Dear Sir,
While Dr. Wiwanitkit's analysis of cost-utility of syphilis screening of blood donors1 may quite rightly conclude that VDRL is ‘the best alternative for serological diagnosis of syphilis in blood banks, based on medical economical principles' I believe that an important element in choice of test has been overlooked.
In order to ensure accuracy of testing, optimal information transfer and good process control (especially in large throughput blood donor testing), tests need to be amenable to automation (especially for reading the results) and computerised information transfer. VDRL is essentially a manual test whereas ELISA and certain formats of TPHA can be automated for processing and reading.
This will significantly reduce the chances of operator and information transfer errors, and where affordable provides a much better option for achieving an error-free pathway. I realise that this may not be affordable in all countries but I believe it is an important issue that should be noted.
References
- 1.Wiwanitkit V. A cost-utility analysis of Treponema pallidum haemagglutination (TPHA) testing for syphilis screening of blood donors: is the TPHA test useful for syphilis screening in a blood centre? Blood Transfusion. 7:65–6. doi: 10.2450/2008.0024-08. [DOI] [PMC free article] [PubMed] [Google Scholar]