title: Evaluation of Commercially Available Assays for Diagnosis of Acute Dengue in Schoolchildren During an Epidemic Period in Medellin, Colombia.
abstract: During an active surveillance study in school children in Medellin, we assessed the performance of two diagnostic strategies for dengue virus. A total of 41 patients with suspected dengue acute infection were evaluated. Diagnostic strategies consisted of one combining Panbio(®) Dengue virus IgM and IgG Capture ELISAs (enzyme-linked immunosorbent assays) with reverse transcriptase polymerase chain reaction (RT-PCR) and another using a commercial rapid SD Bioline Dengue Duo (IgG/IgM + NS1 Ag) test. These two strategies were compared with the enzyme-linked immunospot microneutralization test (ELISPOT-MNT). The sensitivity and specificity were 53.9% and 80.0% for the combination of Panbio(®) ELISAs and RT-PCR tests, and 30.8% and 73.3% for the SD Bioline Duo test, respectively. ELISPOT-MNT detected 16.4% additional cases and revealed the presence of neutralizing antibodies in all the acute samples, evidencing that they were all secondary infections. In contrast, Panbio(®) and SD Dengue Duo rapid tests only classified 23.0% and 26.9% of the cases as secondary dengue infections, respectively. Cohen's kappa coefficient and McNemar's association tests demonstrated a significant disagreement between the two diagnostic strategies and ELISPOT-MNT. Overall, these results evidence the relatively poor performances of commercial assays for the diagnosis of acute and secondary dengue infections, compared with ELISPOT-MNT, and raise concern about the accuracy of these assays for the diagnostic of dengue in endemic areas.
authors.affiliation: Instituto Colombiano de Medicina Tropical (ICMT), Universidad CES, Sabaneta, Colombia.
authors.forename: Leidy D
authors.initials: LD
authors.lastname: Piedrahita
authors.affiliation: Instituto Colombiano de Medicina Tropical (ICMT), Universidad CES, Sabaneta, Colombia.
authors.forename: Ivony Y
authors.initials: IY
authors.lastname: Agudelo
authors.affiliation: Department of Pathobiological Sciences, School of Veterinary Medicine, University of Wisconsin-Madison, Madison, Wisconsin.
authors.forename: Andrea I
authors.initials: AI
authors.lastname: Trujillo
authors.affiliation: Instituto Colombiano de Medicina Tropical (ICMT), Universidad CES, Sabaneta, Colombia.
authors.forename: Ruth E
authors.initials: RE
authors.lastname: Ramírez
authors.affiliation: Department of Pathobiological Sciences, School of Veterinary Medicine, University of Wisconsin-Madison, Madison, Wisconsin.
authors.forename: Jorge E
authors.initials: JE
authors.lastname: Osorio
authors.affiliation: Instituto Colombiano de Medicina Tropical (ICMT), Universidad CES, Sabaneta, Colombia. brestrepo@ces.edu.co.
authors.forename: Berta N
authors.initials: BN
authors.lastname: Restrepo
mesh_terms: D000208:Acute Disease; D000293:Adolescent; D000914:Antibodies, Viral / Q000097:blood*; D002648:Child; D003105:Colombia / Q000453:epidemiology; D003715:Dengue / Q000175:diagnosis* / Q000453:epidemiology* / Q000276:immunology / Q000821:virology; D003716:Dengue Virus / Q000235:genetics / Q000276:immunology / Q000302:isolation & purification*; D004797:Enzyme-Linked Immunosorbent Assay / Q000592:standards / Q000706:statistics & numerical data; D058501:Enzyme-Linked Immunospot Assay / Q000592:standards / Q000706:statistics & numerical data; D058872:Epidemics; D005260:Female; D006801:Humans; D007074:Immunoglobulin G / Q000097:blood; D007075:Immunoglobulin M / Q000097:blood; D008297:Male; D020133:Reverse Transcriptase Polymerase Chain Reaction / Q000592:standards / Q000706:statistics & numerical data; D012574:Schools; D012680:Sensitivity and Specificity
chemical_list: D000914:Antibodies, Viral; D007074:Immunoglobulin G; D007075:Immunoglobulin M