names><![CDATA[SJ]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[Long-term in vitro culture of the syphilis spirochete Treponema pallidum subsp. pallidum]]></article-title>
<source><![CDATA[mBio]]></source>
<year>2018</year>
<volume>9</volume>
<numero>3</numero>
<issue>3</issue>
</nlm-citation>
</ref>
<ref id="B13">
<label>13</label><nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Larsen]]></surname>
<given-names><![CDATA[SA]]></given-names>
</name>
<name>
<surname><![CDATA[Steiner]]></surname>
<given-names><![CDATA[BM]]></given-names>
</name>
<name>
<surname><![CDATA[Rudolph]]></surname>
<given-names><![CDATA[AH]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[Laboratory diagnosis and interpretation of tests for syphilis]]></article-title>
<source><![CDATA[Clin Microbiol Rev]]></source>
<year>1995</year>
<volume>8</volume>
<numero>1</numero>
<issue>1</issue>
<page-range>1-21</page-range></nlm-citation>
</ref>
<ref id="B14">
<label>14</label><nlm-citation citation-type="book">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Larsen]]></surname>
<given-names><![CDATA[S]]></given-names>
</name>
<name>
<surname><![CDATA[Pope]]></surname>
<given-names><![CDATA[V]]></given-names>
</name>
<name>
<surname><![CDATA[Johnson]]></surname>
<given-names><![CDATA[RE]]></given-names>
</name>
<name>
<surname><![CDATA[Kennedy]]></surname>
<given-names><![CDATA[EJ]]></given-names>
</name>
</person-group>
<source><![CDATA[A manual of tests for syphilis]]></source>
<year>1998</year>
<edition>9</edition>
<publisher-loc><![CDATA[Washington, DC ]]></publisher-loc>
<publisher-name><![CDATA[American Public Health Association]]></publisher-name>
</nlm-citation>
</ref>
<ref id="B15">
<label>15</label><nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Buffet]]></surname>
<given-names><![CDATA[M]]></given-names>
</name>
<name>
<surname><![CDATA[Grange]]></surname>
<given-names><![CDATA[PA]]></given-names>
</name>
<name>
<surname><![CDATA[Gerhardt]]></surname>
<given-names><![CDATA[P]]></given-names>
</name>
<name>
<surname><![CDATA[Carlotti]]></surname>
<given-names><![CDATA[A]]></given-names>
</name>
<name>
<surname><![CDATA[Calvez]]></surname>
<given-names><![CDATA[C]]></given-names>
</name>
<name>
<surname><![CDATA[Bianchi]]></surname>
<given-names><![CDATA[A]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[Diagnosing Treponema pallidum in secondary syphilis by PCR and immunohistochemistry]]></article-title>
<source><![CDATA[J Invest Dermatol]]></source>
<year>2007</year>
<volume>127</volume>
<numero>10</numero>
<issue>10</issue>
<page-range>2345-50</page-range></nlm-citation>
</ref>
<ref id="B16">
<label>16</label><nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Ratnam]]></surname>
<given-names><![CDATA[S]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[The laboratory diagnosis of syphilis]]></article-title>
<source><![CDATA[Can J Infect Dis Med Microbiol]]></source>
<year>2005</year>
<volume>16</volume>
<numero>1</numero>
<issue>1</issue>
<page-range>45-51</page-range></nlm-citation>
</ref>
<ref id="B17">
<label>17</label><nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Janier]]></surname>
<given-names><![CDATA[M]]></given-names>
</name>
<name>
<surname><![CDATA[Hegyi]]></surname>
<given-names><![CDATA[V]]></given-names>
</name>
<name>
<surname><![CDATA[Dupin]]></surname>
<given-names><![CDATA[N]]></given-names>
</name>
<name>
<surname><![CDATA[Unemo]]></surname>
<given-names><![CDATA[M]]></given-names>
</name>
<name>
<surname><![CDATA[Tiplica]]></surname>
<given-names><![CDATA[GS]]></given-names>
</name>
<name>
<surname><![CDATA[Poto&#269;nik]]></surname>
<given-names><![CDATA[M]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[European guideline on the management of syphilis]]></article-title>
<source><![CDATA[J Eur Acad Dermatol Venereol]]></source>
<year>2014</year>
<volume>28</volume>
<numero>12</numero>
<issue>12</issue>
<page-range>1581-93</page-range></nlm-citation>
</ref>
<ref id="B18">
<label>18</label><nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Zhou]]></surname>
<given-names><![CDATA[C]]></given-names>
</name>
<name>
<surname><![CDATA[Zhang]]></surname>
<given-names><![CDATA[X]]></given-names>
</name>
<name>
<surname><![CDATA[Zhang]]></surname>
<given-names><![CDATA[W]]></given-names>
</name>
<name>
<surname><![CDATA[Duan]]></surname>
<given-names><![CDATA[J]]></given-names>
</name>
<name>
<surname><![CDATA[Zhao]]></surname>
<given-names><![CDATA[F]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[PCR detection for syphilis diagnosis: Status and prospects]]></article-title>
<source><![CDATA[J Clin Lab Anal]]></source>
<year>2019</year>
<volume>33</volume>
<numero>5</numero>
<issue>5</issue>
</nlm-citation>
</ref>
<ref id="B19">
<label>19</label><nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Berkowitz]]></surname>
<given-names><![CDATA[K]]></given-names>
</name>
<name>
<surname><![CDATA[Baxi]]></surname>
<given-names><![CDATA[L]]></given-names>
</name>
<name>
<surname><![CDATA[Fox]]></surname>
<given-names><![CDATA[HE]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[False-negative syphilis screening: the prozone phenomenon, nonimmune hydrops, and diagnosis of syphilis during pregnancy]]></article-title>
<source><![CDATA[Am J Obstet Gynecol]]></source>
<year>1990</year>
<volume>163</volume>
<numero>3</numero>
<issue>3</issue>
<page-range>975-7</page-range></nlm-citation>
</ref>
<ref id="B20">
<label>20</label><nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Morshed]]></surname>
<given-names><![CDATA[MG]]></given-names>
</name>
<name>
<surname><![CDATA[Singh]]></surname>
<given-names><![CDATA[AE]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[Recent trends in the serologic diagnosis of syphilis]]></article-title>
<source><![CDATA[Clin Vaccine Immunol]]></source>
<year>2015</year>
<volume>22</volume>
<numero>2</numero>
<issue>2</issue>
<page-range>137-47</page-range></nlm-citation>
</ref>
<ref id="B21">
<label>21</label><nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Singh]]></surname>
<given-names><![CDATA[AE]]></given-names>
</name>
<name>
<surname><![CDATA[Guenette]]></surname>
<given-names><![CDATA[T]]></given-names>
</name>
<name>
<surname><![CDATA[Gratrix]]></surname>
<given-names><![CDATA[J]]></given-names>
</name>
<name>
<surname><![CDATA[Bergman]]></surname>
<given-names><![CDATA[J]]></given-names>
</name>
<name>
<surname><![CDATA[Parker]]></surname>
<given-names><![CDATA[P]]></given-names>
</name>
<name>
<surname><![CDATA[Anderson]]></surname>
<given-names><![CDATA[B]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[Seroreversion of treponemal tests in infants meeting Canadian surveillance criteria for confirmed early congenital syphilis]]></article-title>
<source><![CDATA[Pediatr Infect Dis J]]></source>
<year>2013</year>
<volume>32</volume>
<numero>3</numero>
<issue>3</issue>
<page-range>199-202</page-range></nlm-citation>
</ref>
<ref id="B22">
<label>22</label><nlm-citation citation-type="book">
<collab>Organización Panamericana de la Salud - OPAS</collab>
<source><![CDATA[Orientación para el diagnóstico de la sífilis en América Latina y el Caribe: cómo mejorar la adopción, interpretación y calidad del diagnóstico en diferentes entornos clínicos]]></source>
<year>2015</year>
<publisher-loc><![CDATA[Washington, DC ]]></publisher-loc>
<publisher-name><![CDATA[OPAS]]></publisher-name>
</nlm-citation>
</ref>
<ref id="B23">
<label>23</label><nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Holman]]></surname>
<given-names><![CDATA[KM]]></given-names>
</name>
<name>
<surname><![CDATA[Wolff]]></surname>
<given-names><![CDATA[M]]></given-names>
</name>
<name>
<surname><![CDATA[Seña]]></surname>
<given-names><![CDATA[AC]]></given-names>
</name>
<name>
<surname><![CDATA[Martin]]></surname>
<given-names><![CDATA[DH]]></given-names>
</name>
<name>
<surname><![CDATA[Behets]]></surname>
<given-names><![CDATA[F]]></given-names>
</name>
<name>
<surname><![CDATA[Van Damme]]></surname>
<given-names><![CDATA[F]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[Rapid plasma reagin titer variation in the 2 weeks after syphilis therapy]]></article-title>
<source><![CDATA[Sex Transm Dis]]></source>
<year>2012</year>
<volume>39</volume>
<numero>8</numero>
<issue>8</issue>
<page-range>645-7</page-range></nlm-citation>
</ref>
<ref id="B24">
<label>24</label><nlm-citation citation-type="book">
<collab>World Health Organization - WHO</collab>
<source><![CDATA[WHO guidelines for the treatment of Treponema pallidum (syphilis)]]></source>
<year>2013</year>
<publisher-loc><![CDATA[Geneva ]]></publisher-loc>
<publisher-name><![CDATA[World Health Organization]]></publisher-name>
</nlm-citation>
</ref>
<ref id="B25">
<label>25</label><nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Clement]]></surname>
<given-names><![CDATA[ME]]></given-names>
</name>
<name>
<surname><![CDATA[Okeke]]></surname>
<given-names><![CDATA[NL]]></given-names>
</name>
<name>
<surname><![CDATA[Hicks]]></surname>
<given-names><![CDATA[CB]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[Treatment of syphilis: a systematic review]]></article-title>
<source><![CDATA[JAMA]]></source>
<year>2014</year>
<volume>312</volume>
<numero>18</numero>
<issue>18</issue>
<page-range>1905-17</page-range></nlm-citation>
</ref>
<ref id="B26">
<label>26</label><nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Ghanem]]></surname>
<given-names><![CDATA[KG]]></given-names>
</name>
<name>
<surname><![CDATA[Moore]]></surname>
<given-names><![CDATA[RD]]></given-names>
</name>
<name>
<surname><![CDATA[Rompalo]]></surname>
<given-names><![CDATA[AM]]></given-names>
</name>
<name>
<surname><![CDATA[Erbelding]]></surname>
<given-names><![CDATA[EJ]]></given-names>
</name>
<name>
<surname><![CDATA[Zenilman]]></surname>
<given-names><![CDATA[JM]]></given-names>
</name>
<name>
<surname><![CDATA[Gebo]]></surname>
<given-names><![CDATA[KA]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[Lumbar puncture in HIV-infected patients with syphilis and no neurologic symptoms]]></article-title>
<source><![CDATA[Clin Infect Dis]]></source>
<year>2009</year>
<volume>48</volume>
<numero>6</numero>
<issue>6</issue>
<page-range>816-21</page-range></nlm-citation>
</ref>
<ref id="B27">
<label>27</label><nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Marra]]></surname>
<given-names><![CDATA[CM]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[Neurosyphilis]]></article-title>
<source><![CDATA[Continuum (Minneap., Minn.)]]></source>
<year>2015</year>
<volume>21</volume>
<numero>6</numero>
<issue>6</issue>
<page-range>1714-28</page-range></nlm-citation>
</ref>
<ref id="B28">
<label>28</label><nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Ropper]]></surname>
<given-names><![CDATA[AH]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[Neurosyphilis]]></article-title>
<source><![CDATA[N Engl J Med]]></source>
<year>2019</year>
<volume>381</volume>
<numero>14</numero>
<issue>14</issue>
<page-range>1358-63</page-range></nlm-citation>
</ref>
<ref id="B29">
<label>29</label><nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Marra]]></surname>
<given-names><![CDATA[CM]]></given-names>
</name>
<name>
<surname><![CDATA[Tantalo]]></surname>
<given-names><![CDATA[LC]]></given-names>
</name>
<name>
<surname><![CDATA[Maxwell]]></surname>
<given-names><![CDATA[CL]]></given-names>
</name>
<name>
<surname><![CDATA[Ho]]></surname>
<given-names><![CDATA[EL]]></given-names>
</name>
<name>
<surname><![CDATA[Sahi]]></surname>
<given-names><![CDATA[SK]]></given-names>
</name>
<name>
<surname><![CDATA[Jones]]></surname>
<given-names><![CDATA[T]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[The rapid plasma reagin test cannot replace the venereal disease research laboratory test for neurosyphilis diagnosis]]></article-title>
<source><![CDATA[Sex Transm Dis]]></source>
<year>2012</year>
<volume>39</volume>
<numero>6</numero>
<issue>6</issue>
<page-range>453-7</page-range></nlm-citation>
</ref>
<ref id="B30">
<label>30</label><nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Marra]]></surname>
<given-names><![CDATA[CM]]></given-names>
</name>
<name>
<surname><![CDATA[Maxwell]]></surname>
<given-names><![CDATA[CL]]></given-names>
</name>
<name>
<surname><![CDATA[Dunaway]]></surname>
<given-names><![CDATA[SB]]></given-names>
</name>
<name>
<surname><![CDATA[Sahi]]></surname>
<given-names><![CDATA[SK]]></given-names>
</name>
<name>
<surname><![CDATA[Tantalo]]></surname>
<given-names><![CDATA[LC]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[Cerebrospinal fluid Treponema pallidum particle agglutination assay for neurosyphilis diagnosis]]></article-title>
<source><![CDATA[J Clin Microbiol]]></source>
<year>2017</year>
<volume>55</volume>
<numero>6</numero>
<issue>6</issue>
<page-range>1865-70</page-range></nlm-citation>
</ref>
<ref id="B31">
<label>31</label><nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Chesney]]></surname>
<given-names><![CDATA[SOU]]></given-names>
</name>
<name>
<surname><![CDATA[Kemp]]></surname>
<given-names><![CDATA[JE]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[Incidence of Spirochaeta pallida in cerebrospinal fluid during early stage of syphilis]]></article-title>
<source><![CDATA[JAMA]]></source>
<year>1924</year>
<page-range>736-40</page-range></nlm-citation>
</ref>
<ref id="B32">
<label>32</label><nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Madiedo]]></surname>
<given-names><![CDATA[G]]></given-names>
</name>
<name>
<surname><![CDATA[Ho]]></surname>
<given-names><![CDATA[KC]]></given-names>
</name>
<name>
<surname><![CDATA[Walsh]]></surname>
<given-names><![CDATA[P]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[False-positive VDRL and FTA in cerebrospinal fluid]]></article-title>
<source><![CDATA[JAMA]]></source>
<year>1980</year>
<volume>244</volume>
<numero>7</numero>
<issue>7</issue>
<page-range>688-9</page-range></nlm-citation>
</ref>
<ref id="B33">
<label>33</label><nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Lukehart]]></surname>
<given-names><![CDATA[SA]]></given-names>
</name>
<name>
<surname><![CDATA[Hook]]></surname>
<given-names><![CDATA[EW]]></given-names>
</name>
<name>
<surname><![CDATA[Baker-Zander]]></surname>
<given-names><![CDATA[SA]]></given-names>
</name>
<name>
<surname><![CDATA[Collier]]></surname>
<given-names><![CDATA[AC]]></given-names>
</name>
<name>
<surname><![CDATA[Critchlow]]></surname>
<given-names><![CDATA[CW]]></given-names>
</name>
<name>
<surname><![CDATA[Handsfield]]></surname>
<given-names><![CDATA[HH]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[Invasion of the central nervous system by Treponema pallidum: implications for diagnosis and treatment]]></article-title>
<source><![CDATA[Ann Intern Med]]></source>
<year>1988</year>
<volume>109</volume>
<numero>11</numero>
<issue>11</issue>
<page-range>855-62</page-range></nlm-citation>
</ref>
<ref id="B34">
<label>34</label><nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Marra]]></surname>
<given-names><![CDATA[CM]]></given-names>
</name>
<name>
<surname><![CDATA[Critchlow]]></surname>
<given-names><![CDATA[CW]]></given-names>
</name>
<name>
<surname><![CDATA[Hook]]></surname>
<given-names><![CDATA[EW]]></given-names>
</name>
<name>
<surname><![CDATA[Collier]]></surname>
<given-names><![CDATA[AC]]></given-names>
</name>
<name>
<surname><![CDATA[Lukehart]]></surname>
<given-names><![CDATA[SA]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[Cerebrospinal fluid treponemal antibodies in untreated early syphilis]]></article-title>
<source><![CDATA[Arch Neurol]]></source>
<year>1995</year>
<volume>52</volume>
<numero>1</numero>
<issue>1</issue>
<page-range>68-72</page-range></nlm-citation>
</ref>
<ref id="B35">
<label>35</label><nlm-citation citation-type="book">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Merritt]]></surname>
<given-names><![CDATA[HH]]></given-names>
</name>
<name>
<surname><![CDATA[Adams]]></surname>
<given-names><![CDATA[RD]]></given-names>
</name>
<name>
<surname><![CDATA[Solomon]]></surname>
<given-names><![CDATA[HC]]></given-names>
</name>
</person-group>
<source><![CDATA[Neurosyphilis]]></source>
<year>1946</year>
<publisher-loc><![CDATA[New York ]]></publisher-loc>
<publisher-name><![CDATA[Oxford University Press]]></publisher-name>
</nlm-citation>
</ref>
<ref id="B36">
<label>36</label><nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Musher]]></surname>
<given-names><![CDATA[DM]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[Editorial commentary: polymerase chain reaction for the tpp47 gene: a new test for neurosyphilis]]></article-title>
<source><![CDATA[Clin Infect Dis]]></source>
<year>2016</year>
<volume>63</volume>
<numero>9</numero>
<issue>9</issue>
<page-range>1187-8</page-range></nlm-citation>
</ref>
<ref id="B37">
<label>37</label><nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Tuddenham]]></surname>
<given-names><![CDATA[S]]></given-names>
</name>
<name>
<surname><![CDATA[Ghanem]]></surname>
<given-names><![CDATA[KG]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[Neurosyphilis: knowledge gaps and controversies]]></article-title>
<source><![CDATA[Sex Transm Dis]]></source>
<year>2018</year>
<volume>45</volume>
<numero>3</numero>
<issue>3</issue>
<page-range>147-51</page-range></nlm-citation>
</ref>
<ref id="B38">
<label>38</label><nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Peeling]]></surname>
<given-names><![CDATA[RW]]></given-names>
</name>
<name>
<surname><![CDATA[Ye]]></surname>
<given-names><![CDATA[H]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[Diagnostic tools for preventing and managing maternal and congenital syphilis: an overview]]></article-title>
<source><![CDATA[Bull World Health Organ]]></source>
<year>2004</year>
<volume>82</volume>
<numero>6</numero>
<issue>6</issue>
<page-range>439-46</page-range></nlm-citation>
</ref>
<ref id="B39">
<label>39</label><nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Gliddon]]></surname>
<given-names><![CDATA[HD]]></given-names>
</name>
<name>
<surname><![CDATA[Peeling]]></surname>
<given-names><![CDATA[RW]]></given-names>
</name>
<name>
<surname><![CDATA[Kamb]]></surname>
<given-names><![CDATA[ML]]></given-names>
</name>
<name>
<surname><![CDATA[Toskin]]></surname>
<given-names><![CDATA[I]]></given-names>
</name>
<name>
<surname><![CDATA[Wi]]></surname>
<given-names><![CDATA[TE]]></given-names>
</name>
<name>
<surname><![CDATA[Taylor]]></surname>
<given-names><![CDATA[MM]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[A systematic review and meta-analysis of studies evaluating the performance and operational characteristics of dual point-of-care tests for HIV and syphilis]]></article-title>
<source><![CDATA[Sex Transm Infect]]></source>
<year>2017</year>
<volume>93</volume>
<numero>S4</numero>
<issue>S4</issue>
<page-range>S3-15</page-range></nlm-citation>
</ref>
<ref id="B40">
<label>40</label><nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Tesfazghi]]></surname>
<given-names><![CDATA[MT]]></given-names>
</name>
<name>
<surname><![CDATA[Anderson]]></surname>
<given-names><![CDATA[NW]]></given-names>
</name>
<name>
<surname><![CDATA[Gronowski]]></surname>
<given-names><![CDATA[AM]]></given-names>
</name>
<name>
<surname><![CDATA[Yarbrough]]></surname>
<given-names><![CDATA[ML]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[Clinical performance of the BioPlex 2200 syphilis total &amp; RPR assay at a tertiary medical center with a high rate of syphilis]]></article-title>
<source><![CDATA[J Clin Microbiol]]></source>
<year>2019</year>
<volume>57</volume>
<numero>1</numero>
<issue>1</issue>
</nlm-citation>
</ref>
<ref id="B41">
<label>41</label><nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Marks]]></surname>
<given-names><![CDATA[M]]></given-names>
</name>
<name>
<surname><![CDATA[Yin]]></surname>
<given-names><![CDATA[YP]]></given-names>
</name>
<name>
<surname><![CDATA[Chen]]></surname>
<given-names><![CDATA[XS]]></given-names>
</name>
<name>
<surname><![CDATA[Castro]]></surname>
<given-names><![CDATA[A]]></given-names>
</name>
<name>
<surname><![CDATA[Causer]]></surname>
<given-names><![CDATA[L]]></given-names>
</name>
<name>
<surname><![CDATA[Guy]]></surname>
<given-names><![CDATA[R]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[Metanalysis of the performance of a combined treponemal and nontreponemal rapid diagnostic test for syphilis and yaws]]></article-title>
<source><![CDATA[Clin Infect Dis]]></source>
<year>2016</year>
<volume>63</volume>
<numero>5</numero>
<issue>5</issue>
<page-range>627-33</page-range></nlm-citation>
</ref>
<ref id="B42">
<label>42</label><nlm-citation citation-type="book">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Tesic]]></surname>
<given-names><![CDATA[V]]></given-names>
</name>
</person-group>
<source><![CDATA[Recent advances in syphilis testing]]></source>
<year>2017</year>
<publisher-loc><![CDATA[Washington, D.C. ]]></publisher-loc>
<publisher-name><![CDATA[Clinical Laboratory News]]></publisher-name>
</nlm-citation>
</ref>
<ref id="B43">
<label>43</label><nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Bazzo]]></surname>
<given-names><![CDATA[ML]]></given-names>
</name>
<name>
<surname><![CDATA[Motta]]></surname>
<given-names><![CDATA[LR]]></given-names>
</name>
<name>
<surname><![CDATA[Rudolf-Oliveira]]></surname>
<given-names><![CDATA[RCM]]></given-names>
</name>
<name>
<surname><![CDATA[Bigolin]]></surname>
<given-names><![CDATA[A]]></given-names>
</name>
<name>
<surname><![CDATA[Golfetto]]></surname>
<given-names><![CDATA[L]]></given-names>
</name>
<name>
<surname><![CDATA[Mesquita]]></surname>
<given-names><![CDATA[F]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[Evaluation of seven rapid tests for syphilis available in Brazil using defibrinated plasma panels]]></article-title>
<source><![CDATA[Sex Transm Infect]]></source>
<year>2017</year>
<volume>93</volume>
<numero>S4</numero>
<issue>S4</issue>
<page-range>S46-50</page-range></nlm-citation>
</ref>
</ref-list>
</back>
</article>
