DOI: https://doi.org/10.36347/sasjm.2025.v11i05.028

Pages: 542-545

Background: Syphilis remains a global public health concern, particularly in resource-limited settings. Serological testing is central to diagnosis, but the performance of manual versus automated assays remains under evaluation. Objective: To compare the diagnostic performance and concordance between a manual Treponema pallidum hemagglutination assay (TPHA) and an automated chemiluminescent microparticle immunoassay (CMIA) in detecting anti-treponemal antibodies. Methods: A retrospective study was conducted at CHU Mohammed VI of Marrakech. A total of 156 serum samples initially tested using the CMIA-based Architect i2000SR system were re-analyzed using the TPHA method. Concordance, sensitivity, specificity, and co-infections were evaluated. Results: All CMIA-negative samples (n=70) were also negative on TPHA (100% concordance). Among CMIA-positive samples (n=86), 81.25% were confirmed positive by TPHA, 8.75% equivocal, and 10% negative. VDRL was negative in 87.21% of CMIA-positive samples. Co-infections were present in 55.81%, most commonly CMV (30.56%) and hepatitis B (29.17%). CMIA showed a sensitivity of 88.6% and specificity of 100% versus TPHA. Conclusion: CMIA offers superior sensitivity and operational efficiency, while TPHA remains valuable where automation is limited. A combined testing approach may optimize diagnostic accuracy.