Evaluation of the NS1 Rapid Test and the WHO Dengue Classification Schemes for Use as Bedside Diagnosis of Acute Dengue Fever in Adults

Abstract

Because healthcare facilities in many dengue endemic countries lack laboratory support, early dengue diagnosis must rely on either clinical recognition or a bedside diagnostic test. We evaluated the sensitivity and specificity of the 1997 and 2009 World Health Organization (WHO) dengue classification schemes and the NS1 strip test in acute sera from 154 virologically confirmed dengue patients and 200 patients with other febrile illnesses. Both WHO classification schemes had high sensitivity but lacked specificity. The NS1 strip test had high specificity, but its sensitivity was significantly lower in secondary compared with primary dengue infections. Differences in viral serotypes did not affect the performance of any of the three diagnostic approaches. Taken collectively, our findings indicate that the 1997 WHO dengue case definition can be used to exclude dengue, and the NS1 strip test can be used to confirm dengue infection, although the latter should be interpreted with caution in regions where secondary dengue infection is prevalent.

Comparative Analysis of Rapid Dengue Testing and ELISA for NS1 Antigen and IgM in Acute Dengue Infection

“…This indicates that the probability of patient having acute dengue infection if the tests are positive is almost same as the ELISA based tests. This study finding corroborates with other studies, which have shown the PPV of rapid ICTs to be more than 85% (Pal et al, 2014;Groen et al, 2000;Shih et al, 2016).The rapid ICTs have a major advantage in that, they are easy to perform, they need less expertise and can be done within minutes (Chaterji et al, 2011).…”

Spatial Distribution of Epidemiological Cases of Dengue Fever in Suriname, 2001–2012

“…Asymptomatic or flu-like DF cases are frequently under-reported, potentially causing dengue incidence to be under-estimated. Additionally, serology tests have a low specificity and sensitivity to acute dengue infection or to distinguish between primary and secondary infections of dengue (25,26). Therefore, data do not provide information on previous dengue infections, which are an important determinant in the development of DHF.…”

Myocarditis in a Traveler Returning from the Dominican Republic: An Unusual Presentation of Dengue Fever

“…1,12 The diagnosis of dengue infection remains challenging, because its manifestations are varied. 13,14 It is important for healthcare providers to be knowledgeable about the disease to avoid potential iatrogenic complications, including unnecessary diagnostic tests and antimicrobial therapy. …”