| Key Question |
New Evidence |
| 1. Is there new direct evidence that screening for syphilis reduces morbidity or mortality, the prevalence of congenital syphilis in neonates, or disease transmission? |
After initiation of a mandatory screening program, there was a decrease in the proportion of infants with clinical manifestations of syphilis and an increase in the proportion of infants with positive serologies, but no symptoms suggesting improvement in detecting early cases. |
| 2. Can high-risk groups and individuals be reliably identified? |
No studies evaluated this question directly. New incidence and prevalence data indicate rising rates among men who have sex with men and declining rates among other demographic groups. |
| 3. Is there new information on screening tests and methods? |
New tests are being developed, particularly those related to on-site testing or improved testing in newborns. |
| 4. What are the harms and costs of screening? |
A cost study in the U.K. supports continued universal testing during pregnancy. |
| 5. Is there new information on the effectiveness of treatment? |
A number of small studies on alternative treatments such as oral azithromycin have been published and indicate comparable outcomes to penicillin treatment. These alternatives are not included in recent treatment recommendations of the CDC. |
| 6. What are the harms and costs of treatment? |
No new studies identified. |
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