Rapid diagnostic tests for dengue virus infection in febrile Cambodian children: diagnostic accuracy and incorporation into diagnostic algorithms.



Carter, Michael J ORCID: 0000-0003-3403-4746, Emary, Kate R, Moore, Catrin E, Parry, Christopher M ORCID: 0000-0001-7563-7282, Sona, Soeng, Putchhat, Hor, Reaksmey, Sin, Chanpheaktra, Ngoun, Stoesser, Nicole ORCID: 0000-0002-4508-7969, Dobson, Andrew DM ORCID: 0000-0003-1058-2801
et al (show 3 more authors) (2015) Rapid diagnostic tests for dengue virus infection in febrile Cambodian children: diagnostic accuracy and incorporation into diagnostic algorithms. PLoS neglected tropical diseases, 9 (2). e0003424-.

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Abstract

<h4>Background</h4>Dengue virus (DENV) infection is prevalent across tropical regions and may cause severe disease. Early diagnosis may improve supportive care. We prospectively assessed the Standard Diagnostics (Korea) BIOLINE Dengue Duo DENV rapid diagnostic test (RDT) to NS1 antigen and anti-DENV IgM (NS1 and IgM) in children in Cambodia, with the aim of improving the diagnosis of DENV infection.<h4>Methodology and principal findings</h4>We enrolled children admitted to hospital with non-localised febrile illnesses during the 5-month DENV transmission season. Clinical and laboratory variables, and DENV RDT results were recorded at admission. Children had blood culture and serological and molecular tests for common local pathogens, including reference laboratory DENV NS1 antigen and IgM assays. 337 children were admitted with non-localised febrile illness over 5 months. 71 (21%) had DENV infection (reference assay positive). Sensitivity was 58%, and specificity 85% for RDT NS1 and IgM combined. Conditional inference framework analysis showed the additional value of platelet and white cell counts for diagnosis of DENV infection. Variables associated with diagnosis of DENV infection were not associated with critical care admission (70 children, 21%) or mortality (19 children, 6%). Known causes of mortality were melioidosis (4), other sepsis (5), and malignancy (1). 22 (27%) children with a positive DENV RDT had a treatable other infection.<h4>Conclusions</h4>The DENV RDT had low sensitivity for the diagnosis of DENV infection. The high co-prevalence of infections in our cohort indicates the need for a broad microbiological assessment of non-localised febrile illness in these children.

Item Type: Article
Uncontrolled Keywords: Humans, Dengue Virus, Dengue, Fever, Immunoglobulin M, Viral Nonstructural Proteins, Reagent Kits, Diagnostic, Diagnostic Tests, Routine, Prevalence, Sensitivity and Specificity, Prospective Studies, Algorithms, Child, Child, Preschool, Infant, Cambodia, Female, Male, Republic of Korea
Depositing User: Symplectic Admin
Date Deposited: 18 Nov 2020 09:58
Last Modified: 18 Mar 2024 01:03
DOI: 10.1371/journal.pntd.0003424
Related URLs:
URI: https://livrepository.liverpool.ac.uk/id/eprint/3107266