Use of a Rapid Test for Diagnosis of Dengue during Suspected Dengue Outbreaks in Resource-Limited Regions
Use of a Rapid Test for Diagnosis of Dengue during Suspected Dengue Outbreaks in Resource-Limited Regions
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DOI：
10.1128/jcm.00521-16
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发表时间：
2016-08-01
影响因子：
9.4
通讯作者：
Margolis, Harold S.
中科院分区：
文献类型：
--
作者：
Hunsperger, Elizabeth A.;Sharp, Tyler M.;Margolis, Harold S.
登革热是全球主要的公共卫生问题。及时核实疑似登革热暴发，可对公共卫生作出反应，从而启动适当的临床护理。由于登革热的临床表现是非特异性的，登革热诊断将受益于敏感的快速诊断试验(RDT)。我们评估了在四个国家疑似急性发热病(AFI)暴发期间检测登革病毒(DENV)非结构蛋白1(NS1)和抗DENV IgM的RDT的诊断性能。用实时荧光定量逆转录-聚合酶链式反应和抗DENV-IgM酶联免疫吸附试验验证RDT结果。抗DENV IgM RDT敏感性和特异性分别为55.3%~91.7%和85.3%~98.5%，NS1敏感性和特异性分别为49.7%~92.9%和22.2%~89.0%。敏感性因标本采集时间和DENV血清型而异。综合测试结果适度提高了灵敏度。使用RDTs确定登革热是AFI暴发的原因，在那里参考诊断检测有限或不可用。
Dengue is major public health problem, globally. Timely verification of suspected dengue outbreaks allows for public health response, leading to the initiation of appropriate clinical care. Because the clinical presentation of dengue is nonspecific, dengue diagnosis would benefit from a sensitive rapid diagnostic test (RDT). We evaluated the diagnostic performance of an RDT that detects dengue virus (DENV) nonstructural protein 1 (NS1) and anti-DENV IgM during suspected acute febrile illness (AFI) outbreaks in four countries. Real-time reverse transcription-PCR and anti-DENV IgM enzyme-linked immunosorbent assay were used to verify RDT results. Anti-DENV IgM RDT sensitivity and specificity ranged from 55.3 to 91.7% and 85.3 to 98.5%, respectively, and NS1 sensitivity and specificity ranged from 49.7 to 92.9% and 22.2 to 89.0%, respectively. Sensitivity varied by timing of specimen collection and DENV serotype. Combined test results moderately improved the sensitivity. The use of RDTs identified dengue as the cause of AFI outbreaks where reference diagnostic testing was limited or unavailable.