Alberta First Nations health centre will join study aiming to get people tested for syphilis

In this photo from 2022, Dr. Ameeta Singh, left, and nurse Noel Ives work with the syphilis-HIV rapid test. Singh is embarking on a new research program to explore different ways to get the test to people.   (Julia Wong/CBC - image credit)
In this photo from 2022, Dr. Ameeta Singh, left, and nurse Noel Ives work with the syphilis-HIV rapid test. Singh is embarking on a new research program to explore different ways to get the test to people. (Julia Wong/CBC - image credit)

Health officials are teaming up to make syphilis testing more accessible to people living in central Alberta as the province grapples with a worsening years-long outbreak of the serious sexually transmitted infection.

Dr. Ameeta Singh, an infectious disease specialist and clinical professor of medicine at the University of Alberta, oversaw a 19-month clinical trial of a rapid test to quickly and easily test people for both syphilis and HIV.

The test, which was 98 per cent accurate in detecting active syphilis and 100 per cent accurate in detecting HIV, was approved by Health Canada in March 2023.

Now, Singh has received $400,000 in federal funding to explore different ways of reaching — and testing — people potentially affected by syphilis and HIV. Some of the work will happen in Maskwacis, about 85 kilometres south of Edmonton, one of Alberta's largest First Nations communities.

"This test kit that we're using provides a preliminary result for syphilis in less than a minute," Singh told CBC's Radio Active.

"It's very exciting because it provides the opportunity to provide treatment right there and then in a single visit, instead of having to have the person come back for follow-up."

Rapid results, fast intervention

Syphilis, a sexually transmitted infection (STI), can lead to significant health issues if left untreated, including brain, heart and nerve complications. Pregnant people who aren't treated can transmit the infection to their fetus — called congenital syphilis — that could lead to health issues for the child, including stillbirth.

There have been 19 infants born with congenital syphilis in the Maskwacis region since 2018, including three stillborns, Singh noted in the research proposal, approved by the Canadian Institutes of Health Research (CIHR) in April.

Singh said the rapid tests would help protect people's health.

Treatment can cure the STI and, in the case of pregnancy, prevent harmful outcomes for the baby. Diagnosis will also help stop the spread to other people.

Syphilis rates have been spiking across Canada and internationally, recently reaching levels not seen since the 1940s.

Alberta, in particular, has become a hotspot. The ongoing outbreak was first declared in 2019; provincial data shows infectious syphilis cases have risen each year for nearly a decade.

In 2021, Alberta recorded more than 3,200 cases — the most in Canada, according to federal government statistics. In 2022, the most recent year for which syphilis statistics are available, Alberta health officials recorded nearly 3,330 cases — second behind Ontario, which reported about 3,440 cases.

"This infection is an old infection," Singh said.

"It should have gone away, but it has come back with a vengeance."

Multiple factors are contributing to the outbreak, she said, including social determinants of health such as poverty and systemic racism in health care, dating apps that help arrange casual sexual encounters, and people having unprotected sex.

Singh's clinical trial, which ran from August 2020 to February 2022, used rapid tests from two manufacturers. The device made by Biolytical Laboratories received the green light from Health Canada.

The test checks blood droplets for antibodies of the infections with a finger stick — similar to a blood-sugar test for diabetics — and results appear within minutes, Singh said. They differ from most syphilis tests, which send blood samples to a lab and yield results within several days.

The success of the trial led to rapid test use expanding in Alberta: 18 community sites and six acute-care hospital sites use them, she said.

The grant from CIHR, a federal agency that funds health research, allows her to continue the work in the AHS Central Zone by collaborating with Maskwacis Health Centre to figure out non-traditional ways to offer testing.

LISTEN | Cases of syphilis continue to rise: 

"Instead of having people come into a health centre or hospital for testing, it would be nice if we could go out to them — perhaps using mobile vans or events — and offer this testing as part of a range or a group of other health interventions," Singh said.

The Maskwacis Health Centre has already been doing point-of-care testing for over a year, which has allowed patients to start treatment and contact tracing sooner, said CEO Randy Littlechild.

"They can actually start the treatment process right then and there," Littlechild said, noting that a blood sample is still sent to a lab to confirm the rapid test results.

"You could start the backward process of finding out who the [sexual] partner was… and, hopefully, in some of those cases, then you try to get those people to get tested as well and then they get treatment."

Singh and her team are also partnering with an acute-care hospital in the AHS Central Zone to help provide testing to pregnant women, she said.

This is in response to health ministry reporting, she said, which flagged that many of the women giving birth to babies with congenital syphilis were examined in an acute-care centre, but weren't tested for the infection.