title: Rapid diagnostic tests for dengue and leptospirosis: antibody detection is insensitive at presentation.
abstract: OBJECTIVE
  To determine the performance of rapid diagnostic tests for dengue and leptospirosis that rely on detecting antibodies that may not be produced when patients present for medical treatment.
  
  
  METHODS
  We prospectively enrolled 723 patients with undifferentiated febrile illness presenting to rural hospitals in northern and northeastern Thailand over a 1-year period. We evaluated rapid antibody detection diagnostic tests for dengue and leptospirosis on these patients.
  
  
  RESULTS
  Sensitivity of the tests was low at the acute visit (7.6-21.5%). Sensitivity at the convalescent visit ranged from 25.8% to 81.5% and was significantly higher than at the acute visit for all tests (chi(2), P < 0.001).
  
  
  CONCLUSIONS
  Low sensitivity of the rapid tests at presentation suggests that their utility in the acute phase of dengue and leptospirosis is limited.
authors.affiliation: Division of Healthcare Quality Promotion, Centers for Disease Control and Prevention, Atlanta, GA 30333, USA. alcohen1@cdc.gov
authors.forename: Adam L
authors.initials: AL
authors.lastname: Cohen
authors.forename: Scott F
authors.initials: SF
authors.lastname: Dowell
authors.forename: Ananda
authors.initials: A
authors.lastname: Nisalak
authors.forename: Mammen P
authors.initials: MP
authors.lastname: Mammen
authors.forename: Wimol
authors.initials: W
authors.lastname: Petkanchanapong
authors.forename: Tamara L
authors.initials: TL
authors.lastname: Fisk
mesh_terms: D000293:Adolescent; D000328:Adult; D000907:Antibodies, Bacterial / Q000097:blood*; D000914:Antibodies, Viral / Q000097:blood*; D015415:Biomarkers / Q000097:blood; D002648:Child; D003715:Dengue / Q000175:diagnosis* / Q000453:epidemiology / Q000276:immunology; D003955:Diagnostic Tests, Routine / Q000379:methods*; D006801:Humans; D007922:Leptospirosis / Q000175:diagnosis* / Q000453:epidemiology / Q000276:immunology; D008875:Middle Aged; D011237:Predictive Value of Tests; D011446:Prospective Studies; D012423:Rural Health; D012680:Sensitivity and Specificity; D013785:Thailand / Q000453:epidemiology
chemical_list: D000907:Antibodies, Bacterial; D000914:Antibodies, Viral; D015415:Biomarkers