Although this combination provides an excellent screen for all stages of syphilis with the
exception of very early primary infection when the treponemal test may not yet be positive, the cost-benefit of this approach should be considered.
The other option might be to use one of the newer EIA tests, which can serve as both a screening and a confirmatory test. Rapid treponemal tests such as the Syphilis fast (Diesse, Italy) may be useful for point-of-care confirmation of screen results .
Regardless, unless the testing volume demands an on-site treponemal testing service, such testing
should be limited to reference laboratories.