Performance of rapid tests in the management of dengue fever imported cases in Lazio, Italy 2014-2019
Performance of rapid tests in the management of dengue fever imported cases in Lazio, Italy 2014-2019
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DOI：
10.1016/j.ijid.2020.07.008
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发表时间：
2020-10-01
影响因子：
8.4
通讯作者：
Castilletti, Concetta
中科院分区：
文献类型：
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作者：
Matusali, Giulia;Colavita, Francesca;Castilletti, Concetta
背景：在意大利，登革热病毒是最常见的输入性病毒感染。使用快速诊断测试（RDTs）可能有助于作为一个初步的用户友好的快速检测，以促进登革热诊断，因为普通的登革热实验室诊断可能需要在工具的可用性，结果的解释和熟练的人员方面的特殊努力。RDTs的性能，但是，可能会有所不同，根据不同的流行病学和实验室background.Methods：我们回顾了五年的实验室记录的两个登革热RDT结果（比色SDBioline登革-DUO-RDT和荧光SD-Biosensor-STANDARD-F-登革-RDT），能够检测病毒NS 1抗原和特异性IgM和IgG。诊断参数的计算作为参考的分子（RT-PCR）和血清学（免疫荧光，IFA）测试的结果。整体性能，考虑到最终的情况下定义计算，包括在RDTs的准确性assessment。结果：NS 1和IgM/IgG RDT的联合使用，用于检测急性登革热病例导致的总体灵敏度和特异性为87.2%和97.9%的比色RDT，96.2%和96.2%的荧光RDT。NS 1是最可靠的急性感染的标志物，而IgM导致假阳性的9个样本，包括血清来自2寨卡病毒和4非虫媒病毒感染patients.Conclusions：列入RDT的诊断算法是不可否认的帮助，在及时管理和监测登革热感染的非流行区。然而，需要进行诊断性试验以确定或排除登革热诊断。(c)2020作者（S）由爱思唯尔有限公司代表国际传染病学会出版。
Background: In Italy, dengue virus is the most frequent agent of imported viral infections. The use of rapid diagnostic tests (RDTs) may be of help as a preliminary user-friendly quick assay to facilitate dengue diagnosis, as ordinary laboratory diagnosis of dengue fever may require special efforts in terms of tools availability, interpretation of results, and skilled personnel. The performance of RDTs, however, may vary according to different epidemiological and laboratory background.Methods: We reviewed five years of laboratory records of two dengue RDT results (Colorimetric SDBioline Dengue-Duo-RDT and Fluorimetric SD-Biosensor-STANDARD-F-Dengue-RDT), able to detect viral NS1 antigen and specific IgM and IgG. Diagnostic parameters were calculated using as reference the results of molecular (RT-PCR) and serological (immunofluorescence, IFA) tests. Overall performance, calculated considering the final case definition, was included in the accuracy assessment of RDTs.Results: The combined use of NS1 and IgM/IgG RDT for the detection of acute dengue cases resulted in an overall sensitivity and specificity of 87.2% and 97.9% for Colorimetric RDT, 96.2% and 96.2% for Fluorimetric RDT. NS1 was the most reliable marker of acute infection, while IgM resulted falsely positive in nine samples, including sera derived from 2 Zika and 4 non-arbovirus infected patients.Conclusions: The inclusion of RDT in the diagnostic algorithm is of undeniable help in the prompt management and surveillance of dengue infection in non-endemic areas. Confirmatory tests are, however, necessary to rule in or rule out dengue fever diagnosis. (c) 2020 The Author(s). Published by Elsevier Ltd on behalf of International Society for Infectious Diseases.