The Diagnostic Sensitivity of Dengue Rapid Test Assays Is Significantly Enhanced by Using a Combined Antigen and Antibody Testing Approach
2011

Improving Dengue Diagnosis with Combined Testing

Sample size: 298 publication 10 minutes Evidence: moderate

Author Information

Author(s): Fry Scott R., Meyer Michelle, Semple Matthew G., Simmons Cameron P., Sekaran Shamala Devi, Huang Johnny X., McElnea Catriona, Huang Chang-Yi, Valks Andrea, Young Paul R., Cooper Matthew A.

Primary Institution: Alere, Brisbane, Australia

Hypothesis

Can a combined antigen and antibody testing approach enhance the diagnostic sensitivity of dengue rapid tests?

Conclusion

Using dengue NS1 antigen detection in combination with anti-glycoprotein E IgM and IgG serology significantly increases the sensitivity of acute dengue diagnosis.

Supporting Evidence

  • The sensitivity of the Dengue Early Rapid test was 69.2% in Vietnam and 68.9% in Malaysia.
  • Specificity was high at 96% in Vietnam and 96.7% in Malaysia.
  • Combining NS1 detection with IgM and IgG testing increased sensitivity to 93%.
  • NS1 was detected in 60-70% of laboratory-confirmed dengue cases.

Takeaway

This study shows that testing for both dengue virus proteins and antibodies can help doctors find dengue infections earlier and more accurately.

Methodology

The study evaluated the performance of a new rapid test for dengue NS1 in Vietnam and Malaysia using retrospective samples.

Potential Biases

Potential bias due to the predominance of DENV-1 in the sample population.

Limitations

The study's specificity may be affected by a small number of potentially cross-reactive samples.

Participant Demographics

Median age of participants in Vietnam was 10 years (range 3-15 years); in Malaysia, median age was 25 years (range 1-67 years).

Statistical Information

P-Value

p<0.05

Confidence Interval

95% CI: 62.8% to 75.6%

Statistical Significance

p<0.05

Digital Object Identifier (DOI)

10.1371/journal.pntd.0001199

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