Venereal disease research laboratory test-reactive syphilis cases from 2018 to 2022 in North India: Trends across pre-, during-, and post-COVID periods

Objectives: The objectives of the study are to evaluate the serological reactivity to syphilis among patients attending various departments in a tertiary care center and to analyze trends in venereal disease research laboratory (VDRL) test reactivity over a 5-year period (January 2018–December 2022). Materials and Methods: This retrospective observational study was conducted in the serology section of the Microbiology Department at a tertiary care hospital. Serological data from January 2018 to December 2022 were retrieved and analyzed. All samples were screened using the VDRL test. Reactive samples were further analyzed for titer levels and departmental distribution. Results: A total of 14,705 serum samples were tested using the VDRL test. Among these, 116 samples (0.78%) were reactive. The highest VDRL reactivity was noted in the Sexually Transmitted Infections (STIs)/Skin Outpatient department (1.75%), followed by “Others” (0.83%), Surgery (0.83%), General Medicine (0.48%), Antental Care (ANC) clinic (0.47%), and Emergency (0.45%). A male predominance was observed, with 59.48% (69/116) of reactive cases reported in males. The year 2019 showed the highest reactivity (1.04%), while the lowest was in 2021 (0.48%). Limitations: Confirmatory treponemal tests were not performed for all VDRL-reactive cases, and clinical histories were limited. Conclusion: Although the overall VDRL reactivity rate was low, higher rates among STI and ANC attendees underscore the importance of sustained screening and follow-up. Improved confirmatory diagnostics and record-keeping are necessary to reduce missed diagnoses.