title: Evaluation of laboratory tests for dengue diagnosis in clinical specimens from consecutive patients with suspected dengue in Belo Horizonte, Brazil.
abstract: BACKGROUND
  Dengue is a widely spread arboviral disease in tropical and subtropical regions of the world. Dengue fever presents clinical characteristics similar to other febrile illness. Thus laboratory diagnosis is important for adequate management of the disease.
  
  
  OBJECTIVE
  The present study was designed to evaluate the diagnostic performance of real-time PCR and serological methods for dengue in a real epidemic context.
  
  
  METHODS
  Clinical data and blood samples were collected from consecutive patients with suspected dengue who attended a primary health care unit in Belo Horizonte, Brazil. Serologic methods and real-time PCR were performed in serum samples to confirm dengue diagnosis.
  
  
  RESULTS
  Among the 181 consecutive patients enrolled in this study with suspected dengue, 146 were considered positive by serological criteria (positive NS1 ELISA and/or anti-dengue IgM ELISA) and 138 were positive by real-time PCR. Clinical criteria were not sufficient for distinguishing between dengue and non-dengue febrile illness. The PCR reaction was pre-optimized using samples from patients with known viral infection. It had similar sensitivity compared to NS1 ELISA (88% and 89%, respectively). We also evaluated three commercial lateral flow immunochromatographic tests for NS1 detection (BIOEASY, BIORAD and PANBIO). All three tests showed high sensitivity (94%, 91% and 81%, respectively) for dengue diagnosis.
  
  
  CONCLUSIONS
  According to our results it can be suggested that lateral flow tests for NS1 detection are the most feasible methods for early diagnosis of dengue.
authors.affiliation: Laboratório de Imunofarmacologia, Instituto de Ciências Biológicas, Universidade Federal de Minas Gerais, Brazil. ferrazicb@gmail.com
authors.forename: Fernanda Oliveira
authors.initials: FO
authors.lastname: Ferraz
authors.forename: Maria Rosa Quaresma
authors.initials: MR
authors.lastname: Bomfim
authors.forename: Antônio Helvécio
authors.initials: AH
authors.lastname: Totola
authors.forename: Thiago Vinícius
authors.initials: TV
authors.lastname: Ávila
authors.forename: Daniel
authors.initials: D
authors.lastname: Cisalpino
authors.forename: José Eduardo Marques
authors.initials: JE
authors.lastname: Pessanha
authors.forename: Danielle
authors.initials: D
authors.lastname: da Glória de Souza
authors.forename: Antônio Lúcio
authors.initials: AL
authors.lastname: Teixeira Júnior
authors.forename: Maurício Lacerda
authors.initials: ML
authors.lastname: Nogueira
authors.forename: Oscar
authors.initials: O
authors.lastname: Bruna-Romero
authors.forename: Mauro Martins
authors.initials: MM
authors.lastname: Teixeira
mesh_terms: D000328:Adult; D000914:Antibodies, Viral / Q000097:blood; D000956:Antigens, Viral / Q000097:blood; D001938:Brazil; D002846:Chromatography, Affinity / Q000379:methods*; D019411:Clinical Laboratory Techniques / Q000379:methods*; D003715:Dengue / Q000175:diagnosis*; D004797:Enzyme-Linked Immunosorbent Assay / Q000379:methods; D005260:Female; D006801:Humans; D007075:Immunoglobulin M / Q000097:blood; D008297:Male; D008875:Middle Aged; D008969:Molecular Sequence Data; D012367:RNA, Viral / Q000235:genetics; D060888:Real-Time Polymerase Chain Reaction / Q000379:methods*; D012680:Sensitivity and Specificity; D017422:Sequence Analysis, DNA
chemical_list: D000914:Antibodies, Viral; D000956:Antigens, Viral; D007075:Immunoglobulin M; D012367:RNA, Viral
keywords: Anti-dengue IgM; BVDV; DENV; DHF; Dengue diagnosis; ELISA; Lateral flow immunochromatographic assays; NPV; NS1; PCR; PPV; Real-time PCR; SLEV; Saint Louis encephalitis virus; WHO; World Health Organization; YFV; bovine viral diarrhea virus; dengue hemorrhagic fever; dengue virus; negative predictive value; polymerase chain reaction; positive predictive value; yellow fever virus