title: Use of a Rapid Test for Diagnosis of Dengue during Suspected Dengue Outbreaks in Resource-Limited Regions.
abstract: Dengue is major public health problem, globally. Timely verification of suspected dengue outbreaks allows for public health response, leading to the initiation of appropriate clinical care. Because the clinical presentation of dengue is nonspecific, dengue diagnosis would benefit from a sensitive rapid diagnostic test (RDT). We evaluated the diagnostic performance of an RDT that detects dengue virus (DENV) nonstructural protein 1 (NS1) and anti-DENV IgM during suspected acute febrile illness (AFI) outbreaks in four countries. Real-time reverse transcription-PCR and anti-DENV IgM enzyme-linked immunosorbent assay were used to verify RDT results. Anti-DENV IgM RDT sensitivity and specificity ranged from 55.3 to 91.7% and 85.3 to 98.5%, respectively, and NS1 sensitivity and specificity ranged from 49.7 to 92.9% and 22.2 to 89.0%, respectively. Sensitivity varied by timing of specimen collection and DENV serotype. Combined test results moderately improved the sensitivity. The use of RDTs identified dengue as the cause of AFI outbreaks where reference diagnostic testing was limited or unavailable.
authors.affiliation: Centers for Disease Control and Prevention, San Juan, Puerto Rico, USA Enh4@cdc.gov.
authors.forename: Elizabeth A
authors.initials: EA
authors.lastname: Hunsperger
authors.affiliation: Centers for Disease Control and Prevention, San Juan, Puerto Rico, USA.
authors.forename: Tyler M
authors.initials: TM
authors.lastname: Sharp
authors.affiliation: Republic of Marshall Islands Ministry of Health, Majuro, Marshall Islands.
authors.forename: Paul
authors.initials: P
authors.lastname: Lalita
authors.affiliation: Republic of Marshall Islands Ministry of Health, Majuro, Marshall Islands.
authors.forename: Kini
authors.initials: K
authors.lastname: Tikomaidraubuta
authors.affiliation: National Institute of Public Health, Luanda, Angola.
authors.forename: Yolanda Rebello
authors.initials: YR
authors.lastname: Cardoso
authors.affiliation: Fiji Centre for Communicable Disease Control, Suva, Fiji.
authors.forename: Taina
authors.initials: T
authors.lastname: Naivalu
authors.affiliation: Fiji Centre for Communicable Disease Control, Suva, Fiji.
authors.forename: Aalisha Sahu
authors.initials: AS
authors.lastname: Khan
authors.affiliation: Federated States of Micronesia, Yap.
authors.forename: Maria
authors.initials: M
authors.lastname: Marfel
authors.affiliation: Federated States of Micronesia, Yap.
authors.forename: W Thane
authors.initials: WT
authors.lastname: Hancock
authors.affiliation: Centers for Disease Control and Prevention, San Juan, Puerto Rico, USA.
authors.forename: Kay M
authors.initials: KM
authors.lastname: Tomashek
authors.affiliation: Centers for Disease Control and Prevention, San Juan, Puerto Rico, USA.
authors.forename: Harold S
authors.initials: HS
authors.lastname: Margolis
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000914:Antibodies, Viral / Q000097:blood; D002648:Child; D002675:Child, Preschool; D003715:Dengue / Q000175:diagnosis*; D003955:Diagnostic Tests, Routine / Q000379:methods*; D004196:Disease Outbreaks; D005260:Female; D006801:Humans; D007118:Immunoassay / Q000379:methods*; D007075:Immunoglobulin M / Q000097:blood; D007223:Infant; D007231:Infant, Newborn; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D012680:Sensitivity and Specificity; D013997:Time Factors; D017361:Viral Nonstructural Proteins / Q000097:blood; D055815:Young Adult
chemical_list: D000914:Antibodies, Viral; D007075:Immunoglobulin M; D017361:Viral Nonstructural Proteins