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The article deals with a study that examined the performance of the toluidine red unheated serum (TRUST) test at local sexually transmitted disease (STD) clinics against testing conducted at the National STD Reference Laboratory in Guangxi, China. This study involved 14 STD clinics. An EpiData statistical software was used in this study to handle laboratory test data. Results showed that 1,513 serum specimens were read as TRUST positive in the local clinics, while 1,757 specimens were read as TRUST positive at the Reference Laboratory. Particular focus is given to the performance of the local TRUST screening, and those in the Reference Laboratory.

Objective: To measure prevalence of syphilis among the STI clinic population in Guangxi, China, and to assess the socioeconomic and behavioural characteristics associated with the infection. Methods: We undertook a cross-sectional survey and syphilis and HIV serologic testing among 11 473 patients attending 14 community and hospital-based dermatovenereal clinics across eight cities in Guangxi between December 2004 and February 2006. Results: 1297 (11.9%) patients demonstrated positive toludine red unheated serum test and Treponema pallidum particle agglutination results with serologic testing. A total of 58% (752) of seropositive subjects presented with a genital ulcer, palmar/plantar rash or inguinal lymphadenopathy. Female sex (OR = 2.23, 95% confidence intervals (CI)= 1.69 to 3.00, p<0.001), less education (middle school, OR= 1.70, 95% Cl = 1.11 to 2.62, p=0.023; primary school or less, OR= 1.98, 95% Cl = 1.13 to 3.46, p =0.017) and high annual income (OR = 1 .91, 95% CI = 1 .18 to 3.10, p = 0.009 for >30 000 RMB yuan) were associated with serologically positive status. Syphilis infection was significantly more prevalent in city 2 (19.5%, OR=3.07, 95% CI=1.83 to 5.16, p<0.001), city 4(16.6%, OR=1.90, 95% Cl=1.10 to 3.28, p=0.011) and city 8 (13.8%, OR= 1.83, 95% Cl = 1.13 to 2.97, p=0.006). A total of 40.1% (532) of infected subjects engaged in commercial sex and increased rates of the infection was associated with multiple sexual partners (OR = 1 .54, 95% CI = 1.16 to 2.06, p = 0.003). A total of 1 .2% (133) of participants carried laboratory markers for HIV and 1.8% (23) of patients with syphilis were positive for HIV. Conclusions: Syphilis infection has reached alarming rates in China's STI clinic population, suggesting a generalised spread of the disease through commercial sex and bridging populations. Syphilis control is deserving of China's highest priority. Universal screening for syphilis and HIV testing in STI clinics should be considered as measures for control. [ABSTRACT FROM AUTHOR]