Dengue diagnosis in an endemic area of Peru: Clinical characteristics and positive frequencies by RT-PCR and serology for NS1, IgM, and IgG

Abstract

Background: Huánuco is a central eastern region of Peru whose geography includes high forest and low jungle, as well as a mountain range that constitutes the inter-Andean valleys. It is considered a region endemic for dengue due to the many favorable conditions that facilitate transmission of the virus. Methods: A total of 268 serum samples from patients in Huánuco, Peru with an acute febrile illness were assessed for the presence of dengue virus (DENV) via RT-PCR and NS1, IgM, and IgG ELISA during December 2015 and March 2016. Results: DENV was detected in 25% of samples via RT-PCR, 19% of samples by NS1 antigen ELISA, and 10.5% of samples by IgM ELISA. DENV IgG was detected in 15.7% of samples by ELISA. The most frequent symptoms associated with fever across all groups were headache, myalgia, and arthralgia, with no significant difference between the four test methods Conclusions: In this study, DENV was identified in up to 25% of the samples using the standard laboratory method. In addition, a correlation was established between the frequency of positive results and the serological tests that determine NS1, IgM, and IgG. There is an increasing need for point-of-care tests to strengthen epidemiological surveillance in Peru.

MCP-1 LEVELS AND ATYPICAL LYMPHOCYTES IN EARLY FEVER OF DENGUE VIRUS INFECTION WITH NON-STRUCTURAL PROTEIN 1 (NS-1) ANTIGEN TEST IN dr DARSONO HOSPITAL, PACITAN

“…In primary infection, the sensitivity can exceed 90%, while in secondary infection, the sensitivity is lower and ranges from 60% to 80%. 40,41,42 A longer duration of NS-1 antigenemia than that of viremia in primary DENV infection makes the NS-1 detection method an advantage over DENV nucleic acid detection technique for dengue diagnosis during the acute phase of infection. In secondary DENV infection, however, a decreased sensitivity of the NS-1 Ag Strip test was observed.…”

Role of RTPCR in Early Dengue Diagnosis: A Latest Update

“…It was found that there was a greater correlation between RT-PCR and NS1 ELISA for the diagnosis of acute DENV infection. There was growing need for confirmatory diagnostic laboratory tests for clinically defined dengue cases to strengthen epidemiological surveillance in endemic areas.Finally, it is concluded that the diagnostic accuracy of the tests investigated can be ordered from highest to lowest as follows: RT-PCR > NS1 ELISA > IgM ELISA [33]. JC Guzman et al showed in phillipins that Thrombocytopenia, leukopenia, and hemoconcentration had specificities of 20%, 76%, and 63% respectively, while sensitivities were found to be, 100%, 33% and 66%, respectively.…”

Situation of Dengue after the Phenomenon of the Coastal El Niño

“…It is known that the cross-immunity of dengue serotypes is limited, which increases the possibility of reinfections and with them more florid clinical pictures [25,26].…”

“…In Peru, there could be a subdiagnosis or overdiagnosis of dengue and therefore of the clinical variability, on the one hand; the amount of arbovirosis that can give a similar clinical presentation is wide, and within these viruses is oropuche, which can be confused with dengue during the endemic months [31]. The contrary occurs in patients with a second dengue virus infection in which the diagnostic methods have a lower sensitivity of 60%, as is the case of non-structural (NS1), a test widely used in our environment [26].…”