Estimating syphilis seroprevalence among patients in a sexually transmitted infections clinic in Lilongwe, Malawi.

The syndromic management of genital ulcer disease (GUD) misses asymptomatic syphilis cases but is widely utilized in limited resource settings without diagnostic capabilities, to ensure treatment for the most common etiologies of GUD. We used rapid serology tests for syphilis screening at a Malawian sexually transmitted infections clinic. The estimated seroprevalence was 9% and was highest among patients with genital ulcers (26%) and newly diagnosed HIV infection (19%). Rapid syphilis screening has the potential to increase syphilis detection, but accurate patient histories regarding syphilis diagnosis and prior treatment are needed.