Grant: Project Grant

Syphilis is a sexually transmitted infection with serious health consequences if left untreated, including transmission to unborn children. This may result in death or serious complications. In several parts of the Arctic, syphilis has emerged in the last few years and continues unabated. Identifying and treating cases promptly is critical to preventing transmission. The remoteness of most villages and lack of specialized diagnostic labs however, makes timely access to diagnostics difficult. Reliance on testing in distant labs leads to delays of typically 6-19 days between screening and treatment. This delay may contribute to continued transmission within sexual networks and between communities. Reducing this delay is therefore a key priority in Arctic communities. Rapid diagnostic tests (RDTs) intended to screen for syphilis, have been developed and used successfully in several counties. Syphilis RDTs are designed to be used without additional equipment and by individuals with minimal training to inform treatment decisions within the same visit thereby eliminating delays to treatment. To stop disease transmission and overcome obstacles to timely treatment, we will evaluate the use of RDTs in parallel with current standard lab-based testing. Unlike traditional testing, the RDTs will be used directly in affected communities and provide results in minutes, allowing for immediate initiation of treatment to help stop transmission. We will estimate the number of cases averted by early treatment of infectious syphilis, and model the impact of rapid testing on syphilis transmission. Our research aims to provide robust evidence for both the benefit and lack-of-harm from much needed interventions to control of syphilis transmission in remote Arctic communities. As such, this work aims to fill gaps in both knowledge and implementation using innovative evidence-based solutions for an ongoing public health emergency that can be readily solved.