A prospective evaluation of diagnostic methodologies for the acute diagnosis of dengue virus infection on the Thailand-Myanmar border.

Journal article

Clinically useful diagnostic tests of dengue virus infection are lacking. We prospectively evaluated the performance of real-time reverse transcriptase (rRT)-PCR, NS-1 antigen and IgM antibody tests to confirm dengue virus infection in acute blood specimens from 162 patients presenting with undifferentiated febrile illness compatible with dengue infection. rRT-PCR was the most sensitive test (89%) and potentially could be used as a single test for confirmation of dengue infection. NS-1 antigen and IgM antibody were not sufficiently sensitive to be used as a single confirmatory test with sensitivities of 54% and 17% respectively. The specificities of rRT-PCR, NS-1 antigen and IgM antibody tests were 96%, 100% and 88% respectively. Combining NS-1 and rRT-PCR or the combination of all three tests resulted in the highest sensitivity (93%) but specificities dropped to 96% and 83% respectively. We conclude that at least the combination of two tests, either agent detection (rRT-PCR) or antigen detection (NS-1) plus IgM antibody detection should be used for laboratory confirmation of dengue infection.

Authors: Watthanaworawit, W; Turner, P; Turner, C; Tanganuchitcharnchai, A; Jarman, R

• Publication status: Published
• Journal: Transactions of the Royal Society of Tropical Medicine and Hygiene
• Volume: 105
• Issue: 1
• Pages: 32-37
• Publication date: 2011-01-01
• DOI: 10.1016/j.trstmh.2010.09.007
• EISSN: 1878-3503
• ISSN: 0035-9203
• Language: English
• Keywords: Adolescent; Myanmar; Male; Dengue Virus; Female; Viral Nonstructural Proteins; Sensitivity and Specificity; Thailand; Middle Aged; Prospective Studies; Dengue; Humans; Adult; Enzyme-Linked Immunosorbent Assay; Reverse Transcriptase Polymerase Chain Reaction; Young Adult