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LETTER TO EDITOR
Year : 2003  |  Volume : 69  |  Issue : 3  |  Page : 252-253
 

Comments on “Serological study for sexually transmitted diseases in patients attending Std clinics in Calcutta”


Department of Dermatology Veneorology and Leprology, PGIMER, Chandigarh-160012.

Correspondence Address:
Department of Dermatology Veneorology and Leprology, PGIMER, Chandigarh-160012.
kumarbhushan@hotmail.com



How to cite this article:
Dogra S, Kumar B. Comments on “Serological study for sexually transmitted diseases in patients attending Std clinics in Calcutta” . Indian J Dermatol Venereol Leprol 2003;69:252-3


How to cite this URL:
Dogra S, Kumar B. Comments on “Serological study for sexually transmitted diseases in patients attending Std clinics in Calcutta” . Indian J Dermatol Venereol Leprol [serial online] 2003 [cited 2019 Aug 17];69:252-3. Available from: http://www.ijdvl.com/text.asp?2003/69/3/252/1018


Sir,
It was interesting reading “Serological study for sexually transmitted diseases in patients attending STD clinics in Calcutta” published in Indian J Dermatol Venereol Leprol 2002; 68 275-278. We have some queries:comments for the authors to address.

What was the purpose of doing a qualitative VDRL test (which is more relevant in field conditions) in such a reputed institute of serology? A test with undiluted serum can result in false negativity because of the prozone phenomenon. Any titre cannot be considered significant (reactive). The VDRL test always has a standard cut off value for the uniform interpretation of results. However, the authors have not mentioned any such value in their article. In a developing country like India, various chronic infections can result in a false positive VDRL test in 1-3% of the patients. Further, a 'reactive' non-treponemal test indicates a present infection or a recently treated or untreated infection.[1] The result needs to be correlated with the medical history, examination and even with specific treponemal tests.

TPHA is a quantitative test reported in titre and so agglutination at a particular titre is more meaningful than mere agglutination. It is well known that a low degree of TPHA positivity will remain for years even in cases who have been adequately treated.[2] VDRL and TPHA tests indicate the same disease and adding them up falsely increases the total number of positive tests without any logical basis.

Serologic assays may be useful in detecting the prevalence of Chlamydia trachomatis infections of the genital tract in the community. Since 45-65% of patients may have IgG antibodies resulting from past infection, only a certain level of titre or demonstration of a four-fold rise in titre in a repeat sample is meaningful. Detection of IgM antibodies is more helpful in establishing acute chlamydia infections of the genital tract.[3] The present test report does not make us any wiser.

The results section is confusing; tabulating one or more serological tests in various combinations does not give any meaningful information. The article does not give us any idea about what the authors want to convey -single sample seropositivity without any cut off value?

It is commendable that the authors have tried to study the serum sample of such a large number of STD clinic attendees. However, a better-designed and interpreted study would have resulted in more useful information especially coming from such a leading centre. We hope our comments will be taken in the spirit they are meant to be.


 

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