title: Value of Routine Dengue Diagnostic Tests in Urine and Saliva Specimens.
abstract: BACKGROUND
  Dengue laboratory diagnosis is essentially based on detection of the virus, its components or antibodies directed against the virus in blood samples. Blood, however, may be difficult to draw in some patients, especially in children, and sampling during outbreak investigations or epidemiological studies may face logistical challenges or limited compliance to invasive procedures from subjects. The aim of this study was to assess the possibility of using saliva and urine samples instead of blood for dengue diagnosis.
  
  
  RESULTS
  Serial plasma, urine and saliva samples were collected at several time-points between the day of admission to hospital until three months after the onset of fever in children with confirmed dengue disease. Quantitative RT-PCR, NS1 antigen capture and ELISA serology for anti-DENV antibody (IgG, IgM and IgA) detection were performed in parallel on the three body fluids. RT-PCR and NS1 tests demonstrated an overall sensitivity of 85.4%/63.4%, 41.6%/14.5% and 39%/28.3%, in plasma, urine and saliva specimens, respectively. When urine and saliva samples were collected at the same time-points and tested concurrently, the diagnostic sensitivity of RNA and NS1 detection assays was 69.1% and 34.4%, respectively. IgG/IgA detection assays had an overall sensitivity of 54.4%/37.4%, 38.5%/26.8% and 52.9%/28.6% in plasma, urine and saliva specimens, respectively. IgM were detected in 38.1% and 36% of the plasma and saliva samples but never in urine.
  
  
  CONCLUSIONS
  Although the performances of the different diagnostic methods were not as good in saliva and urine as in plasma specimens, the results obtained by qRT-PCR and by anti-DENV antibody ELISA could well justify the use of these two body fluids to detect dengue infection in situations when the collection of blood specimens is not possible.
authors.affiliation: Institut Pasteur in Cambodia, Virology Unit, Phnom Penh, Cambodia.
authors.forename: Anne-Claire
authors.initials: AC
authors.lastname: Andries
authors.affiliation: Institut Pasteur in Cambodia, Virology Unit, Phnom Penh, Cambodia.
authors.forename: Veasna
authors.initials: V
authors.lastname: Duong
authors.affiliation: Institut Pasteur in Cambodia, Epidemiology and Public Health Unit, Phnom Penh, Cambodia.
authors.forename: Sowath
authors.initials: S
authors.lastname: Ly
authors.affiliation: Institut Pasteur in Cambodia, Epidemiology and Public Health Unit, Phnom Penh, Cambodia; Centre de Coopération Internationale en Recherche Agronomique pour le Développement (CIRAD), Unité AGIRs, Montpellier, France.
authors.forename: Julien
authors.initials: J
authors.lastname: Cappelle
authors.affiliation: Kampong Cham Provincial Hospital, Pediatric Department, Kampong Cham, Cambodia.
authors.forename: Kim Srorn
authors.initials: KS
authors.lastname: Kim
authors.affiliation: Kampong Cham Provincial Hospital, Pediatric Department, Kampong Cham, Cambodia.
authors.forename: Patrich
authors.initials: P
authors.lastname: Lorn Try
authors.affiliation: Institut Pasteur in Cambodia, Virology Unit, Phnom Penh, Cambodia.
authors.forename: Sopheaktra
authors.initials: S
authors.lastname: Ros
authors.affiliation: Institut Pasteur in Cambodia, Virology Unit, Phnom Penh, Cambodia.
authors.forename: Sivuth
authors.initials: S
authors.lastname: Ong
authors.affiliation: Ministry of Health, Centre National de Malariologie, Phnom Penh, Cambodia.
authors.forename: Rekol
authors.initials: R
authors.lastname: Huy
authors.affiliation: Institut Pasteur in Cambodia, Virology Unit, Phnom Penh, Cambodia.
authors.forename: Paul
authors.initials: P
authors.lastname: Horwood
authors.affiliation: Institut Pasteur, Structural Virology Unit & CNRS UMR 3569, Paris, France.
authors.forename: Marie
authors.initials: M
authors.lastname: Flamand
authors.affiliation: Institut Pasteur, Functional Genetics of Infectious Diseases Unit, Paris, France; Centre National de la Recherche Scientifique, Unité de Recherche Associée 3012, Paris, France.
authors.forename: Anavaj
authors.initials: A
authors.lastname: Sakuntabhai
authors.affiliation: Institut Pasteur in Cambodia, Epidemiology and Public Health Unit, Phnom Penh, Cambodia.
authors.forename: Arnaud
authors.initials: A
authors.lastname: Tarantola
authors.affiliation: Institut Pasteur in Cambodia, Virology Unit, Phnom Penh, Cambodia; GlaxoSmithKline Vaccines, Vaccine Value and Health Sciences, Singapore, Singapore.
authors.forename: Philippe
authors.initials: P
authors.lastname: Buchy
mesh_terms: D000293:Adolescent; D000914:Antibodies, Viral / Q000032:analysis* / Q000097:blood / Q000652:urine; D002160:Cambodia; D002648:Child; D002675:Child, Preschool; D003715:Dengue / Q000097:blood / Q000175:diagnosis* / Q000453:epidemiology* / Q000652:urine; D003716:Dengue Virus / Q000235:genetics / Q000276:immunology / Q000302:isolation & purification*; D003955:Diagnostic Tests, Routine; D018450:Disease Progression; D004797:Enzyme-Linked Immunosorbent Assay; D058872:Epidemics; D005260:Female; D016679:Genome, Viral; D006801:Humans; D007132:Immunoglobulin Isotypes / Q000032:analysis / Q000097:blood / Q000652:urine; D008297:Male; D010949:Plasma / Q000737:chemistry / Q000276:immunology / Q000821:virology; D016133:Polymerase Chain Reaction; D012367:RNA, Viral / Q000302:isolation & purification; D012463:Saliva / Q000737:chemistry / Q000276:immunology / Q000821:virology; D014556:Urine / Q000737:chemistry / Q000502:physiology / Q000821:virology; D017361:Viral Nonstructural Proteins / Q000032:analysis* / Q000097:blood / Q000652:urine
chemical_list: D000914:Antibodies, Viral; D007132:Immunoglobulin Isotypes; C082515:NS1 protein, dengue-1 virus; D012367:RNA, Viral; D017361:Viral Nonstructural Proteins