Syphilis point-of-care tests (POCTs): Implementation considerations in Canada
Bibliographic record
Abstract
Starting in the early 2000s, the rate of infectious syphilis in Canada began rising. Since the mid-2010s, the rate among females, particularly females in their reproductive years, has increased rapidly. Coincident with this shift, congenital syphilis has re-emerged in Canada in recent years. Infectious and congenital syphilis disproportionately impact communities affected by social and structural determinants of health, including homelessness and inadequate or inaccessible health care services. These realities underscore the importance of emerging strategies, including rapid diagnostic tests that can be deployed at the point of care, as tools to help reverse these trends. Increased access to testing is one of the pillars of the Pan-Canadian Framework for Action on Sexually Transmitted and Blood-Borne Infections (STBBI) and the Government of Canada's STBBI Action Plan 2024-2030. The National Microbiology Laboratory Branch of the Public Health Agency of Canada has worked towards introducing rapid diagnostic tests including point-of-care tests (POCTs) for STBBI testing. With Health Canada's first approval of a syphilis POCT (bioLytical's INSTI MULTIPLEX HIV-1/2 Syphilis Ab Test) in 2023, it is timely to reflect on important implementation considerations for this and other syphilis POCTs in Canada. In this article, we aim to review antibody-detecting syphilis POCTs that are commercially available, their performance in recent Canadian field studies, and key contextual considerations for Canada in implementing POCTs for syphilis.
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.025 | 0.065 |
| Meta-epidemiology (narrow) | 0.001 | 0.001 |
| Meta-epidemiology (broad) | 0.001 | 0.001 |
| Bibliometrics | 0.003 | 0.006 |
| Science and technology studies | 0.006 | 0.004 |
| Scholarly communication | 0.009 | 0.003 |
| Open science | 0.006 | 0.003 |
| Research integrity | 0.004 | 0.005 |
| Insufficient payload (model declined to judge) | 0.004 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".