title: Clinical evaluation of dengue RNA, NS1, and IgM for diagnosis of dengue in Southern China.
abstract: In 2014, a large outbreak of dengue occurred in Guangzhou, China. This outbreak prompted us to evaluate NS1 and RNA for the early diagnosis of acute dengue infection, in addition to the combination with IgM antibody. We aimed to find the differences of three assays about dengue diagnosis. This study was an evaluation of diagnosis test. Based on WHO criteria 2009, dengue RNA, NS1, and IgM/IgG were detected from 294 patients (180 dengue patients, 114 non-dengue patients) by three diagnostic kits made in China. The χ(2) test, sensitivity, and specificity were used in statistical analysis. The ratios of dengue patients with low platelet counts (<100 × 10(9) /L 32.2%) or white blood cell counts (<4.0 × 10(9) /L 58.9%) were significantly higher compared to non-dengue patients (P < 0.05). Dengue NS1 was shown sensitive (93.9%) for diagnostic use. RNA had a better performance with 98.1% of sensitivity from day 1 to day 4 after illness onset. IgM performed better at day 5 or more with 74.0% of sensitivity. The diagnostic rate using a combination of RNA and IgM was 97.8% and 96.7% using NS1 and IgM. A patient with low platelet and white blood cell counts needs additional tests for dengue during an epidemic. RNA and NS1 were most valuable for early diagnosis of dengue, whereas IgM was best suited as a supplementary method for patients at day 5 or more after illness onset.
authors.affiliation: Department of Clinical Laboratory, Sun Yat-Sen Memorial Hospital, Guangzhou, Guangdon, P.R. China.
authors.forename: Xinliang
authors.initials: X
authors.lastname: Chen
authors.affiliation: Department of Respiratory Medicine, Sun Yat-Sen Memorial Hospital, Guangzhou, Guangdong, P.R. China.
authors.forename: Rui
authors.initials: R
authors.lastname: Chen
authors.affiliation: Department of Clinical Laboratory, Sun Yat-Sen Memorial Hospital, Guangzhou, Guangdon, P.R. China.
authors.forename: Wenshen
authors.initials: W
authors.lastname: Gu
authors.affiliation: Department of Clinical Laboratory, Sun Yat-Sen Memorial Hospital, Guangzhou, Guangdon, P.R. China.
authors.forename: Jian
authors.initials: J
authors.lastname: He
authors.affiliation: Department of Clinical Laboratory, Sun Yat-Sen Memorial Hospital, Guangzhou, Guangdon, P.R. China.
authors.forename: Weipeng
authors.initials: W
authors.lastname: Cai
authors.affiliation: Zhongshan School of Medicine, Sun Yat-Sen University, Guangzhou, Guangdong, P.R. China.
authors.forename: Jiajia
authors.initials: J
authors.lastname: Li
authors.affiliation: Department of Clinical Laboratory, Sun Yat-Sen Memorial Hospital, Guangzhou, Guangdon, P.R. China.
authors.forename: Chaohui
authors.initials: C
authors.lastname: Duan
authors.affiliation: Department of Clinical Laboratory, Sun Yat-Sen Memorial Hospital, Guangzhou, Guangdon, P.R. China.
authors.forename: Haiyan
authors.initials: H
authors.lastname: Yan
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000914:Antibodies, Viral / Q000097:blood; D000956:Antigens, Viral / Q000097:blood; D002648:Child; D002675:Child, Preschool; D002681:China; D003715:Dengue / Q000175:diagnosis*; D005260:Female; D006801:Humans; D007075:Immunoglobulin M / Q000097:blood; D008297:Male; D008875:Middle Aged; D025202:Molecular Diagnostic Techniques / Q000379:methods*; D012367:RNA, Viral / Q000097:blood / Q000235:genetics; D012680:Sensitivity and Specificity; D012698:Serologic Tests / Q000379:methods*; D013997:Time Factors; D017361:Viral Nonstructural Proteins / Q000097:blood; D055815:Young Adult
chemical_list: D000914:Antibodies, Viral; D000956:Antigens, Viral; D007075:Immunoglobulin M; C100315:NS1 protein, Flavivirus; D012367:RNA, Viral; D017361:Viral Nonstructural Proteins
keywords: ELISA; IgM; NS1; RNA; RT-PCR; dengue