Comparison of Four Diagnostic Tests Methods for the Detection of Dengue Virus Non-Structural-1 Antigen and IgM/IgG Antibodies

摘要

Objectives: Dengue virus (DENV) infection is a mosquito-borne disease that stands out as one of the major public health issues and has a wide-ranging geographical distribution throughout the tropics and subtropics. The general alarming increase in the number of cases over the last two decades can be attributed to an extent by the change in national practices to keeping records and reporting dengue to the Ministries of Health, and WHO. Dengue diagnosis is routinely carried out by detection of dengue virus (DENV) antigen NS1 (Non-structural Antigen 1) and/or anti-DENV IgM/IgG antibodies using enzyme-linked immunosorbent assays (ELISAs) and rapid diagnostic tests (RDTs). This study compared the performance of three RDTs and one ELISA used for dengue diagnosis in southeastern, Nigeria. Design: This study adopted a cross-sectional design that included prospective hospital-based surveillance of cases among febrile participants attending two major health facilities within the southeastern region of Nigeria. In this study, 338 HIV-infected participants from two teaching hospitals in Nigeria’s southeast were systematically tested for Dengue with four methods: NS1 RDT, IgG RDT, IgM RDT, and NS1 ELISA. Their specificities and sensitivities were compared, as well as their level of concordance. Their respective performances were also evaluated using the Receivers Operational curve (ROC). Results: Out of the 338 patients, the dengue prevalence from the four dengue diagnostic methods Dengue virus NS1 ELISA, NS1 RDT, IgM and IgG seropositivity were 8.9%, 0.6%, 5.6%, and 8.0%, respectively. The Dengue IgM RDT test indicated 36.8% sensitivity, 92.8% specificity, the IgG anti-dengue specific test indicated 29.6% sensitivity, 92.9% specificity and the dengue NS1 RDT test indicated 3.3% sensitivity, 99.4% specificity when compared with the Dengue NSI Elisa test method as a reference method. Conclusion: The use of NSI ELISA for DENV diagnosis showed good performance and the RDTs showed, to an extent, reliable results compared with ELISA. However, diagnostic laboratories should be aware of performance variations across tests and the possibilities of cross-reactivity that may affect results.