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Zorilla R, Ching LL, Elisara T, Kramer K, Nerurkar VR. Re-Emerging, Under-Recognized Zoonotic, and Neglected Tropical Diseases in Hawai'i. Jpn J Infect Dis 2024; 77:187-200. [PMID: 38825457 DOI: 10.7883/yoken.jjid.2023.476] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/04/2024]
Abstract
Hawai'i, the United States' most western geographic state in the Pacific, lies between the North and South American continents and the Indo-Pacific regions, including Japan. The tropical environmental conditions of the Hawaiian Islands provide favorable ecosystems for various infectious pathogens, their vectors, and reservoirs. This creates an environment conducive to the transmission of zoonotic diseases affecting both humans and animals. Hawai'i has experienced an increase in dengue, leptospirosis, and murine typhus outbreaks. Furthermore, toxoplasmosis and neuroangiostrongyliasis cases remain prevalent throughout the state, and the putative presence of autochthonous Zika cases identified in a retrospective study may be of national public health concern. Understanding the factors that affect the transmission and distribution of zoonoses is necessary to identify at-risk locations and populations. The One Health approach seeks to understand, report, and interpret these factors and requires collaboration between private and governmental institutions. One Health should focus on neglected tropical diseases (NTD) and prioritize development of interventions to control and prevent the transmission of diseases that spread between animals and humans. This review focuses on the epidemiological and clinical characteristics of under-recognized zoonotic and NTD affecting Hawai'i, including leptospirosis, murine typhus, neuroangiostrongyliasis, toxoplasmosis, dengue, and Zika.
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Affiliation(s)
- Rodson Zorilla
- Department of Tropical Medicine, Medical Microbiology, and Pharmacology, John A Burns School of Medicine, University of Hawai'i at Mānoa, USA
- Pacific Center for Emerging Infectious Diseases, John A Burns School of Medicine, University of Hawai'i at Mānoa, USA
- Minority Health Research Training Program, John A Burns School of Medicine, University of Hawai'i at Mānoa, USA
| | - Lauren Lei Ching
- Department of Tropical Medicine, Medical Microbiology, and Pharmacology, John A Burns School of Medicine, University of Hawai'i at Mānoa, USA
- Pacific Center for Emerging Infectious Diseases, John A Burns School of Medicine, University of Hawai'i at Mānoa, USA
| | - Tiana Elisara
- Department of Tropical Medicine, Medical Microbiology, and Pharmacology, John A Burns School of Medicine, University of Hawai'i at Mānoa, USA
- Pacific Center for Emerging Infectious Diseases, John A Burns School of Medicine, University of Hawai'i at Mānoa, USA
- Minority Health Research Training Program, John A Burns School of Medicine, University of Hawai'i at Mānoa, USA
| | - Kenton Kramer
- Department of Tropical Medicine, Medical Microbiology, and Pharmacology, John A Burns School of Medicine, University of Hawai'i at Mānoa, USA
| | - Vivek Ramchandra Nerurkar
- Department of Tropical Medicine, Medical Microbiology, and Pharmacology, John A Burns School of Medicine, University of Hawai'i at Mānoa, USA
- Pacific Center for Emerging Infectious Diseases, John A Burns School of Medicine, University of Hawai'i at Mānoa, USA
- Minority Health Research Training Program, John A Burns School of Medicine, University of Hawai'i at Mānoa, USA
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Macêdo JVL, Júnior AGS, Oliveira MDL, Andrade CAS. Systematic review and meta-analysis: assessing the accuracy of rapid immunochromatographic tests in dengue diagnosis. Diagn Microbiol Infect Dis 2024; 109:116227. [PMID: 38503028 DOI: 10.1016/j.diagmicrobio.2024.116227] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/25/2024] [Revised: 02/17/2024] [Accepted: 02/19/2024] [Indexed: 03/21/2024]
Abstract
The objective of this systematic review is to analyze the diagnostic accuracy of rapid dengue diagnostic tests. The search was conducted in the following databases: LILACS, Medline (Pubmed), CRD, The Cochrane Library, Trip Medical Database and Google Scholar. ELISA and PCR assays were adopted as reference methods. Thirty-four articles were included in this systematic review. Receiver operating characteristic (ROC) and Forest Plot were performed to evaluate sensitivity and specificity for each parameter analyzed (NS1, IgM and IgG). The results revealed that the combined analysis of the IgM antibody with the NS1 antigen resulted in greater sensitivity than the isolated analysis of IgM. The three analytes together showed the best performance, with a combined sensitivity of 90 % (95 % CI: 89-92 %) using ELISA as a comparator. Thus, the present review provides relevant knowledge for decision-making between the available rapid diagnostic tests.
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Affiliation(s)
- Jéssica V L Macêdo
- Programa de Pós-Graduação em Inovação Terapêutica, Universidade Federal de Pernambuco, 50670-901 Recife, PE, Brazil; Núcleo de Pesquisa em Avaliação de Tecnologias em Saúde - NUPIATS, Universidade Federal de Pernambuco, 50670-901 Recife, PE, Brazil
| | - Alberto G S Júnior
- Programa de Pós-Graduação em Inovação Terapêutica, Universidade Federal de Pernambuco, 50670-901 Recife, PE, Brazil; Departamento de Bioquímica, Universidade Federal de Pernambuco, 50670-901 Recife, PE, Brazil
| | - Maria D L Oliveira
- Programa de Pós-Graduação em Inovação Terapêutica, Universidade Federal de Pernambuco, 50670-901 Recife, PE, Brazil; Departamento de Bioquímica, Universidade Federal de Pernambuco, 50670-901 Recife, PE, Brazil; Núcleo de Pesquisa em Avaliação de Tecnologias em Saúde - NUPIATS, Universidade Federal de Pernambuco, 50670-901 Recife, PE, Brazil
| | - César A S Andrade
- Programa de Pós-Graduação em Inovação Terapêutica, Universidade Federal de Pernambuco, 50670-901 Recife, PE, Brazil; Departamento de Bioquímica, Universidade Federal de Pernambuco, 50670-901 Recife, PE, Brazil; Núcleo de Pesquisa em Avaliação de Tecnologias em Saúde - NUPIATS, Universidade Federal de Pernambuco, 50670-901 Recife, PE, Brazil.
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Perera DR, Ranadeva ND, Sirisena K, Wijesinghe KJ. Roles of NS1 Protein in Flavivirus Pathogenesis. ACS Infect Dis 2024; 10:20-56. [PMID: 38110348 DOI: 10.1021/acsinfecdis.3c00566] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/20/2023]
Abstract
Flaviviruses such as dengue, Zika, and West Nile viruses are highly concerning pathogens that pose significant risks to public health. The NS1 protein is conserved among flaviviruses and is synthesized as a part of the flavivirus polyprotein. It plays a critical role in viral replication, disease progression, and immune evasion. Post-translational modifications influence NS1's stability, secretion, antigenicity, and interactions with host factors. NS1 protein forms extensive interactions with host cellular proteins allowing it to affect vital processes such as RNA processing, gene expression regulation, and cellular homeostasis, which in turn influence viral replication, disease pathogenesis, and immune responses. NS1 acts as an immune evasion factor by delaying complement-dependent lysis of infected cells and contributes to disease pathogenesis by inducing endothelial cell damage and vascular leakage and triggering autoimmune responses. Anti-NS1 antibodies have been shown to cross-react with host endothelial cells and platelets, causing autoimmune destruction that is hypothesized to contribute to disease pathogenesis. However, in contrast, immunization of animal models with the NS1 protein confers protection against lethal challenges from flaviviruses such as dengue and Zika viruses. Understanding the multifaceted roles of NS1 in flavivirus pathogenesis is crucial for effective disease management and control. Therefore, further research into NS1 biology, including its host protein interactions and additional roles in disease pathology, is imperative for the development of strategies and therapeutics to combat flavivirus infections successfully. This Review provides an in-depth exploration of the current available knowledge on the multifaceted roles of the NS1 protein in the pathogenesis of flaviviruses.
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Affiliation(s)
- Dayangi R Perera
- Department of Chemistry, Faculty of Science, University of Colombo, Sri Lanka 00300
| | - Nadeeka D Ranadeva
- Department of Biomedical Science, Faculty of Health Sciences, KIU Campus Sri Lanka 10120
| | - Kavish Sirisena
- Department of Chemistry, Faculty of Science, University of Colombo, Sri Lanka 00300
- Section of Genetics, Institute for Research and Development in Health and Social Care, Sri Lanka 10120
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Cismaru IM, Radu MA, Cotar AI, Oancea F, Melinte V, Vacaroiu C, Ghemulet I, Gheorghita V. Increasing the Awareness of Under-Diagnosed Tropical Cases of Dengue in Romania. Trop Med Infect Dis 2023; 8:469. [PMID: 37888597 PMCID: PMC10611290 DOI: 10.3390/tropicalmed8100469] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/30/2023] [Revised: 09/30/2023] [Accepted: 09/30/2023] [Indexed: 10/28/2023] Open
Abstract
Global travelling increases every year and according to a report released during the COVID-19 pandemic by the UN World Tourism Organization, international travel doubled in 2022, compared to levels in 2021. his fact led also to travel-imported cases of arboviral infections and physicians are often confronted with tropical diseases, such as dengue or chikungunya. Since there is are no pathognomonic cues for these tropical illnesses, early diagnosis is still a big challenge and it depends on many factors, such as exposure risk factors, the epidemiological context, the incubation period, and the wide spectrum of differential diagnoses, including cosmopolitan or exotic infections. Since the clinical presentation of dengue is not typical and there are other febrile illnesses similar to arboviral diseases, misdiagnosis is common even among experienced doctors. Differential diagnosis needs up to date knowledge considering the short viraemic period, the antibody cross-reactivity, and the traps in recognising the nonspecific symptom picture. We present two cases of Dengue diagnosed in Romania which were initially clinically misconstrued, despite the characteristic symptom picture. The main purpose is to increase the level of awareness and to underline the difficulties that clinicians face in recognizing travel-related imported dengue virus disease.
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Affiliation(s)
- Ioana Miriana Cismaru
- Faculty of Medicine, Carol Davila University of Medicine and Pharmacy, 020021 Bucharest, Romania (V.M.); (C.V.)
| | - Maria Adelina Radu
- Faculty of Medicine, Carol Davila University of Medicine and Pharmacy, 020021 Bucharest, Romania (V.M.); (C.V.)
- Agrippa Ionescu Clinical Emergency Hospital, 011356 Bucharest, Romania
| | - Ani Ioana Cotar
- Cantacuzino National Institute of Research-Development for Microbiology and Immunology, 020021 Bucharest, Romania; (A.I.C.)
| | - Florin Oancea
- Cantacuzino National Institute of Research-Development for Microbiology and Immunology, 020021 Bucharest, Romania; (A.I.C.)
| | - Violeta Melinte
- Faculty of Medicine, Carol Davila University of Medicine and Pharmacy, 020021 Bucharest, Romania (V.M.); (C.V.)
- Agrippa Ionescu Clinical Emergency Hospital, 011356 Bucharest, Romania
| | - Cristina Vacaroiu
- Faculty of Medicine, Carol Davila University of Medicine and Pharmacy, 020021 Bucharest, Romania (V.M.); (C.V.)
| | - Isabela Ghemulet
- Agrippa Ionescu Clinical Emergency Hospital, 011356 Bucharest, Romania
| | - Valeriu Gheorghita
- Faculty of Medicine, Carol Davila University of Medicine and Pharmacy, 020021 Bucharest, Romania (V.M.); (C.V.)
- Agrippa Ionescu Clinical Emergency Hospital, 011356 Bucharest, Romania
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Performance of VIDAS® Diagnostic Tests for the Automated Detection of Dengue Virus NS1 Antigen and of Anti-Dengue Virus IgM and IgG Antibodies: A Multicentre, International Study. Diagnostics (Basel) 2023; 13:diagnostics13061137. [PMID: 36980445 PMCID: PMC10047366 DOI: 10.3390/diagnostics13061137] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/01/2023] [Revised: 03/13/2023] [Accepted: 03/14/2023] [Indexed: 03/19/2023] Open
Abstract
Dengue is a serious mosquito-transmitted disease caused by the dengue virus (DENV). Rapid and reliable diagnosis of DENV infection is urgently needed in dengue-endemic regions. We describe here the performance evaluation of the CE-marked VIDAS® dengue immunoassays developed for the automated detection of DENV NS1 antigen and anti-DENV IgM and IgG antibodies. A multicenter concordance study was conducted in 1296 patients from dengue-endemic regions in Asia, Latin America, and Africa. VIDAS® dengue results were compared to those of competitor enzyme-linked immunosorbent assays (ELISA). The VIDAS® dengue assays showed high precision (CV ≤ 10.7%) and limited cross-reactivity (≤15.4%) with other infections. VIDAS® DENGUE NS1 Ag showed high positive and negative percent agreement (92.8% PPA and 91.7% NPA) in acute patients within 0–5 days of symptom onset. VIDAS® Anti-DENGUE IgM and IgG showed a moderate-to-high concordance with ELISA (74.8% to 90.6%) in post-acute and recovery patients. PPA was further improved in combined VIDAS® NS1/IgM (96.4% in 0–5 days acute patients) and IgM/IgG (91.9% in post-acute patients) tests. Altogether, the VIDAS® dengue NS1, IgM, and IgG assays performed well, either alone or in combination, and should be suitable for the accurate diagnosis of DENV infection in dengue-endemic regions.
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Zerfu B, Kassa T, Legesse M. Epidemiology, biology, pathogenesis, clinical manifestations, and diagnosis of dengue virus infection, and its trend in Ethiopia: a comprehensive literature review. Trop Med Health 2023; 51:11. [PMID: 36829222 PMCID: PMC9950709 DOI: 10.1186/s41182-023-00504-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/14/2022] [Accepted: 02/15/2023] [Indexed: 02/26/2023] Open
Abstract
Dengue fever is a dengue virus infection, emerging rapidly and posing public health threat worldwide, primarily in tropical and subtropical countries. Nearly half of the world's population is now at risk of contracting the dengue virus, including new countries with no previous history-like Ethiopia. However, little is known about the epidemiology and impact of the disease in different countries. This is especially true in countries, where cases have recently begun to be reported. This review aims to summarize epidemiology, biology, pathogenesis, clinical manifestations, and diagnosis of dengue virus infection and its trend in Ethiopia. It may help countries, where dengue fever is not yet on the public health list-like Ethiopia to alert healthcare workers to consider the disease for diagnosis and treatment. The review retrieved and incorporated 139 published and organizational reports showing approximately 390 million new infections. About 100 million of these infections develop the clinical features of dengue, and thousands of people die annually from severe dengue fever in 129 countries. It is caused by being bitten by a dengue virus-infected female mosquito, primarily Aedes aegypti and, lesser, Ae. albopictus. Dengue virus is a member of the Flavivirus genus of the Flaviviridae family and has four independent but antigen-related single-stranded positive-sense RNA virus serotypes. The infection is usually asymptomatic but causes illnesses ranging from mild febrile illness to fatal dengue hemorrhagic fever or shock syndrome. Diagnosis can be by detecting the virus genome using nucleic acids amplification tests or testing NS1 antigen and/or anti-dengue antibodies from serum, plasma, circulating blood cells, or other tissues. Dengue cases and outbreaks have increased in recent decades, with a significant public health impact. Ethiopia has had nearly annual outbreaks since 2013, devastating an already fragmented health system and economy. Standardization of medication, population-level screening for early diagnosis and prompt treatment, and minimization of mosquito bites reduce overall infection and mortality rates.
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Affiliation(s)
- Biruk Zerfu
- Department of Medical Laboratory Science, College of Health Science, Addis Ababa University, Addis Ababa, Ethiopia. .,Aklilu Lema Institute of Pathobiology, Addis Ababa University, Addis Ababa, Ethiopia.
| | - Tesfu Kassa
- grid.7123.70000 0001 1250 5688Aklilu Lema Institute of Pathobiology, Addis Ababa University, Addis Ababa, Ethiopia
| | - Mengistu Legesse
- grid.7123.70000 0001 1250 5688Aklilu Lema Institute of Pathobiology, Addis Ababa University, Addis Ababa, Ethiopia
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Luvira V, Thawornkuno C, Lawpoolsri S, Thippornchai N, Duangdee C, Ngamprasertchai T, Leaungwutiwong P. Diagnostic Performance of Dengue NS1 and Antibodies by Serum Concentration Technique. Trop Med Infect Dis 2023; 8:tropicalmed8020117. [PMID: 36828533 PMCID: PMC9963119 DOI: 10.3390/tropicalmed8020117] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/16/2022] [Revised: 02/03/2023] [Accepted: 02/06/2023] [Indexed: 02/17/2023] Open
Abstract
Dengue infection has been a public health problem worldwide, especially in tropical areas. A lack of sensitive diagnostic methods in the early phase of the illness is one of the challenging problems in clinical practices. We, herein, analyzed 86 sera of acute febrile patients, from both dengue and non-dengue febrile illness, to study the diagnostic performance of dengue diagnostics. When compared with detection by Polymerase Chain Reaction (PCR), dengue NS1 detection by enzyme-linked immunosorbent assay (ELISA) had the highest sensitivity of 82.4% (with 94.3% specificity), while NS1 by rapid diagnostic test (RDT) had 76.5% sensitivity. IgM detection by ELISA and RDT showed only 27.5% and 17.9% sensitivity, respectively. The combination of NS1 and IgM in RDT yielded a sensitivity of 78.4%, with 97.1% specificity. One of the essential steps in making a diagnosis from patient samples is the preparation process. At present, a variety of techniques have been used to increase the number of analytes in clinical samples. In this study, we focused on the sample concentration method. The sera were concentrated three times with the ultrafiltration method using a 10 kDa molecular weight cut-off membrane. The results showed an increase in the sensitivity of RDT-NS1 detection at 80.4%, with 100% specificity. When combining NS1 and IgM detection, the concentration method granted RDT an 82.4% sensitivity, with 100% specificity. In conclusion, serum concentration by the ultrafiltration method is a simple and applicable technique. It could increase the diagnostic performance of point-of-care dengue diagnostics.
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Affiliation(s)
- Viravarn Luvira
- Department of Clinical Tropical Medicine, Faculty of Tropical Medicine, Mahidol University, Bangkok 10400, Thailand
| | - Charin Thawornkuno
- Department of Molecular Tropical Medicine and Genetics, Faculty of Tropical Medicine, Mahidol University, Bangkok 10400, Thailand
| | - Saranath Lawpoolsri
- Department of Tropical Hygiene, Faculty of Tropical Medicine, Mahidol University, Bangkok 10400, Thailand
| | - Narin Thippornchai
- Department of Microbiology and Immunology, Faculty of Tropical Medicine, Mahidol University, Bangkok 10400, Thailand
| | - Chatnapa Duangdee
- Hospital for Tropical Diseases, Faculty of Tropical Medicine, Mahidol University, Bangkok 10400, Thailand
| | - Thundon Ngamprasertchai
- Department of Clinical Tropical Medicine, Faculty of Tropical Medicine, Mahidol University, Bangkok 10400, Thailand
| | - Pornsawan Leaungwutiwong
- Department of Microbiology and Immunology, Faculty of Tropical Medicine, Mahidol University, Bangkok 10400, Thailand
- Correspondence: ; Tel.: +66-9-9261-9545
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Dengue virus infection - a review of pathogenesis, vaccines, diagnosis and therapy. Virus Res 2023; 324:199018. [PMID: 36493993 DOI: 10.1016/j.virusres.2022.199018] [Citation(s) in RCA: 10] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/03/2022] [Revised: 10/19/2022] [Accepted: 12/04/2022] [Indexed: 12/12/2022]
Abstract
The transmission of dengue virus (DENV) from an infected Aedes mosquito to a human, causes illness ranging from mild dengue fever to fatal dengue shock syndrome. The similar conserved structure and sequence among distinct DENV serotypes or different flaviviruses has resulted in the occurrence of cross reaction followed by antibody-dependent enhancement (ADE). Thus far, the vaccine which can provide effective protection against infection by different DENV serotypes remains the biggest hurdle to overcome. Therefore, deep investigation is crucial for the potent and effective therapeutic drugs development. In addition, the cross-reactivity of flaviviruses that leads to false diagnosis in clinical settings could result to delay proper intervention management. Thus, the accurate diagnostic with high specificity and sensitivity is highly required to provide prompt diagnosis in respect to render early treatment for DENV infected individuals. In this review, the recent development of neutralizing antibodies, antiviral agents, and vaccine candidates in therapeutic platform for DENV infection will be discussed. Moreover, the discovery of antigenic cryptic epitopes, principle of molecular mimicry, and application of single-chain or single-domain antibodies towards DENV will also be presented.
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In-situ growth of multienzyme-inorganic hybrid nanoflowers on PVA-co-PE nanofibrous strip for colorimetric biosensor. Colloids Surf A Physicochem Eng Asp 2022. [DOI: 10.1016/j.colsurfa.2022.128419] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
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Furtado KM, Kar A. Private Sector Engagement for Infectious Disease Surveillance in Mixed Health Systems: Lessons from a Model Dengue Reporting Network in India. JOURNAL OF HEALTH MANAGEMENT 2022. [DOI: 10.1177/09720634221091011] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
Disease estimates from surveillance in mixed health systems is affected by lack of data from the private sector. We aimed to characterize private sector engagement and reporting to a disease surveillance network, and determine the implications on dengue case detection. We developed and set up a public–private network (CODREN—Community Disease Detection and Response Network) with recruitment of eligible health resources ( n = 462) in a municipal ward of Pune city, India (population 209,331). Dengue cases reported through CODREN were compared with reports of the local dengue surveillance (LDS) over 1 year. Private clinics constituted the majority of eligible providers (60%, 276). Retention of participants was 81.7% with 13.9% reporting dengue cases. Phone call was the preferred reporting method (85.5%, 564 reports). CODREN captured a higher number of cases than LDS (78.9%, 251 vs 50.6%, 161), increasing case detection by 18% due to increased private reporting points. A twofold lower number of cases was reported by LDS from shared reporting points with CODREN, due to discrepancies in case definitions and diagnostic test preferences among private providers. We conclude that private sector engagement can improve dengue case detection with the selective inclusion of providers, sustained contact, feedback and simple reporting methods. Testing guidelines and case definitions adopted by the LDS need to address heterogeneity of private practice in mixed health systems, in order to improve dengue estimates in India.
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Affiliation(s)
- Kheya Melo Furtado
- Goa Institute of Management, Sanquelim, Goa, India
- School of Health Sciences-Savitribai Phule Pune University, Ganeshkhind, Pune, Maharashtra, India
| | - Anita Kar
- School of Health Sciences-Savitribai Phule Pune University, Ganeshkhind, Pune, Maharashtra, India
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Lai SC, Huang YY, Wey JJ, Tsai MH, Chen YL, Shu PY, Chang SF, Hung YJ, Hou JN, Lin CC. Development of Novel Dengue NS1 Multiplex Lateral Flow Immunoassay to Differentiate Serotypes in Serum of Acute Phase Patients and Infected Mosquitoes. Front Immunol 2022; 13:852452. [PMID: 35309328 PMCID: PMC8931297 DOI: 10.3389/fimmu.2022.852452] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/11/2022] [Accepted: 02/14/2022] [Indexed: 11/25/2022] Open
Abstract
Dengue is among the most rapidly spreading arboviral disease in the world. A low-cost, easy to use point-of-care diagnostic tool for the detection and differentiation of dengue virus serotypes could improve clinical management, disease prevention, epidemiological surveillance, and outbreak monitoring, particularly in regions where multiple serotypes co-circulate. Despite widespread deployment, no commercial dengue antigen diagnostic test has proven effective in differentiating among dengue virus serotypes. In the current study, we first established mAb pairs and developed a multiplex lateral flow immunoassay for the simultaneous detection of the dengue viral NS1 antigen and identification of serotype. The proposed system, called Dengue serotype NS1 Multiplex LFIA, provides high sensitivity and specificity. In testing for JEV, ZIKV, YFV, WNV, and CHIKV, the multiplex LFIA gave no indication of cross- reactivity with cell culture supernatants of other flaviviruses or chikungunya virus. In analyzing 187 samples from patients suspected of dengue infection, the detection sensitivity for serotype D1 to D4 was 90.0%, 88.24%, 82.61%, and 83.33% and serotype specificity was 98.74%, 96.13%, 99.39%, and 97.04%, respectively. Our multiplex LFIA can also identify mono- and co-infection of different serotype of dengue viruses in mosquitoes. The proposed Multiplex LFIA provides a simple tool for the rapid detection of dengue serotypes and in the differential diagnosis of fever patients in regions where medical resources are limited and/or multiple DENVs co-circulate.
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Affiliation(s)
- Szu-Chia Lai
- Institute of Preventive Medicine, National Defense Medical Center, New Taipei City, Taiwan
| | - Yu-Yine Huang
- Institute of Preventive Medicine, National Defense Medical Center, New Taipei City, Taiwan
| | - Jiunn-Jye Wey
- Institute of Preventive Medicine, National Defense Medical Center, New Taipei City, Taiwan
| | - Meng-Hung Tsai
- Institute of Preventive Medicine, National Defense Medical Center, New Taipei City, Taiwan
| | - Yi-Ling Chen
- Institute of Preventive Medicine, National Defense Medical Center, New Taipei City, Taiwan
| | - Pei-Yun Shu
- Center for Diagnostics and Vaccine Development, Centers for Disease Control, Ministry of Health and Welfare, Taipei City, Taiwan
| | - Shu-Fen Chang
- Center for Diagnostics and Vaccine Development, Centers for Disease Control, Ministry of Health and Welfare, Taipei City, Taiwan
| | - Yi-Jen Hung
- Institute of Preventive Medicine, National Defense Medical Center, New Taipei City, Taiwan
| | - Jiu-Nan Hou
- Diagnostic Device Group, Trison Technology Corporation, Taoyuan City, Taiwan
| | - Chang-Chi Lin
- Institute of Preventive Medicine, National Defense Medical Center, New Taipei City, Taiwan
- Institute of Microbiology and Immunology, National Defense Medical Center, Taipei City, Taiwan
- *Correspondence: Chang-Chi Lin, ;
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12
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Alidjinou EK, Tardieu S, Vrenken I, Hober D, Gourinat AC. Prospective Evaluation of a Commercial Dengue NS1 Antigen Rapid Diagnostic Test in New Caledonia. Microorganisms 2022; 10:microorganisms10020346. [PMID: 35208800 PMCID: PMC8879109 DOI: 10.3390/microorganisms10020346] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/15/2021] [Revised: 01/17/2022] [Accepted: 01/31/2022] [Indexed: 11/18/2022] Open
Abstract
Dengue virus infection is endemic in New Caledonia, with outbreaks occurring every year. We evaluated the Biosynex® Dengue NS1 antigen rapid diagnostic test (RDT) for the early diagnosis of dengue in patients attending a local hospital in northern New Caledonia. Samples collected from patients suspected of dengue infection were tested with RDT at the local laboratory, and then sent to the reference laboratory for confirmation with real-time RT-PCR. A total of 472 samples were included during the study period. RT-PCR yielded a positive result in 154 samples (32.6%). The sensitivity and specificity of the NS1 antigen RDT were 79.9% and 96.2%, respectively. The performance of the RDT varied by the time of sampling and dengue virus serotype. In conclusion, Biosynex® Dengue NS1 antigen RDT showed a sensitivity and a specificity in the upper range usually reported for this type of test. Several factors can lead to a suboptimal sensitivity, and negative samples with suggestive clinical features should be retested with reference methods.
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Affiliation(s)
- Enagnon Kazali Alidjinou
- Laboratoire de Virologie ULR3610, University of Lille, CHU Lille, F-59000 Lille, France;
- Microbiology Laboratory, Centre Hospitalier Territorial de Nouvelle-Calédonie, 98835 Dumbea, France;
- Correspondence: ; Tel.: +33-32-044-5480; Fax: +33-32-044-4895
| | - Sylvie Tardieu
- Laboratory Department, Centre Hospitalier du Nord, 98860 Kone, France; (S.T.); (I.V.)
| | - Isabelle Vrenken
- Laboratory Department, Centre Hospitalier du Nord, 98860 Kone, France; (S.T.); (I.V.)
| | - Didier Hober
- Laboratoire de Virologie ULR3610, University of Lille, CHU Lille, F-59000 Lille, France;
| | - Ann-Claire Gourinat
- Microbiology Laboratory, Centre Hospitalier Territorial de Nouvelle-Calédonie, 98835 Dumbea, France;
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13
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The Distribution of Dengue Virus Serotype in Quang Nam Province (Vietnam) during the Outbreak in 2018. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19031285. [PMID: 35162303 PMCID: PMC8835360 DOI: 10.3390/ijerph19031285] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 11/20/2021] [Revised: 01/19/2022] [Accepted: 01/20/2022] [Indexed: 02/01/2023]
Abstract
Objectives: Quang Nam province in the Centre of Vietnam has faced an outbreak of dengue hemorrhagic fever (DHF) in 2018. Although DHF is a recurrent disease in this area, no epidemiological and microbiological reports on dengue virus serotypes have been conducted mainly due to lack of facilities for such a kind of advanced surveillance. The aim of this study was to detect different dengue virus serotypes in patients' blood samples. Design and Methods: Suspected cases living in Quang Nam province (Vietnam) and presenting clinical and hematological signs of dengue hemorrhagic fever were included in the study. The screening was performed, and the results were compared by using two methodologies: RT real-time PCR (RT-rPCR) and the Dengue NS1 rapid test. Results: From December 2018 to February 2019, looking both at RT-rPCR [+] and NS1 [+] methodologies, a total of 488 patients were screened and 336 were positive for dengue virus detection (74 children and 262 adults); 273 of these patients (81.3%) underwent viral serotype identification as follows: 12.82% (35/273) D1 serotype, 17.95% (49/273) D2, 0.37% (1/273) D3, 68.50 (187/283) D4, and 0.37% (1/273) D2+D4 serotypes. The RT-rPCR outcomes showed higher sensitivity during the first three days of infection compared to NS1 (92.3% vs. 89.7%). The NS1 increased sensitivity after the first 3 days whilst the RT-rPCR decreased. Conclusions: Advanced surveillance with dengue virus serotypes identification, if performed routinely, may help to predict and prevent further DHF epidemics based on the exposure of the different serotypes during different periods that lead to the intensification of disease severity as a consequence of antibody-dependent enhancement (ADE).
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14
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Gahlaut SK, Pathak A, Gupta BD, Singh JP. Portable fiber-optic SPR platform for the detection of NS1-antigen for dengue diagnosis. Biosens Bioelectron 2022; 196:113720. [PMID: 34710813 DOI: 10.1016/j.bios.2021.113720] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/27/2021] [Revised: 10/06/2021] [Accepted: 10/14/2021] [Indexed: 11/18/2022]
Abstract
Here, we present a portable, selective and cost-effective fiber-optic surface plasmon resonance (SPR) based platform for early detection of Dengue virus. NS1 protein was targeted as the biomarker of dengue. Antibody-antigen specific binding was exploited for NS1 antigen detection. The binding of antibody was assisted by a self-assembled monolayer of alkanethiols on the surface of silver-coated unclad fiber. A wavelength interrogation mode of SPR was utilized to detect NS1 antigen in the dynamic range of 0.2-2.0 μg/ml. The 40 nm thick silver coated optical fiber exhibited resonance wavelength around 500 nm and change in resonance wavelength was monitored for each attachment step on the fiber. The sensitivity at the lowest concentration of NS1 antigen was found to be 54.7 nm/(μg/ml). The limit of detection of the sensor was found to be 0.06 μg/ml, which lies in the physiological range of NS1 protein present in the infected blood, hence the present technique may provide a very early detection advantage. Real blood serum samples were also successfully tested on the set-up, confirming compatibility with the conventional methods. The presented field-deployable platform has wide applications in mass monitoring of dengue, such as during outbreaks and epidemics.
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Affiliation(s)
- Shashank K Gahlaut
- Department of Physics, Indian Institute of Technology Delhi, New Delhi, 110016, India
| | - Anisha Pathak
- Department of Physics, Indian Institute of Technology Delhi, New Delhi, 110016, India
| | - Banshi D Gupta
- Department of Physics, Indian Institute of Technology Delhi, New Delhi, 110016, India
| | - J P Singh
- Department of Physics, Indian Institute of Technology Delhi, New Delhi, 110016, India.
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15
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Magnitude, Seasonal-variation, Serological and Hematological Profile of Dengue in a Tertiary Teaching Hospital, Karwar, India. JOURNAL OF PURE AND APPLIED MICROBIOLOGY 2021. [DOI: 10.22207/jpam.15.4.10] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
Dengue viral infection is the most widely spread arbo-viral disease in Indian subcontinent. High index of clinical suspicion especially during its peak season can be rewarding in diagnosing as well as early case management of anticipated DHF and DSS cases. To estimate the magnitude, seasonal-variation, serological as well as hematological aspects of dengue cases. This was a prospective observational study held in Microbiology and Hematology laboratories of our hospital for duration of one year from July-2019 to June-2020. All the suspected dengue cases were subjected to NS1-antigen, IgM and IgG antibody detection. The samples were also tested for platelet count, total count, haematocrit as well as hemoglobin estimation. All 1,550 dengue suspected cases were subjected to serological testing, among which 157 (10.1%) were positive. The most affected populations were the adult male. As the study was conducted for one year, we could observe the seasonal trend which peaked during post-monsoon. Out of 157 cases, 81.5%, 0.6% and 17.8% were determined as primary, secondary and old dengue cases respectively. There was a significant association between NS1 antigen and fever of </= 5 days duration with ‘p’ value< 0.00001. Thrombocytopenia, leucopenia and increased haematocrit were witnessed in 15.9%, 28.6% and 35% respectively. Our study shows that we had a high magnitude of primary cases that are prone to secondary dengue infection which might have a catastrophic effect giving rise to DHF, DSS or SD.
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16
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Siqueira Silva M, Moreira Tavares AP, Leomil Coelho LF, Morganti Ferreira Dias LE, Chura-Chambi RM, Guimarães da Fonseca F, Ferreira Sales MG, Costa Figueiredo E. Rational selection of hidden epitopes for a molecularly imprinted electrochemical sensor in the recognition of heat-denatured dengue NS1 protein. Biosens Bioelectron 2021; 191:113419. [PMID: 34144470 DOI: 10.1016/j.bios.2021.113419] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/25/2021] [Revised: 05/30/2021] [Accepted: 06/05/2021] [Indexed: 10/21/2022]
Abstract
Rational selection of predicted peptides to be employed as templates in molecular imprinting was carried out for the heat-denatured non-structural protein 1 (NS1) of dengue virus (DENV). Conservation analysis among 301 sequences of Brazilian isolates of DENV and zika virus (ZIKV) NS1 was carried out by UniProtKB, and peptide selection was based on in silico data of the conservational, structural and immunogenic properties of the sequences. The selected peptide (from dengue 1 NS1) was synthesized and employed as a template in the electropolymerization of polyaminophenol-imprinted films on the surface of carbon screen-printed electrodes. Heat denaturation of the protein was carried out prior to analysis, in order to expose its internal hidden epitopes. After removal of the template, the molecularly imprinted cavities were able to rebind to the whole denatured protein as determined by electrochemical impedance spectroscopy. This label-free sensor was efficient to distinguish the NS1 of DENV from the NS1 of ZIKV. Additionally, the sensor was also selective for dengue NS1, in comparison with human serum immunoglobulin G and human serum albumin. Additionally, the device was able to detect the DENV NS1 at concentrations from 50 to 200 μg L-1 (RSD below 5.04%, r = 0.9678) in diluted human serum samples. The calculated LOD and LOQ were, respectively, 29.3 and 88.7 μg L-1 and each sensor could be used for six sequential cycles with the same performance.
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Affiliation(s)
- Matheus Siqueira Silva
- Laboratory of Toxicant and Drug Analyses, Federal University of Alfenas, 37130-001, Alfenas, MG, Brazil
| | - Ana Patricia Moreira Tavares
- BioMark@ISEP, School of Engineering of the Polytechnic School of Porto, 4200-072, Paranhos, Portugal; BioMark@UC, Department of Chemical Engineering, Faculty of Sciences and Technology of the University of Coimbra, 3030-790, Coimbra, Portugal
| | - Luiz Felipe Leomil Coelho
- Laboratory of Vaccines, Department of Microbiology and Immunology, Institute of Biomedical Sciences, Federal University of Alfenas, 37130-001, Alfenas, MG, Brazil
| | | | - Rosa Maria Chura-Chambi
- Center of Biotechnology, Institute of Energetic and Nuclear Research, IPEN-CNEN/SP, 05508-000, São Paulo, SP, Brazil
| | | | - Maria Goreti Ferreira Sales
- BioMark@ISEP, School of Engineering of the Polytechnic School of Porto, 4200-072, Paranhos, Portugal; BioMark@UC, Department of Chemical Engineering, Faculty of Sciences and Technology of the University of Coimbra, 3030-790, Coimbra, Portugal.
| | - Eduardo Costa Figueiredo
- Laboratory of Toxicant and Drug Analyses, Federal University of Alfenas, 37130-001, Alfenas, MG, Brazil.
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17
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Lathika S, Raj A, Sen AK. LSPR based on-chip detection of dengue NS1 antigen in whole blood. RSC Adv 2021; 11:33770-33780. [PMID: 35497567 PMCID: PMC9042277 DOI: 10.1039/d1ra05009e] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/29/2021] [Accepted: 10/07/2021] [Indexed: 01/23/2023] Open
Abstract
The development of a biosensor for rapid and quantitative detection of the dengue virus continues to remain a challenge. We report a lab-on-chip device that combines membrane-based blood plasma separation and a localized surface plasmon resonance (LSPR) based biosensor for on-chip detection of dengue NS1 antigen from a few drops of blood. The LSPR effect is realized by irradiating UV-NIR light having a spectral peak at 655 nm onto nanostructures fabricated via thermal annealing of a thin metal film. We study the effect of the resulting metal nanostructures on the LSPR performance in terms of sensitivity and limit of detection, by annealing silver films at temperatures ranging from 100 to 500 °C. The effect of annealing temperature on the nanostructure size and uniformity and the resulting optical characteristics are investigated. Further, the binding between non-targeted blood plasma proteins and NS1-antibody-functionalized nanostructures on the LSPR performance is studied by considering different blocking mechanisms. Using a nanostructure annealed at 200 °C and 2X-phosphate buffer saline with 0.05% Tween-20 as the blocking buffer, from 10 μL of whole blood, the device can detect NS1 antigen at a concentration as low as 0.047 μg mL-1 within 30 min. Finally, we demonstrate the detection of NS1 in the blood samples of dengue-infected patients and validate our results with those obtained from the gold-standard ELISA test.
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Affiliation(s)
- S Lathika
- Fluid Systems Lab, Department of Mechanical Engineering, Indian Institute of Technology Madras Chennai India
| | - A Raj
- Department of Mechanical Engineering, Indian Institute of Technology Patna Patna India
| | - A K Sen
- Fluid Systems Lab, Department of Mechanical Engineering, Indian Institute of Technology Madras Chennai India
- Micro Nano Bio Fluidics Group, Indian Institute of Technology Madras Chennai India
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18
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Tran L, Park S. Highly sensitive detection of dengue biomarker using streptavidin-conjugated quantum dots. Sci Rep 2021; 11:15196. [PMID: 34312404 PMCID: PMC8313577 DOI: 10.1038/s41598-021-94172-x] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/08/2021] [Accepted: 07/07/2021] [Indexed: 11/24/2022] Open
Abstract
A highly sensitive immunosensor using streptavidin-conjugated quantum dots (QDs/SA) was developed to detect dengue biomarker of non-structural protein 1 (NS1) at very low concentration, so that it can probe dengue infection even in the early stage. The QDs/SA were first bound to biotinylated NS1 antibody (Ab) and the QDs/SA-Ab conjugates were then used to detect the NS1 antigen (Ag) in the Ag concentration range of 1 pM to 120 nM. The formation of QDs/SA-Ab and QDs/SA-Ab-Ag conjugates was confirmed by the measurements of field emission scanning electron microscopy (FF-SEM), field emission transmission electron microscopy (FE-TEM), dynamic light scattering (DLS), and zeta-potential. Fluorescence emission spectra of QDs/SA-Ab-Ag conjugates showed that the magnitude of fluorescence quenching was linearly proportional to the NS1 Ag concentration and it nicely followed the Stern-Volmer (SV) equation in phosphate buffer solution. However, in human plasma serum solution, the fluorescence quenching behavior was negatively deviated from the SV equation presumably due to interference by the serum component biomolecules, and it was well explained by the Lehrer equation. These results suggest that the current approach is promising because it is highly sensitive, fast, simple, and convenient, and thus it has a potential of application for point-of-care.
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Affiliation(s)
- Linh Tran
- Department of Chemical and Biochemical Engineering, Dongguk University, Pildong-ro 1-gil 30, Jung-gu, Seoul, 04620, South Korea
| | - Sangkwon Park
- Department of Chemical and Biochemical Engineering, Dongguk University, Pildong-ro 1-gil 30, Jung-gu, Seoul, 04620, South Korea.
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19
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Evaluation of VIDAS ® Diagnostic Assay Prototypes Detecting Dengue Virus NS1 Antigen and Anti-Dengue Virus IgM and IgG Antibodies. Diagnostics (Basel) 2021; 11:diagnostics11071228. [PMID: 34359311 PMCID: PMC8307080 DOI: 10.3390/diagnostics11071228] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/02/2021] [Revised: 07/02/2021] [Accepted: 07/05/2021] [Indexed: 01/24/2023] Open
Abstract
Dengue is a serious tropical disease caused by the mosquito-borne dengue virus (DENV). Performant, rapid, and easy-to-use assays are needed for the accurate diagnosis of acute DENV infection. We evaluated the performance of three prototype assays developed for the VIDAS® automated platform to detect dengue NS1 antigen and anti-dengue IgM and IgG antibodies. Positive and negative agreement with competitor enzyme-linked immunosorbent assays (ELISA) and rapid diagnostic tests (RDT) was evaluated in 91 Lao patients (57 adults, 34 children) with acute DENV infection. The VIDAS® NS1 assay showed the best overall agreement (95.6%) with the competitor NS1 ELISA. Both VIDAS® NS1 and NS1 ELISA assays also demonstrated high sensitivity relative to DENV RNA RT-PCR set as gold standard (85.7% and 83.9%, respectively). In contrast, NS1 RDT was less sensitive relative to DENV RNA RT-PCR (72.7%). The overall agreement of VIDAS® IgM and IgG assays with the competitor assays was moderate (72.5% for IgM ELISA, 76.9% for IgG ELISA, and 68.7% for IgM and IgG RDT). In most analyses, test agreements of the VIDAS® assays were comparable in adults and children. Altogether, the VIDAS® dengue prototypes performed very well and appear to be suitable for routine detection of dengue NS1 antigen and anti-dengue IgM/IgG antibodies.
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20
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Kabir MA, Zilouchian H, Younas MA, Asghar W. Dengue Detection: Advances in Diagnostic Tools from Conventional Technology to Point of Care. BIOSENSORS 2021; 11:206. [PMID: 34201849 PMCID: PMC8301808 DOI: 10.3390/bios11070206] [Citation(s) in RCA: 21] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/29/2021] [Revised: 06/05/2021] [Accepted: 06/15/2021] [Indexed: 06/02/2023]
Abstract
The dengue virus (DENV) is a vector-borne flavivirus that infects around 390 million individuals each year with 2.5 billion being in danger. Having access to testing is paramount in preventing future infections and receiving adequate treatment. Currently, there are numerous conventional methods for DENV testing, such as NS1 based antigen testing, IgM/IgG antibody testing, and Polymerase Chain Reaction (PCR). In addition, novel methods are emerging that can cut both cost and time. Such methods can be effective in rural and low-income areas throughout the world. In this paper, we discuss the structural evolution of the virus followed by a comprehensive review of current dengue detection strategies and methods that are being developed or commercialized. We also discuss the state of art biosensing technologies, evaluated their performance and outline strategies to address challenges posed by the disease. Further, we outline future guidelines for the improved usage of diagnostic tools during recurrence or future outbreaks of DENV.
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Affiliation(s)
- Md Alamgir Kabir
- Asghar-Lab, Micro and Nanotechnology in Medicine, College of Engineering and Computer Science, Boca Raton, FL 33431, USA; (M.A.K.); (H.Z.)
- Department of Computer & Electrical Engineering and Computer Science, Florida Atlantic University, Boca Raton, FL 33431, USA
| | - Hussein Zilouchian
- Asghar-Lab, Micro and Nanotechnology in Medicine, College of Engineering and Computer Science, Boca Raton, FL 33431, USA; (M.A.K.); (H.Z.)
- College of Medicine, University of Central Florida, Orlando, FL 32827, USA
| | | | - Waseem Asghar
- Asghar-Lab, Micro and Nanotechnology in Medicine, College of Engineering and Computer Science, Boca Raton, FL 33431, USA; (M.A.K.); (H.Z.)
- Department of Computer & Electrical Engineering and Computer Science, Florida Atlantic University, Boca Raton, FL 33431, USA
- Department of Biological Sciences (Courtesy Appointment), Florida Atlantic University, Boca Raton, FL 33431, USA
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21
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Chong ZL, Soe HJ, Ismail AA, Mahboob T, Chandramathi S, Sekaran SD. Evaluation of the Diagnostic Accuracy of a New Biosensors-Based Rapid Diagnostic Test for the Point-Of-Care Diagnosis of Previous and Recent Dengue Infections in Malaysia. BIOSENSORS 2021; 11:129. [PMID: 33921935 PMCID: PMC8143448 DOI: 10.3390/bios11050129] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/22/2021] [Revised: 04/03/2021] [Accepted: 04/06/2021] [Indexed: 12/21/2022]
Abstract
Dengue is a major threat to public health globally. While point-of-care diagnosis of acute/recent dengue is available to reduce its mortality, a lack of rapid and accurate testing for the detection of previous dengue remains a hurdle in expanding dengue seroepidemiological surveys to inform its prevention, especially vaccination, to reduce dengue morbidity. This study evaluated ViroTrack Dengue Serostate, a biosensors-based semi-quantitative anti-dengue IgG (immunoglobulin G) immuno-magnetic agglutination assay for the diagnosis of previous and recent dengue in a single test. Blood samples were obtained from 484 healthy participants recruited randomly from two communities in Petaling district, Selangor, Malaysia. The reference tests were Panbio Dengue IgG indirect and capture enzyme-linked immunosorbent assays, in-house hemagglutination inhibition assay, and focus reduction neutralization test. Dengue Serostate had a sensitivity and specificity of 91.1% (95%CI 87.8-93.8) and 91.1% (95%CI 83.8-95.8) for the diagnosis of previous dengue, and 90.2% (95%CI 76.9-97.3) and 93.2% (95%CI 90.5-95.4) for the diagnosis of recent dengue, respectively. Its positive predictive value of 97.5% (95%CI 95.3-98.8) would prevent most dengue-naïve individuals from being vaccinated. ViroTrack Dengue Serostate's good point-of-care diagnostic accuracy can ease the conduct of dengue serosurveys to inform dengue vaccination strategy and facilitate pre-vaccination screening to ensure safety.
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Affiliation(s)
- Zhuo Lin Chong
- Centre for Communicable Diseases Research, Institute for Public Health, National Institutes of Health, Ministry of Health, Persiaran Setia Murni, Setia Alam, Shah Alam 40170, Selangor, Malaysia
| | - Hui Jen Soe
- Department of Medical Microbiology, Faculty of Medicine, University of Malaya, Jalan Profesor Diraja Ungku Aziz, Kuala Lumpur 50603, Malaysia; (H.J.S.); (A.A.I.); (T.M.); (S.C.)
| | - Amni Adilah Ismail
- Department of Medical Microbiology, Faculty of Medicine, University of Malaya, Jalan Profesor Diraja Ungku Aziz, Kuala Lumpur 50603, Malaysia; (H.J.S.); (A.A.I.); (T.M.); (S.C.)
| | - Tooba Mahboob
- Department of Medical Microbiology, Faculty of Medicine, University of Malaya, Jalan Profesor Diraja Ungku Aziz, Kuala Lumpur 50603, Malaysia; (H.J.S.); (A.A.I.); (T.M.); (S.C.)
| | - Samudi Chandramathi
- Department of Medical Microbiology, Faculty of Medicine, University of Malaya, Jalan Profesor Diraja Ungku Aziz, Kuala Lumpur 50603, Malaysia; (H.J.S.); (A.A.I.); (T.M.); (S.C.)
| | - Shamala Devi Sekaran
- Faculty of Medical & Health Sciences, UCSI University, Jalan Menara Gading, Cheras, Kuala Lumpur 56000, Malaysia
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22
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Yow KS, Aik J, Tan EYM, Ng LC, Lai YL. Rapid diagnostic tests for the detection of recent dengue infections: An evaluation of six kits on clinical specimens. PLoS One 2021; 16:e0249602. [PMID: 33793682 PMCID: PMC8016316 DOI: 10.1371/journal.pone.0249602] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/29/2020] [Accepted: 03/17/2021] [Indexed: 11/18/2022] Open
Abstract
Introduction Early and rapid confirmation of dengue infections strengthens disease surveillance program and are critical to the success of vector control measures. Rapid diagnostics tests (RDTs) are increasingly used to confirm recent dengue infections due to their ease of use and short turnaround time for results. Several studies undertaken in dengue-endemic Southeast Asia have reported the performance of RDTs against enzyme-linked immunosorbent assay (ELISA), reverse transcriptase polymerase chain reaction (RT-PCR) and virus isolation methods. However, few studies have compared multiple RDTs for the detection of dengue NS1 antigen and IgM antibody in a single combo cassette. We evaluated six RDTs in Singapore for their utility in routine clinical testing to detect recent dengue infections. Methods The evaluation comprised two phases. The first phase sought to determine each RDT’s specificity to dengue NS1 and IgM using zika and chikungunya virus supernatant and zika convalescent samples. RDTs that cross-reacted with zika or chikungunya were not further tested in phase 2. The second phase sought to determine the sensitivity and specificity of the remaining RDTs to dengue NS1 and IgM using pre-characterised dengue specimens and non-dengue/chikungunya febrile clinical specimens. Results None of the RDTs cross-reacted with zika IgM in Phase 1. Truquick and Quickprofile cross reacted with zika and chikungunya viruses and were not evaluated thereafter. Standard Q had the highest dengue NS1 and IgM sensitivity at 87.0% and 84.3% respectively whereas Bioline (68.5%) and Multisure (58.3%) had the lowest dengue NS1 and IgM sensitivity respectively. Combining dengue NS1/IgM detection results greatly improved the RDT ability to detect recent dengue infection; Standard Q had the highest sensitivity at 99.1% while Multisure had the lowest at 92.6%. All the RDTs were highly specific for dengue NS1 and IgM (96.7% to 100%). All the RDTs had high positive predictive values (98.4% to 100%) for NS1, IgM and combined NS1/IgM parameters whereas Standard Q had the highest negative predictive values at 68.2% (NS1), 63.8% (IgM) and 96.8% (NS1/IgM). For the RDTs, detection of NS1 declined from acute to convalescent phase of illness whereas IgM detection rate gradually increased over time. Conclusion In our study, several RDTs were evaluated for their diagnostic accuracy and capability in detecting recent dengue infection. Standard Q demonstrated a high degree of diagnostic accuracy and capability in the detection of NS1 and IgM biomarkers. RDTs can provide rapid and accurate confirmation of recent dengue infections and augment dengue surveillance and control programmes. Further studies are required to assess the usefulness of these RDTs in other epidemiology settings.
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Affiliation(s)
- Kok-Siang Yow
- Environmental Health Institute, National Environment Agency, Singapore, Singapore
- * E-mail:
| | - Joel Aik
- Environmental Health Institute, National Environment Agency, Singapore, Singapore
| | - Eugene Yong-Meng Tan
- Environmental Health Institute, National Environment Agency, Singapore, Singapore
| | - Lee-Ching Ng
- Environmental Health Institute, National Environment Agency, Singapore, Singapore
| | - Yee-Ling Lai
- Environmental Health Institute, National Environment Agency, Singapore, Singapore
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Oishee MJ, Ali T, Jahan N, Khandker SS, Haq MA, Khondoker MU, Sil BK, Lugova H, Krishnapillai A, Abubakar AR, Kumar S, Haque M, Jamiruddin MR, Adnan N. COVID-19 Pandemic: Review of Contemporary and Forthcoming Detection Tools. Infect Drug Resist 2021; 14:1049-1082. [PMID: 33762831 PMCID: PMC7982560 DOI: 10.2147/idr.s289629] [Citation(s) in RCA: 36] [Impact Index Per Article: 12.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/30/2020] [Accepted: 01/30/2021] [Indexed: 01/10/2023] Open
Abstract
Recent severe acute respiratory syndrome 2 (SARS-CoV-2) known as COVID-19, presents a deadly challenge to the global healthcare system of developing and developed countries, exposing the limitations of health facilities preparedness for emerging infectious disease pandemic. Opportune detection, confinement, and early treatment of infected cases present the first step in combating COVID-19. In this review, we elaborate on various COVID-19 diagnostic tools that are available or under investigation. Consequently, cell culture, followed by an indirect fluorescent antibody, is one of the most accurate methods for detecting SARS-CoV-2 infection. However, restrictions imposed by the regulatory authorities prevented its general use and implementation. Diagnosis via radiologic imaging and reverse transcriptase PCR assay is frequently employed, considered as standard procedures, whereas isothermal amplification methods are currently on the verge of clinical introduction. Notably, techniques such as CRISPR-Cas and microfluidics have added new dimensions to the SARS-CoV-2 diagnosis. Furthermore, commonly used immunoassays such as enzyme-linked immunosorbent assay (ELISA), lateral flow immunoassay (LFIA), neutralization assay, and the chemiluminescent assay can also be used for early detection and surveillance of SARS-CoV-2 infection. Finally, advancement in the next generation sequencing (NGS) and metagenomic analysis are smoothing the viral detection further in this global challenge.
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Affiliation(s)
| | - Tamanna Ali
- Gonoshasthaya-RNA Molecular Diagnostic and Research Center, Dhaka, Bangladesh
| | - Nowshin Jahan
- Gonoshasthaya-RNA Molecular Diagnostic and Research Center, Dhaka, Bangladesh
| | | | - Md Ahsanul Haq
- Gonoshasthaya-RNA Molecular Diagnostic and Research Center, Dhaka, Bangladesh
| | | | | | - Halyna Lugova
- Faculty of Medicine and Defence Health, National Defence University of Malaysia, Kuala Lumpur, Malaysia
| | - Ambigga Krishnapillai
- Faculty of Medicine and Defence Health, National Defence University of Malaysia, Kuala Lumpur, Malaysia
| | - Abdullahi Rabiu Abubakar
- Department of Pharmacology and Therapeutics, Faculty of Pharmaceutical Sciences, Bayero University, Kano, 700233, Kano, Nigeria
| | - Santosh Kumar
- Department of Periodontology and Implantology, Karnavati University, Gandhinagar, 382422, India
| | - Mainul Haque
- The Unit of Pharmacology, Faculty of Medicine and Defence Health Universiti Pertahanan, Nasional Malaysia (National Defence University of Malaysia), Kuala Lumpur, Malaysia
| | | | - Nihad Adnan
- Department of Microbiology, Jahangirnagar University, Dhaka, 1342, Bangladesh
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Santoso MS, Masyeni S, Haryanto S, Yohan B, Hibberd ML, Sasmono RT. Assessment of dengue and COVID-19 antibody rapid diagnostic tests cross-reactivity in Indonesia. Virol J 2021; 18:54. [PMID: 33706767 PMCID: PMC7948652 DOI: 10.1186/s12985-021-01522-2] [Citation(s) in RCA: 22] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/10/2020] [Accepted: 03/02/2021] [Indexed: 01/31/2023] Open
Abstract
Background The coronavirus disease 2019 (COVID-19) pandemic remains ongoing around the world, including in areas where dengue is endemic. Dengue and COVID-19, to some extent, have similar clinical and laboratory features, which can lead to misdiagnosis, delayed treatment and patient’s isolation. The use of rapid diagnostic tests (RDT) is easy and convenient for fast diagnosis, however there may be issues with cross-reactivity with antibodies for other pathogens. Methods We assessed the possibility of cross-reactivity between SARS-CoV-2 and dengue antibodies by: (1) testing five brands of COVID-19 IgG / IgM RDTs on 60 RT-PCR-confirmed dengue samples; (2) testing 95 RT-PCR-confirmed COVID-19 samples on dengue RDT; and (3) testing samples positive for COVID-19 IgG and/or IgM on dengue RDT. Results We observed a high specificity across all five brands of COVID-19 RDTs, ranging from 98.3 to 100%. Out of the confirmed COVID-19 samples, one patient tested positive for dengue IgM only, another tested positive for dengue IgG only. One patient tested positive for dengue IgG, IgM, and NS1, suggesting a co-infection. In COVID-19 IgG and/or IgM samples, 6.3% of COVID-19 IgG-positive samples also tested positive for dengue IgG, while 21.1% of COVID-19 IgM-positive samples also tested positive for dengue IgG. Conclusion Despite the high specificity of the COVID-19 RDT, we observed cross-reactions and false-positive results between dengue and COVID-19. Dengue and COVID-19 co-infection was also found. Health practitioners in dengue endemic areas should be careful when using antibody RDT for the diagnosis of dengue during the COVID-19 pandemic to avoid misdiagnosis.
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Affiliation(s)
- Marsha S Santoso
- Dengue Research Unit, Eijkman Institute for Molecular Biology, Ministry of Research and Technology/National Agency for Research and Innovation of the Republic Indonesia, Jl. Diponegoro 69, Jakarta, 10430, Indonesia
| | - Sri Masyeni
- Department of Internal Medicine, Faculty of Medicine and Health Sciences, Universitas Warmadewa, Denpasar, Bali, 80235, Indonesia
| | | | - Benediktus Yohan
- Dengue Research Unit, Eijkman Institute for Molecular Biology, Ministry of Research and Technology/National Agency for Research and Innovation of the Republic Indonesia, Jl. Diponegoro 69, Jakarta, 10430, Indonesia
| | - Martin L Hibberd
- Department of Pathogen Molecular Biology, London School of Hygiene and Tropical Medicine, London, WC1E 7HT, UK
| | - R Tedjo Sasmono
- Dengue Research Unit, Eijkman Institute for Molecular Biology, Ministry of Research and Technology/National Agency for Research and Innovation of the Republic Indonesia, Jl. Diponegoro 69, Jakarta, 10430, Indonesia.
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Zhuang J, Yin J, Lv S, Wang B, Mu Y. Advanced "lab-on-a-chip" to detect viruses - Current challenges and future perspectives. Biosens Bioelectron 2020; 163:112291. [PMID: 32421630 PMCID: PMC7215165 DOI: 10.1016/j.bios.2020.112291] [Citation(s) in RCA: 82] [Impact Index Per Article: 20.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/16/2020] [Revised: 05/02/2020] [Accepted: 05/10/2020] [Indexed: 12/28/2022]
Abstract
Massive viral outbreaks draw attention to viruses that have not been thoroughly studied or understood. In recent decades, microfluidic chips, known as "lab-on-a-chip", appears as a promising tool for the detection of viruses. Here, we review the development of microfluidic chips that could be used in response to viral detection, specifically for viruses involved in more recent outbreaks. The advantages as well as the disadvantages of microfluidic systems are discussed and analyzed. We also propose ideas for future development of these microfluidic chips and we expect this advanced technology to be used in the future for viral outbreaks.
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Affiliation(s)
- Jianjian Zhuang
- College of Life Sciences, Zhejiang University, Hangzhou, 310058, Zhejiang, China
| | - Juxin Yin
- Research Centre for Analytical Instrumentation, Institute of Cyber-Systems and Control, State Key Laboratory of Industrial Control Technology, Zhejiang University, Hangzhou, Zhejiang Province, 310058, China; Cancer Institute (Key Laboratory of Cancer Prevention and Intervention, National Ministry of Education), The Second Affiliated Hospital, School of Medicine, Zhejiang University, Hangzhou, 310009, China; Institute of Translational Medicine, Zhejiang University, Hangzhou, 310029, China
| | - Shaowu Lv
- Key Laboratory for Molecular Enzymology and Engineering of the Ministry of Education, College of Life Science, Jilin University, Changchun, 130000, China
| | - Ben Wang
- Cancer Institute (Key Laboratory of Cancer Prevention and Intervention, National Ministry of Education), The Second Affiliated Hospital, School of Medicine, Zhejiang University, Hangzhou, 310009, China; Institute of Translational Medicine, Zhejiang University, Hangzhou, 310029, China
| | - Ying Mu
- Research Centre for Analytical Instrumentation, Institute of Cyber-Systems and Control, State Key Laboratory of Industrial Control Technology, Zhejiang University, Hangzhou, Zhejiang Province, 310058, China; College of Life Sciences, Zhejiang University, Hangzhou, 310058, Zhejiang, China.
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Matusali G, Colavita F, Carletti F, Lalle E, Bordi L, Vairo F, Ippolito G, Capobianchi MR, Castilletti C. Performance of rapid tests in the management of dengue fever imported cases in Lazio, Italy 2014-2019. Int J Infect Dis 2020; 99:193-198. [PMID: 32659449 DOI: 10.1016/j.ijid.2020.07.008] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/31/2019] [Revised: 07/02/2020] [Accepted: 07/05/2020] [Indexed: 01/12/2023] Open
Abstract
BACKGROUND In Italy, dengue virus is the most frequent agent of imported viral infections. The use of rapid diagnostic tests (RDTs) may be of help as a preliminary user-friendly quick assay to facilitate dengue diagnosis, as ordinary laboratory diagnosis of dengue fever may require special efforts in terms of tools availability, interpretation of results, and skilled personnel. The performance of RDTs, however, may vary according to different epidemiological and laboratory background. METHODS We reviewed five years of laboratory records of two dengue RDT results (Colorimetric SD-Bioline Dengue-Duo-RDT and Fluorimetric SD-Biosensor-STANDARD-F-Dengue-RDT), able to detect viral NS1 antigen and specific IgM and IgG. Diagnostic parameters were calculated using as reference the results of molecular (RT-PCR) and serological (immunofluorescence, IFA) tests. Overall performance, calculated considering the final case definition, was included in the accuracy assessment of RDTs. RESULTS The combined use of NS1 and IgM/IgG RDT for the detection of acute dengue cases resulted in an overall sensitivity and specificity of 87.2% and 97.9% for Colorimetric RDT, 96.2% and 96.2% for Fluorimetric RDT. NS1 was the most reliable marker of acute infection, while IgM resulted falsely positive in nine samples, including sera derived from 2 Zika and 4 non-arbovirus infected patients. CONCLUSIONS The inclusion of RDT in the diagnostic algorithm is of undeniable help in the prompt management and surveillance of dengue infection in non-endemic areas. Confirmatory tests are, however, necessary to rule in or rule out dengue fever diagnosis.
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Affiliation(s)
- Giulia Matusali
- National Institute for Infectious Diseases "Lazzaro Spallanzani" IRCCS, Via Portuense 292, 00149 Rome, Italy.
| | - Francesca Colavita
- National Institute for Infectious Diseases "Lazzaro Spallanzani" IRCCS, Via Portuense 292, 00149 Rome, Italy.
| | - Fabrizio Carletti
- National Institute for Infectious Diseases "Lazzaro Spallanzani" IRCCS, Via Portuense 292, 00149 Rome, Italy
| | - Eleonora Lalle
- National Institute for Infectious Diseases "Lazzaro Spallanzani" IRCCS, Via Portuense 292, 00149 Rome, Italy
| | - Licia Bordi
- National Institute for Infectious Diseases "Lazzaro Spallanzani" IRCCS, Via Portuense 292, 00149 Rome, Italy
| | - Francesco Vairo
- National Institute for Infectious Diseases "Lazzaro Spallanzani" IRCCS, Via Portuense 292, 00149 Rome, Italy
| | - Giuseppe Ippolito
- National Institute for Infectious Diseases "Lazzaro Spallanzani" IRCCS, Via Portuense 292, 00149 Rome, Italy
| | - Maria R Capobianchi
- National Institute for Infectious Diseases "Lazzaro Spallanzani" IRCCS, Via Portuense 292, 00149 Rome, Italy
| | - Concetta Castilletti
- National Institute for Infectious Diseases "Lazzaro Spallanzani" IRCCS, Via Portuense 292, 00149 Rome, Italy
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Mata VE, Andrade CAFD, Passos SRL, Hökerberg YHM, Fukuoka LVB, Silva SAD. Rapid immunochromatographic tests for the diagnosis of dengue: a systematic review and meta-analysis. CAD SAUDE PUBLICA 2020; 36:e00225618. [PMID: 32520127 DOI: 10.1590/0102-311x00225618] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/25/2018] [Accepted: 02/18/2020] [Indexed: 11/22/2022] Open
Abstract
Dengue is an important arthropod-borne viral disease in terms of morbidity, mortality, economic impact and challenges in vector control. Benchmarks are expensive, time consuming and require trained personnel. Preventing dengue complications with rapid diagnosis has been based on the testing of easy-to-perform optimized immunochromatographic methods (ICT). This is a systematic meta-analysis review of the diagnostic accuracy of IgA, NS1, IgM and/or IgG ICT studies in suspected cases of acute or convalescent dengue, using a combination of RT-PCR, ELISA NS1, IgM IgG or viral isolation as a reference standard. This protocol was registered in PROSPERO (CRD42014009885). Two pairs of reviewers searched the PubMed, BIREME, Science Direct, Scopus, Web of Science, Ovid MEDLINE JBrigs, SCIRUS and EMBASE databases, selected, extracted, and quality-assessed by QUADAS 2. Of 3,783 studies, we selected 57, of which 40 in meta-analyses according to the analyte tested, with high heterogeneity (I2 > 90%), as expected for diagnostic tests. We detected higher pooled sensitivity in acute phase IgA (92.8%) with excellent (90%) specificity. ICT meta-analysis with NS1/IgM/IgG showed 91% sensitivity and 96% specificity. Poorer screening performance was for IgM/IgG ICT (sensitivity = 56%). Thus, the studies with NS1/IgM/IgG ICT showed the best combined performance in the acute phase of the disease.
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Pokharel S, White LJ, Aguas R, Celhay O, Pellé KG, Dittrich S. Algorithm in the Diagnosis of Febrile Illness Using Pathogen-specific Rapid Diagnostic Tests. Clin Infect Dis 2020; 70:2262-2269. [PMID: 31313805 PMCID: PMC7245147 DOI: 10.1093/cid/ciz665] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/10/2019] [Accepted: 07/16/2019] [Indexed: 11/21/2022] Open
Abstract
BACKGROUND In the absence of proper guidelines and algorithms, available rapid diagnostic tests (RDTs) for common acute undifferentiated febrile illnesses are often used inappropriately. METHODS Using prevalence data of 5 common febrile illnesses from India and Cambodia, and performance characteristics (sensitivity and specificity) of relevant pathogen-specific RDTs, we used a mathematical model to predict the probability of correct identification of each disease when diagnostic testing occurs either simultaneously or sequentially in various algorithms. We developed a web-based application of the model so as to visualize and compare output diagnostic algorithms when different disease prevalence and test performance characteristics are introduced. RESULTS Diagnostic algorithms with appropriate sequential testing predicted correct identification of etiology in 74% and 89% of patients in India and Cambodia, respectively, compared with 46% and 49% with simultaneous testing. The optimally performing sequential diagnostic algorithms differed in India and Cambodia due to varying disease prevalence. CONCLUSIONS Simultaneous testing is not appropriate for the diagnosis of acute undifferentiated febrile illnesses with presently available tests, which should deter the unsupervised use of multiplex diagnostic tests. The implementation of adaptive algorithms can predict better diagnosis and add value to the available RDTs. The web application of the model can serve as a tool to identify the optimal diagnostic algorithm in different epidemiological settings, while taking into account the local epidemiological variables and accuracy of available tests.
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Affiliation(s)
- Sunil Pokharel
- Centre for Tropical Medicine and Global Health, Nuffield Department of Medicine, University of Oxford, United Kingdom
- Foundation for Innovative New Diagnostics, Geneva, Switzerland
| | - Lisa J White
- Centre for Tropical Medicine and Global Health, Nuffield Department of Medicine, University of Oxford, United Kingdom
- Mahidol-Oxford Tropical Medicine Research Unit, Faculty of Tropical Medicine, Mahidol University, Bangkok, Thailand
| | - Ricardo Aguas
- Centre for Tropical Medicine and Global Health, Nuffield Department of Medicine, University of Oxford, United Kingdom
- Mahidol-Oxford Tropical Medicine Research Unit, Faculty of Tropical Medicine, Mahidol University, Bangkok, Thailand
| | - Olivier Celhay
- Mahidol-Oxford Tropical Medicine Research Unit, Faculty of Tropical Medicine, Mahidol University, Bangkok, Thailand
| | - Karell G Pellé
- Foundation for Innovative New Diagnostics, Geneva, Switzerland
| | - Sabine Dittrich
- Centre for Tropical Medicine and Global Health, Nuffield Department of Medicine, University of Oxford, United Kingdom
- Foundation for Innovative New Diagnostics, Geneva, Switzerland
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Musso D, Desprès P. Serological Diagnosis of Flavivirus-Associated Human Infections. Diagnostics (Basel) 2020; 10:E302. [PMID: 32423058 PMCID: PMC7277941 DOI: 10.3390/diagnostics10050302] [Citation(s) in RCA: 31] [Impact Index Per Article: 7.8] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/06/2020] [Revised: 05/02/2020] [Accepted: 05/04/2020] [Indexed: 12/13/2022] Open
Abstract
Arthropod-borne viruses (arboviruses) belonging to the Flavivirus genus of the Flaviviridae family, are a major public health threat in tropical and subtropical regions, and have recently become a medical concern in temperate zones. Most flaviviruses are classified as zoonotic viruses. Human flavivirus infections can be asymptomatic, responsible for unspecific symptoms in the first few days following infection, or responsible for severe complications potentially resulting in death. During the first days following symptom onset, laboratory diagnosis of acute human flavivirus infection is mainly based on molecular detection of the viral genome by RT-PCR methods, followed by the capture of specific antibodies using serological tests after the first week of infection. The detection of antibodies that have virus neutralizing activity can be used to confirm flavivirus infection. However, human flavivirus infections induce the production of cross-reactive antibodies, often making serology inconclusive. Indeed, serological diagnosis of flavivirus infection can be hampered by a patient's history of flavivirus exposure, particularly in regions where multiple antigenically related flaviviruses co-circulate. We focus our mini review on conventional immunoassays that allow the diagnosis of major flavivirus-associated human infections in basic, routine and high-profile central health centers; and the interpretation of diagnostic serology tests for patients living within different epidemiological situations.
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Affiliation(s)
- Didier Musso
- IRD, AP-HM, SSA, VITROME, IHU-Méditerranée infection, Aix Marseille Université, 13005 Marseille, France
- Laboratoire Eurofins Labazur Guyane, 35 rue Lieutenant Brassé, 97300 Cayenne, French Guiana
| | - Philippe Desprès
- INSERM U1187, CNRS UMR 9192, IRD UMR 249, Unité Mixte Processus Infectieux en Milieu Insulaire Tropical, Plateforme Technologique CYROI, Université de La Réunion, 97491 Sainte-Clotilde, La Réunion, France;
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Specificity of NS1-based immunochromatographic tests for dengue virus with regard to the Zika virus protein. Int J Infect Dis 2020; 95:276-278. [PMID: 32289563 DOI: 10.1016/j.ijid.2020.04.012] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/04/2020] [Revised: 04/02/2020] [Accepted: 04/04/2020] [Indexed: 02/01/2023] Open
Abstract
OBJECTIVES This study was performed to determine whether Dengue virus (DENV) immunochromatographic tests can detect and differentiate nonstructural protein 1 (NS1) from each of the four DENV serotypes and do not cross-react with the Zika virus (ZIKV) NS1 protein. METHODS We compared the specificity of six NS1-based DENV immunochromatographic tests (point of care) in the detection of NS1 proteins from each of the four DENV serotypes and ZIKV. The tests were performed with NS1 proteins produced in mammalian cells. Cross-reactivity was confirmed with a purified recombinant ZIKV NS1 protein and DENV+ or ZIKV+ human serum samples. RESULTS Cross-reaction was observed in 2 out of the 6 evaluated tests using cell culture supernatants containing NS1 protein of each tested virus. Cross-reactivity with ZIKV was confirmed with purified recombinant ZIKV NS1 produced in Escherichia coli. Further analyses with serum samples collected from DENV+ or ZIKV+ patients confirmed the cross-reactivity with ZIKV protein in 2 tests. CONCLUSIONS The detection of the NS1 protein is the basis for several commercially available serological DENV diagnostic tests. The present results emphasize the relevance of testing specificity of presently available NS1-based DENV serological tests and the need of adjustments of tests that cross-react with the ZIKV protein. Our results are particularly relevant for regions where both viruses are endemically found, as in the case of Brazil.
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Chong ZL, Sekaran SD, Soe HJ, Peramalah D, Rampal S, Ng CW. Diagnostic accuracy and utility of three dengue diagnostic tests for the diagnosis of acute dengue infection in Malaysia. BMC Infect Dis 2020; 20:210. [PMID: 32164538 PMCID: PMC7069157 DOI: 10.1186/s12879-020-4911-5] [Citation(s) in RCA: 17] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/18/2019] [Accepted: 02/20/2020] [Indexed: 12/15/2022] Open
Abstract
BACKGROUND Dengue is an emerging infectious disease that infects up to 390 million people yearly. The growing demand of dengue diagnostics especially in low-resource settings gave rise to many rapid diagnostic tests (RDT). This study evaluated the accuracy and utility of ViroTrack Dengue Acute - a new biosensors-based dengue NS1 RDT, SD Bioline Dengue Duo NS1/IgM/IgG combo - a commercially available RDT, and SD Dengue NS1 Ag enzyme-linked immunosorbent assay (ELISA), for the diagnosis of acute dengue infection. METHODS This prospective cross-sectional study consecutively recruited 494 patients with suspected dengue from a health clinic in Malaysia. Both RDTs were performed onsite. The evaluated ELISA and reference tests were performed in a virology laboratory. The reference tests comprised of a reverse transcription-polymerase chain reaction and three ELISAs for the detection of dengue NS1 antigen, IgM and IgG antibodies, respectively. The diagnostic performance of evaluated tests was computed using STATA version 12. RESULTS The sensitivity and specificity of ViroTrack were 62.3% (95%CI 55.6-68.7) and 95.0% (95%CI 91.7-97.3), versus 66.5% (95%CI 60.0-72.6) and 95.4% (95%CI 92.1-97.6) for SD NS1 ELISA, and 52.4% (95%CI 45.7-59.1) and 97.7% (95%CI 95.1-99.2) for NS1 component of SD Bioline, respectively. The combination of the latter with its IgM and IgG components were able to increase test sensitivity to 82.4% (95%CI 76.8-87.1) with corresponding decrease in specificity to 87.4% (95%CI 82.8-91.2). Although a positive test on any of the NS1 assays would increase the probability of dengue to above 90% in a patient, a negative result would only reduce this probability to 23.0-29.3%. In contrast, this probability of false negative diagnosis would be further reduced to 14.7% (95%CI 11.4-18.6) if SD Bioline NS1/IgM/IgG combo was negative. CONCLUSIONS The performance of ViroTrack Dengue Acute was comparable to SD Dengue NS1 Ag ELISA. Addition of serology components to SD Bioline Dengue Duo significantly improved its sensitivity and reduced its false negative rate such that it missed the fewest dengue patients, making it a better point-of-care diagnostic tool. New RDT like ViroTrack Dengue Acute may be a potential alternative to existing RDT if its combination with serology components is proven better in future studies.
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Affiliation(s)
- Zhuo Lin Chong
- Department of Social and Preventive Medicine, Faculty of Medicine, University of Malaya, Kuala Lumpur, Malaysia
- Institute for Public Health, National Institutes of Health, Ministry of Health, Setia Alam, Selangor Malaysia
| | - Shamala Devi Sekaran
- Faculty of Medicine and Biomedical Sciences, MAHSA University, Jenjarom, Selangor Malaysia
| | - Hui Jen Soe
- Department of Medical Microbiology, Faculty of Medicine, University of Malaya, Kuala Lumpur, Malaysia
| | - Devi Peramalah
- Department of Social and Preventive Medicine, Faculty of Medicine, University of Malaya, Kuala Lumpur, Malaysia
| | - Sanjay Rampal
- Department of Social and Preventive Medicine, Faculty of Medicine, University of Malaya, Kuala Lumpur, Malaysia
| | - Chiu-Wan Ng
- Department of Social and Preventive Medicine, Faculty of Medicine, University of Malaya, Kuala Lumpur, Malaysia
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Bavia L, Melanda FN, de Arruda TB, Mosimann ALP, Silveira GF, Aoki MN, Kuczera D, Sarzi ML, Junior WLC, Conchon-Costa I, Pavanelli WR, Duarte Dos Santos CN, Barreto RC, Bordignon J. Epidemiological study on dengue in southern Brazil under the perspective of climate and poverty. Sci Rep 2020; 10:2127. [PMID: 32034173 PMCID: PMC7005746 DOI: 10.1038/s41598-020-58542-1] [Citation(s) in RCA: 20] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/12/2019] [Accepted: 01/13/2020] [Indexed: 11/09/2022] Open
Abstract
Social and epidemiological aspects of dengue were evaluated in an important metropolitan area in southern Brazil, from August 2012 to September 2014. Demographic, clinical, serological data were collected from patients with acute dengue symptoms treated at public health system units (HSUs). A systematic approach to analyze the spatial and temporal distribution of cases was developed, considering the temporal cross-correlation between dengue and weather, and the spatial correlation between dengue and income over the city's census tracts. From the 878 patients with suggestive symptoms, 249 were diagnosed as positive dengue infection (28%). Considering the most statistically significant census tracts, a negative correlation was found between mean income and dengue (r = -0.65; p = 0.02; 95% CI: -0.03 to -0.91). The occurrence of dengue followed a seasonal distribution, and it was found to be three and four months delayed in relation to precipitation and temperature, respectively. Unexpectedly, the occurrence of symptomatic patients without dengue infection followed the same seasonal distribution, however its spatial distribution did not correlate with income. Through this methodology, we have found evidence that suggests a relation between dengue and poverty, which enriches the debate in the literature and sheds light on an extremely relevant socioeconomic and public health issue.
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Affiliation(s)
- Lorena Bavia
- Setor de Ciências da Saúde, Hospital de Clínicas, UFPR, Curitiba, 80060-900, Brazil
| | - Francine Nesello Melanda
- Laboratório de Parasitologia Experimental, Departamento de Ciências Patológicas, UEL, Londrina, 86057-970, Brazil
| | - Thais Bonato de Arruda
- Laboratório de Virologia Molecular do Instituto Carlos Chagas, ICC/Fiocruz/PR, Curitiba, 81350-010, Brazil
| | | | | | - Mateus Nóbrega Aoki
- Laboratório de Ciências e Tecnologias Aplicadas em Saúde do Instituto Carlos Chagas, ICC/Fiocruz/PR, Curitiba, 81350-010, Brazil
| | - Diogo Kuczera
- Laboratório de Virologia Molecular do Instituto Carlos Chagas, ICC/Fiocruz/PR, Curitiba, 81350-010, Brazil
| | - Maria Lo Sarzi
- Secretaria Municipal de Saúde de Cambé, Cambé, 86181-300, Brazil
| | | | - Ivete Conchon-Costa
- Laboratório de Parasitologia Experimental, Departamento de Ciências Patológicas, UEL, Londrina, 86057-970, Brazil
| | - Wander Rogério Pavanelli
- Laboratório de Parasitologia Experimental, Departamento de Ciências Patológicas, UEL, Londrina, 86057-970, Brazil
| | | | | | - Juliano Bordignon
- Laboratório de Virologia Molecular do Instituto Carlos Chagas, ICC/Fiocruz/PR, Curitiba, 81350-010, Brazil.
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Gahlaut SK, Savargaonkar D, Sharan C, Yadav S, Mishra P, Singh JP. SERS Platform for Dengue Diagnosis from Clinical Samples Employing a Hand Held Raman Spectrometer. Anal Chem 2020; 92:2527-2534. [PMID: 31909593 DOI: 10.1021/acs.analchem.9b04129] [Citation(s) in RCA: 39] [Impact Index Per Article: 9.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
Dengue is a serious global health concern especially in tropical and subtropical countries. About 2.5 billion of the world's population is at risk for dengue infection. Early diagnosis is the key to prevent the deterioration of health of the patient to severe illness. Laboratory diagnosis of dengue is essential for providing appropriate supportive treatment to dengue patients with febrile illness, which is difficult to diagnose clinically. Here, we demonstrate surface enhanced Raman scattering (SERS) based diagnosis of dengue virus in clinical blood samples collected from total of 102 subjects. All of the samples were well characterized by conventional NS1 antigen and IgM antibody ELISA kits. The silver nanorods array fabricated by glancing angle deposition technique were employed as SERS substrates. A small amount of patient blood serum (5 μL) was taken for analysis and the report was prepared within a minute. SERS spectra of pure NS1 protein as well as spiked in serum was also recorded separately. Principal component analysis (PCA) was employed as the statistical tool to differentiate dengue positive, dengue negative, and healthy subjects on the basis of their respective SERS spectra. This method provides a sensitive, rapid, and field deployable diagnosis of dengue at the early stage (within 5 days of the onset of symptoms).
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Affiliation(s)
- S K Gahlaut
- Department of Physics , Indian Institute of Technology Delhi , Hauz Khas , New Delhi 110016 , India
| | - D Savargaonkar
- ICMR-National Institute of Malaria Research , Dwarka , New Delhi 110077 , India
| | - C Sharan
- Department of Physics , Indian Institute of Technology Delhi , Hauz Khas , New Delhi 110016 , India
| | - Sarjana Yadav
- Department of Physics , Indian Institute of Technology Delhi , Hauz Khas , New Delhi 110016 , India
| | - P Mishra
- Department of Biochemical Engineering and Biotechnology , Indian Institute of Technology Delhi , Hauz Khas , New Delhi 110016 , India
| | - J P Singh
- Department of Physics , Indian Institute of Technology Delhi , Hauz Khas , New Delhi 110016 , India
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Bonaparte M, Zheng L, Garg S, Guy B, Lustig Y, Schwartz E, DiazGranados CA, Savarino S, Ataman-Önal Y. Evaluation of rapid diagnostic tests and conventional enzyme-linked immunosorbent assays to determine prior dengue infection. J Travel Med 2019; 26:5588085. [PMID: 31616949 DOI: 10.1093/jtm/taz078] [Citation(s) in RCA: 35] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/06/2019] [Revised: 10/07/2019] [Accepted: 10/10/2019] [Indexed: 11/13/2022]
Abstract
BACKGROUND In September 2018, the World Health Organization recommended that prevaccination screening be used with the tetravalent dengue vaccine (CYD-TDV), to ensure that only individuals with evidence of prior dengue infection (PDI) are vaccinated. Dengue rapid diagnostic tests (RDTs) would offer a potential solution for prevaccination screening at the point-of-care, but data on performance of available RDTs for identifying PDI are limited. We determined the suitability of four dengue RDTs and two conventional enzyme-linked immunosorbent assays (ELISAs) to identify PDI and evaluated cross-reactivity with co-circulating flaviviruses. UNLABELLED Methods: Specificity was assessed using 534 dengue-negative [determined by 50% plaque reduction neutralization test (PRNT50)] serum samples from USA (n = 229) and dengue-endemic regions (n = 305). Sensitivity was assessed using 270 samples from recent (n = 90) or remote (n = 90) virologically confirmed prior dengue cases, and dengue PRNT50-positive samples (n = 90). Cross-reactivity was assessed in dengue-seronegative samples that were seropositive for yellow fever (n = 57), Japanese encephalitis (n = 37), West Nile (n = 59) or Zika (n = 41). UNLABELLED Results: Dengue IgG RDTs and the Panbio ELISA exhibited favourable specificities (99-100%), higher than the Focus ELISA (95%). The RDTs had variable sensitivities (40-70%) that were lower than those of the ELISAs (≥90%). Cross-reactivity to other flaviviruses was low with RDTs (≤7%), but more significant with ELISAs (up to 51% for West Nile and 34% for Zika). No cross-reactivity to any of the four closely related flaviviruses was observed with the CTK Biotech RDT. For each SeroTest, sensitivity appeared similar in samples from individuals with recent (<13 months) vs remote (3-4 years) virologically confirmed PDI. UNLABELLED Conclusions: In general, dengue IgG RDTs were found to be more specific and less cross-reactive than the ELISAs, but the latter were more sensitive for identifying PDI cases. Currently available RDTs could be temporizing tools for rapid and safe prevaccination screening until improved RDTs with increased sensitivity become available.
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Affiliation(s)
- Matthew Bonaparte
- Global Clinical Immunology, Sanofi Pasteur, 1 Discovery Drive, Swiftwater PA 18370, USA
| | - Lingyi Zheng
- Global Biostatistics, Sanofi Pasteur, 1 Discovery Drive, Swiftwater PA 18370, USA
| | - Sanjay Garg
- Global Clinical Immunology, Sanofi Pasteur, 1 Discovery Drive, Swiftwater PA 18370, USA
| | - Bruno Guy
- Global Research, Sanofi Pasteur, 1541 Avenue Marcel Mérieux, Marcy l'Etoile 69280, France
| | - Yaniv Lustig
- Central Virology Laboratory, Public Health Services, Israel Ministry of Health, Chaim Sheba Medical Center, Ramat Gan 52621, Israel
| | - Eli Schwartz
- Institute of Geographic Medicine and Tropical Diseases, Sheba Medical Center, Ramat Gan, Israel, and Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - Carlos A DiazGranados
- Global Clinical Sciences, Sanofi Pasteur, 1 Discovery Drive, Swiftwater PA 18370, USA
| | - Stephen Savarino
- Translational Sciences and Biomarkers, Sanofi Pasteur, 1 Discovery Drive, Swiftwater PA 18370, USA
| | - Yasemin Ataman-Önal
- Translational Sciences and Biomarkers, Sanofi Pasteur, 1541 Avenue Marcel Mérieux, Marcy l'Etoile 69280, France
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35
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Kyaw AK, Ngwe Tun MM, Naing ST, Htet KKK, Htwe TT, Khaing YY, Tu Mar T, Aung T, Win KN, Tar T, Aye KS, Thant KZ, Morita K. Evaluation of commercially available three dengue rapid diagnostic test kits for diagnosis of acute dengue virus infection at the point-of-care setting in Myanmar. J Virol Methods 2019; 273:113724. [PMID: 31437465 DOI: 10.1016/j.jviromet.2019.113724] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/27/2019] [Revised: 08/05/2019] [Accepted: 08/18/2019] [Indexed: 11/19/2022]
Abstract
Early and accurate diagnosis of dengue virus (DENV) infection is very important and Rapid Diagnostic Test (RDT) Kits are been used as a point-of-care test to check DENV infection. A Hospital and Laboratory-based descriptive study was conducted at 550-bedded Mandalay Children Hospital in 2018. Acute-phase serum samples were collected from 202 dengue suspected patients to evaluate the efficacy of RDT Kits for the diagnosis of DENV infection. Commercially available three test kits which include: ((i) CareUs Dengue Combo, Korea, (ii) Humasis Dengue Combo, Korea and (iii) Wondfo Dengue Combo, China) were validated against WHO-based reference standard tests. 140/202 patients (69.3%) was confirmed to have DENV infection. All four serotypes of dengue viruses (57 DENV-1, 7 DENV-2, 6 DENV-3 and 10 DENV-4) were identified from 80 dengue confirmed patients and DENV-1 was the dominant serotype. Combining the NS-1 antigen and IgM antibody results from the CareUs Dengue Combo Kit gave the best sensitivity (92.1%, 95% CI 86.4%-96.0%) and specificity (75.8%, 95%CI 63.3%-85.8%). Among the three RDT Kits, the performance of CareUS Kit was better than the other two. This study explored the evidence of the usefulness of RDT Kits at the point-of-care setting for diagnosis of acute dengue infection.
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Affiliation(s)
- Aung Kyaw Kyaw
- Department of Medical Research (Pyin Oo Lwin Branch), Ministry of Health and Sports, Myanmar
| | - Mya Myat Ngwe Tun
- Department of Virology, Institute of Tropical Medicine, Nagasaki University, Japan.
| | - Shine Thura Naing
- Department of Medical Research (Pyin Oo Lwin Branch), Ministry of Health and Sports, Myanmar
| | - Kyaw Ko Ko Htet
- Department of Medical Research (Pyin Oo Lwin Branch), Ministry of Health and Sports, Myanmar
| | - Thein Thein Htwe
- Department of Medical Research (Pyin Oo Lwin Branch), Ministry of Health and Sports, Myanmar
| | - Yin Yin Khaing
- Department of Medical Research (Pyin Oo Lwin Branch), Ministry of Health and Sports, Myanmar
| | - Tu Tu Mar
- Department of Medical Research (Pyin Oo Lwin Branch), Ministry of Health and Sports, Myanmar
| | - Thidar Aung
- Department of Medical Research (Pyin Oo Lwin Branch), Ministry of Health and Sports, Myanmar
| | - Khin Nilar Win
- 550-bedded Mandalay Children Hospital, Ministry of Health and Sports, Myanmar
| | - Thi Tar
- 550-bedded Mandalay Children Hospital, Ministry of Health and Sports, Myanmar
| | - Khin Saw Aye
- Department of Medical Research (Pyin Oo Lwin Branch), Ministry of Health and Sports, Myanmar
| | - Kyaw Zin Thant
- Department of Medical Research (Pyin Oo Lwin Branch), Ministry of Health and Sports, Myanmar
| | - Kouichi Morita
- Department of Virology, Institute of Tropical Medicine, Nagasaki University, Japan
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Suzuki K, Nakayama EE, Saito A, Egawa A, Sato T, Phadungsombat J, Rahim R, Hasan A, Iwamoto H, Rahman M, Shioda T. Evaluation of novel rapid detection kits for dengue virus NS1 antigen in Dhaka, Bangladesh, in 2017. Virol J 2019; 16:102. [PMID: 31416485 PMCID: PMC6694664 DOI: 10.1186/s12985-019-1204-y] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/03/2019] [Accepted: 07/21/2019] [Indexed: 02/07/2023] Open
Abstract
BACKGROUND Dengue virus (DENV) infection is one of the biggest challenges for human health in the world. In addition, a secondary DENV infection sometimes causes dengue hemorrhagic fever (DHF), which frequently leads to death. For this reason, accurate diagnosis record management is useful for prediction of DHF. Therefore, the demand for DENV rapid diagnosis tests (RDTs) is increasing because these tests are easy and rapid to use. However, commercially available RDTs often show low sensitivity for DENV and cross-reactivity against other flaviviruses, especially Zika virus (ZIKV). METHODS We developed two types of novel DENV non-structural protein 1 (NS1) detection RDTs, designated TKK-1st and TKK-2nd kits. Specificities of the monoclonal antibodies (MAbs) used in these kits were confirmed by enzyme-linked immuno-sorbent assay (ELISA), dot blot, and western blot using recombinant NS1 proteins and synthetic peptides. For evaluation of sensitivity, specificity, and cross-reactivity of the novel DENV NS1 RDTs, we first used cultured DENV and other flaviviruses, ZIKV and Japanese encephalitis virus (JEV). We then used clinical specimens obtained in Bangladesh in 2017 for further evaluation of kit sensitivity and specificity in comparison with commercially available RDTs. In addition, RNA extracted from sera were used for viral genome sequencing and genotyping. RESULTS Epitopes of three out of four MAbs used in the two novel RDTs were located in amino acid positions 100 to 122 in the NS1 protein, a region that shows low levels of homology with other flaviviruses. Our new kits showed high levels of sensitivity against various serotypes and genotypes of DENV and exhibited high levels of specificity without cross-reactivity against ZIKV and JEV. In clinical specimens, our RDTs showed sensitivities of 96.0% (145/151, TKK-1st kit) and 96.7% (146/151, TKK-2nd kit), and specificities of 98.0% (98/100, TKK-1st kit and TKK-2nd kit). On the other hand, in the case of the commercially available SD Bioline RDT, sensitivity was 83.4% (126/151) and specificity was 99.0% (99/100) against the same clinical specimens. CONCLUSIONS Our novel DENV NS1-targeting RDTs demonstrated high levels of sensitivity and lacked cross-reactivity against ZIKV and JEV compared with commercially available RDTs.
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Affiliation(s)
- Keita Suzuki
- Department of Viral Infections, Research Institute for Microbial Diseases, Osaka University, 3-1, Yamada-oka, Suita, Osaka, 565-0871 Japan
- POCT Business Unit, TANAKA Kikinzoku Kogyo K.K, 2-73, Shinmachi, Hiratsuka, Kanagawa 254-0076 Japan
| | - Emi E. Nakayama
- Department of Viral Infections, Research Institute for Microbial Diseases, Osaka University, 3-1, Yamada-oka, Suita, Osaka, 565-0871 Japan
| | - Akatsuki Saito
- Department of Viral Infections, Research Institute for Microbial Diseases, Osaka University, 3-1, Yamada-oka, Suita, Osaka, 565-0871 Japan
| | - Akio Egawa
- Department of Viral Infections, Research Institute for Microbial Diseases, Osaka University, 3-1, Yamada-oka, Suita, Osaka, 565-0871 Japan
| | - Tairyu Sato
- Department of Viral Infections, Research Institute for Microbial Diseases, Osaka University, 3-1, Yamada-oka, Suita, Osaka, 565-0871 Japan
| | - Juthamas Phadungsombat
- Mahidol-Osaka Center for Infectious Diseases, Mahidol University, 420/6 Ratchawithi road, Ratchathewi, Bangkok, 10400 Thailand
| | - Rummana Rahim
- Apollo Hospitals Dhaka, Plot-81, Block-E, Bashundhara R/A, Dhaka, 1229 Bangladesh
| | - Abu Hasan
- Apollo Hospitals Dhaka, Plot-81, Block-E, Bashundhara R/A, Dhaka, 1229 Bangladesh
| | - Hisahiko Iwamoto
- POCT Business Unit, TANAKA Kikinzoku Kogyo K.K, 2-73, Shinmachi, Hiratsuka, Kanagawa 254-0076 Japan
| | - Mizanur Rahman
- Apollo Hospitals Dhaka, Plot-81, Block-E, Bashundhara R/A, Dhaka, 1229 Bangladesh
| | - Tatsuo Shioda
- Department of Viral Infections, Research Institute for Microbial Diseases, Osaka University, 3-1, Yamada-oka, Suita, Osaka, 565-0871 Japan
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Goncalves A, Peeling RW, Chu MC, Gubler DJ, de Silva AM, Harris E, Murtagh M, Chua A, Rodriguez W, Kelly C, Wilder-Smith A. Innovative and New Approaches to Laboratory Diagnosis of Zika and Dengue: A Meeting Report. J Infect Dis 2019; 217:1060-1068. [PMID: 29294035 DOI: 10.1093/infdis/jix678] [Citation(s) in RCA: 48] [Impact Index Per Article: 9.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/18/2017] [Accepted: 12/22/2017] [Indexed: 12/30/2022] Open
Abstract
Epidemics of dengue, Zika, and other arboviral diseases are increasing in frequency and severity. Current efforts to rapidly identify and manage these epidemics are limited by the short diagnostic window in acute infection, the extensive serologic cross-reactivity among flaviviruses, and the lack of point-of-care diagnostic tools to detect these viral species in primary care settings. The Partnership for Dengue Control organized a workshop to review the current landscape of Flavivirus diagnostic tools, identified current gaps, and developed strategies to accelerate the adoption of promising novel technologies into national programs. The rate-limiting step to bringing new diagnostic tools to the market is access to reference materials and well-characterized clinical samples to facilitate performance evaluation. We suggest the creation of an international laboratory-response consortium for flaviviruses with a decentralized biobank of well-characterized samples to facilitate assay validation. Access to proficiency panels are needed to ensure quality control, in additional to in-country capacity building.
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Affiliation(s)
| | | | - May C Chu
- Department of Epidemiology, Colorado School of Public Health, University of Colorado, Anschutz Medical Center, Aurora
| | - Duane J Gubler
- Emerging Infectious Diseases Program, Duke-NUS Medical School, Singapore
| | - Aravinda M de Silva
- Department of Microbiology and Immunology, University of North Carolina School of Medicine, Chapel Hill
| | - Eva Harris
- Division of Infectious Diseases and Vaccinology, School of Public Health, University of California, Berkeley
| | | | | | | | | | - Annelies Wilder-Smith
- Lee Kong Chian School of Medicine, Singapore.,Institute of Public Health, University of Heidelberg, Germany.,Department of Global Health and Epidemiology, University of Umea, Sweden
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38
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Austin Suthanthiraraj PP, Sen AK. Localized surface plasmon resonance (LSPR) biosensor based on thermally annealed silver nanostructures with on-chip blood-plasma separation for the detection of dengue non-structural protein NS1 antigen. Biosens Bioelectron 2019; 132:38-46. [PMID: 30851494 DOI: 10.1016/j.bios.2019.02.036] [Citation(s) in RCA: 38] [Impact Index Per Article: 7.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/29/2018] [Revised: 02/05/2019] [Accepted: 02/15/2019] [Indexed: 12/29/2022]
Abstract
Early diagnosis of dengue biomarkers by employing a technology that is less labor- and time-intensive and offers higher sensitivity and lower limits of detection would find great significance in the developing world. Here, we report the development of a biosensor that exploits the localized surface plasmon resonance (LSPR) effect of silver nanostructures, created via thermal annealing of thin metal film, to detect dengue NS1 antigen, which appears as early as the onset of infection. The biosensor integrates membrane-based blood-plasma separation to develop lab-on-chip device that facilitates rapid diagnosis (within 30 min) of dengue NS1 antigen from a small volume (10 µL) of whole blood. The refractive index (RI) sensitivity of the LSPR biosensor was verified by using aqueous glycerol (0-100 wt%) which showed that it is sufficiently sensitive to detect 10-3 change in RI, which is comparable to that observed with protein-protein interaction. The RI sensitivity was utilized to demonstrate protein binding by using bovine serum albumin and detection of antibody-antigen immune reaction by binding human chorionic gonadotropin antigen to immunoglobulin antibody immobilized in our LSPR biosensor. Next, we demonstrated the detection of NS1 in plasma obtained via centrifugation and in plasma separated on-chip. From 10 µL of whole blood spiked with NS1 antigen, our biosensor reliably detects 0.06 µg/mL of NS1, which lies within the clinical limit observed during the first seven days of infection, with a sensitivity of 9 nm/(µg/mL). These results confirm that the proposed LSPR biosensor can potentially be used in point-of-care dengue diagnostics.
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Affiliation(s)
| | - Ashis Kumar Sen
- Department of Mechanical Engineering, Indian Institute of Technology Madras, Chennai 600036, India.
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39
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Boillat-Blanco N, Klaassen B, Mbarack Z, Samaka J, Mlaganile T, Masimba J, Franco Narvaez L, Mamin A, Genton B, Kaiser L, D'Acremont V. Dengue fever in Dar es Salaam, Tanzania: clinical features and outcome in populations of black and non-black racial category. BMC Infect Dis 2018; 18:644. [PMID: 30541456 PMCID: PMC6292068 DOI: 10.1186/s12879-018-3549-z] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/06/2017] [Accepted: 11/23/2018] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Although the incidence of dengue across Africa is high, severe dengue is reported infrequently. We describe the clinical features and the outcome of dengue according to raceduring an outbreak in Dar es Salaam, Tanzania that occurred in both native and expatriate populations. METHODS Adults with confirmed dengue (NS1 and/or IgM on rapid diagnostic test and/or PCR positive) were included between December 2013 and July 2014 in outpatient clinics. Seven-day outcome was assessed by a visit or a call. Association between black race and clinical presentation, including warning signs, was assessed by logistic regression adjusted for age, malaria coinfection, secondary dengue and duration of symptoms at inclusion. The independent association between demographic and comorbidities characteristics of the patients and severe dengue was evaluated by multivariate logistic regression that included potential confounders. RESULTS After exclusion of 3 patients of mixed race, 431 patients with dengue (serotype 2, genotype Cosmopolitan) were included: 241 of black and 190 of non-black race. Black patients were younger (median age 30 versus 41 years; p < 0.001) and attended care after a slightly longer duration of symptoms (median of 2.9 versus 2.7 days; p = 0.01). Malaria coinfection was not significantly different between black (5%) and non-black (1.6%) patients (p = 0.06). The same proportion of patients in both group had secondary dengue (13 and 14%; p = 0.78). Among warning signs, only mucosal bleed was associated with race, black race being protective (adjusted OR 0.44; 95% CI 0.21-0.92). Overall, 20 patients (4.7%) presented with severe dengue. Non-black race (adjusted OR 3.9; 95% CI 1.3-12) and previously known diabetes (adjusted OR 43; 95% CI 5.2-361) were independently associated with severe dengue. CONCLUSIONS Although all patients were infected with the same dengue virus genotype, black race was independently protective against a severe course of dengue, suggesting the presence of protective genetic or environmental host factors among people of African ancestry. The milder clinical presentation of dengue in black patients might partly explain why dengue outbreaks are under-reported in Africa and often mistaken for malaria. These results highlight the need to introduce point-of-care tests, beside the one for malaria, to detect outbreaks and orientate diagnosis. TRIAL REGISTRATION Clinicaltrials.gov Identifier: NCT01947075 , retrospectively registered on the 13 of September 2014.
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Affiliation(s)
- Noémie Boillat-Blanco
- Ifakara Health Institute, Dar es Salaam, United Republic of Tanzania. .,Swiss Tropical and Public Health Institute, Basel, Switzerland. .,Department of Sciences, University of Basel, Basel, Switzerland. .,Infectious Diseases Service, University Hospital of Lausanne (CHUV), Rue du Bugnon 46, 1011, Lausanne, Switzerland.
| | | | - Zainab Mbarack
- Mwananyamala Hospital, Dar es Salaam, United Republic of Tanzania
| | - Josephine Samaka
- Ifakara Health Institute, Dar es Salaam, United Republic of Tanzania
| | - Tarsis Mlaganile
- Ifakara Health Institute, Dar es Salaam, United Republic of Tanzania
| | - John Masimba
- Ifakara Health Institute, Dar es Salaam, United Republic of Tanzania
| | - Leticia Franco Narvaez
- Arbovirus and imported viral diseases laboratory, National Center of Microbiology, Madrid, Spain
| | - Aline Mamin
- Virology laboratory, University of Geneva, University Hospital of Geneva, Geneva, Switzerland
| | - Blaise Genton
- Swiss Tropical and Public Health Institute, Basel, Switzerland.,Infectious Diseases Service, University Hospital of Lausanne (CHUV), Rue du Bugnon 46, 1011, Lausanne, Switzerland.,Department of Ambulatory Care and Community Medicine, University Hospital of Lausanne, Rue du Bugnon 46, 1011, Lausanne, Switzerland
| | - Laurent Kaiser
- Virology laboratory, University of Geneva, University Hospital of Geneva, Geneva, Switzerland
| | - Valérie D'Acremont
- Swiss Tropical and Public Health Institute, Basel, Switzerland. .,Department of Ambulatory Care and Community Medicine, University Hospital of Lausanne, Rue du Bugnon 46, 1011, Lausanne, Switzerland.
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Abstract
BACKGROUND Morbidity and mortality from influenza A (Flu A) have increased in recent years. Timely diagnosis and management are critical for disease control. Therefore, the development of a rapid, accurate, and portable analytical method for on-site analysis is imperative. OBJECTIVES The aim of this work was to develop a rapid, on-site, automated assay for the detection of Flu A and to evaluate the assay. METHODS A handheld instrument (TD-01) based on capillary convective polymerase chain reaction (PCR) was developed for rapid on-site detection of Flu A. Since a previous version of the instrument, an automated motion mechanism has been introduced to TD-01 to achieve RNA automated testing. The primers and probe used for Flu A detection were designed according to the Flu A gene sequence of matrix proteins. Finally, we evaluated the detection spectra, sensitivity, specificity, and diagnostic performance of the assay. RESULTS The TD-01 was able to successfully automatically detect Flu A RNA within 30 min. Results for serially diluted viruses indicated that the lower limit of detection for Flu A was 0.1 TCID50/ml (50% tissue culture infective dose). After evaluating known virus stocks, including 15 strains of Flu A, four strains of Flu B, and two strains of respiratory syncytial virus (RSV), the assay had a favorable detection spectrum and no obvious cross-reactivity. Method verification based on 554 clinical samples indicated that the sensitivity and specificity of TD-01 were 98.30% (231/235) and 98.75% (315/319), respectively. CONCLUSIONS The results indicate that Flu A detection by TD-01 is particularly suitable for on-site testing and has the potential for application in point-of-care testing.
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Zongo S, Carabali M, Munoz M, Ridde V. Dengue rapid diagnostic tests: Health professionals' practices and challenges in Burkina Faso. SAGE Open Med 2018; 6:2050312118794589. [PMID: 30147936 PMCID: PMC6100125 DOI: 10.1177/2050312118794589] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/06/2018] [Accepted: 07/23/2018] [Indexed: 12/23/2022] Open
Abstract
Objectives Dengue fever remains unrecognized and under-reported in Africa due to several factors, including health professionals' lack of awareness, important prevalence of other febrile illnesses, most of which are treated presumptively as malaria, and the absence of surveillance systems. In Burkina Faso, health centers have no diagnostic tools to identify and manage dengue, which remains ignored, despite the evidence of seasonal outbreaks in recent years. A qualitative study was conducted to analyze the use of rapid diagnostic tests in six health and social promotion centers (i.e. health-care centers, from the French Centers de Santé et de Promotion Sociale) of Ouagadougou (Burkina Faso) in an exploratory research context. Methods Dengue rapid diagnostic tests were introduced into fever-related consultations from December 2013 to January 2014. In-depth individual interviews were conducted in May and June 2014 with 32 health professionals. Results Prior to the introduction of the tests, dengue was not well known or diagnosed by health professionals during consultations. Most febrile cases were routinely presumed to be malaria and treated accordingly. With training and routine use of rapid diagnostic tests, health professionals became more knowledgeable about dengue, improving the diagnosis of non-malaria febrile cases and its management, and better prescription practices. Conclusions In a context of dengue re-emergence and high prevalence of other febrile illnesses, having rapid diagnostic tools available, especially during epidemics reinforces health professionals' diagnostic and prescribing capacities, allowing an opportune and accurate case management and facilitates diseases surveillance.
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Affiliation(s)
- Sylvie Zongo
- Département Socio-économie et Anthropologie du Développement, Institut des Sciences des Sociétés, Centre National de la Recherche Scientifique et Technologique, Ouagadougou, Burkina Faso
| | - Mabel Carabali
- Department of Epidemiology, Biostatistics and Occupational Health, McGill University Health Centre, Montreal, QC, Canada
| | - Marie Munoz
- Faculté de médicine, Université de Montréal, Montreal, QC, Canada
| | - Valéry Ridde
- IRD (French Institute For Research on sustainable Development), CEPED (IRD-Université Paris Descartes), Universités Paris Sorbonne Cités, ERL INSERM SAGESUD, Paris, France
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Chen L, Wang H, Guo T, Xiao C, Liu L, Zhang X, Liu B, Li P, Liu A, Li B, Li B, Mao Y. A rapid point-of-care test for dengue virus-1 based on a lateral flow assay with a near-infrared fluorescent dye. J Immunol Methods 2018; 456:23-27. [DOI: 10.1016/j.jim.2018.02.005] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/15/2017] [Revised: 02/06/2018] [Accepted: 02/13/2018] [Indexed: 10/18/2022]
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Murugananthan K, Coonghe PAD, Ketheesan N, Noordeen F. Comparison of a rapid immuno-chromatography assay with a standard ELISA for the detection of IgM and IgG antibodies against dengue viruses. Virusdisease 2018; 29:199-202. [PMID: 29911153 DOI: 10.1007/s13337-018-0440-x] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/04/2017] [Accepted: 02/26/2018] [Indexed: 10/17/2022] Open
Abstract
A total of 765 blood samples collected from dengue suspected patients admitted to a Teaching Hospital in Sri Lanka were used to compare a rapid ICT assay with a standard ELISA for the detection of anti-dengue virus (DENV) IgM and IgG. Detection accuracy indices including sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV), Chi square and Cohen's kappa values were determined for the ICT assay using the ELISA as a comparator for the detection of anti-DENV IgM and IgG. The rapid ICT assay showed a sensitivity of 64%, specificity of 75%, NPV of 68% and PPV of 72% for anti-DENV IgM detection. However, all the accuracy indices were relatively higher for the anti-DENV IgG detection by the ICT assay than those for anti-DENV IgM detection. Despite the low sensitivity for anti-DENV IgM detection by the ICT assay, considering the limitations in using ELISAs in resource limited regions, rapid ICT assays would be useful for the detection of more recent DENV infections. As many patients present after fever days 5 in the study area, anti-DENV IgM/IgG would be the suitable marker to be detected by rapid ICT assays in such areas.
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Affiliation(s)
- Kalamathy Murugananthan
- 1Department of Microbiology, Faculty of Medicine, University of Jaffna, Jaffna, Sri Lanka.,5Department of Microbiology, Faculty of Medicine, University of Peradeniya, Peradeniya, Sri Lanka
| | | | - Natkunam Ketheesan
- 3College of Public Health, Medical and Veterinary Sciences, James Cook University, Townsville, QLD Australia.,4University of New England, Armidale, NSW 2351 Australia
| | - Faseeha Noordeen
- 5Department of Microbiology, Faculty of Medicine, University of Peradeniya, Peradeniya, Sri Lanka
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Predicting the severity of dengue fever in children on admission based on clinical features and laboratory indicators: application of classification tree analysis. BMC Pediatr 2018. [PMID: 29534694 PMCID: PMC5850907 DOI: 10.1186/s12887-018-1078-y] [Citation(s) in RCA: 32] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/27/2023] Open
Abstract
Background Dengue fever is a re-emerging viral disease commonly occurring in tropical and subtropical areas. The clinical features and abnormal laboratory test results of dengue infection are similar to those of other febrile illnesses; hence, its accurate and timely diagnosis for providing appropriate treatment is difficult. Delayed diagnosis may be associated with inappropriate treatment and higher risk of death. Early and correct diagnosis can help improve case management and optimise the use of resources such as hospital staff, beds, and intensive care equipment. The goal of this study was to develop a predictive model to characterise dengue severity based on early clinical and laboratory indicators using data mining and statistical tools. Methods We retrieved data from a study of febrile illness in children at Angkor Hospital for Children, Cambodia. Of 1225 febrile episodes recorded, 198 patients were confirmed to have dengue. A classification and regression tree (CART) was used to construct a predictive decision tree for severe dengue, while logistic regression analysis was used to independently quantify the significance of each parameter in the decision tree. Results A decision tree algorithm using haematocrit, Glasgow Coma Score, urine protein, creatinine, and platelet count predicted severe dengue with a sensitivity, specificity, and accuracy of 60.5%, 65% and 64.1%, respectively. Conclusions The decision tree we describe, using five simple clinical and laboratory indicators, can be used to predict severe cases of dengue among paediatric patients on admission. This algorithm is potentially useful for guiding a patient-monitoring plan and outpatient management of fever in resource-poor settings.
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Reliable Serological Testing for the Diagnosis of Emerging Infectious Diseases. ADVANCES IN EXPERIMENTAL MEDICINE AND BIOLOGY 2018; 1062:19-43. [PMID: 29845523 DOI: 10.1007/978-981-10-8727-1_3] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/24/2022]
Abstract
Climate change, increased urbanization and international travel have facilitated the spread of mosquito vectors and the viral species they carry. Zika virus (ZIKV) is currently spreading in the Americas, while dengue virus (DENV) and chikungunya virus (CHIKV) have already become firmly established in most tropical and also many non-tropical regions. ZIKV, DENV and CHIKV overlap in their endemic areas and cause similar clinical symptoms, especially in the initial stages of infection. Infections with each of these viruses can lead to severe complications, and co-infections have been reported. Therefore, laboratory analyses play an important role in differential diagnostics. A timely and accurate diagnosis is crucial for patient management, prevention of unnecessary therapies, rapid adoption of vector control measures, and collection of epidemiological data.There are two pillars to diagnosis: direct pathogen detection and the determination of specific antibodies. Serological tests provide a longer diagnostic window than direct methods, and are suitable for diagnosing acute and past infections, for disease surveillance and for vaccination monitoring. ELISA and indirect immunofluorescence test (IIFT) systems based on optimized antigens enable sensitive and specific detection of antibodies against ZIKV, DENV and CHIKV in patient serum or plasma. In recent years, Euroimmun (Lübeck, Germany) has developed numerous test systems for the serological diagnosis of (re-)emerging diseases, including a very sensitive and specific anti-ZIKV ELISA.
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Lim JK, Alexander N, Di Tanna GL. A systematic review of the economic impact of rapid diagnostic tests for dengue. BMC Health Serv Res 2017; 17:850. [PMID: 29284474 PMCID: PMC5747037 DOI: 10.1186/s12913-017-2789-8] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/09/2017] [Accepted: 12/11/2017] [Indexed: 12/20/2022] Open
Abstract
BACKGROUND Dengue fever is rapidly expanding geographically, with about half of the world's population now at risk. Among the various diagnostic options, rapid diagnostic tests (RDTs) are convenient and prompt, but limited in terms of accuracy and availability. METHODS A systematic review was conducted of published data on the use of RDTs for dengue with respect to their economic impact. The search was conducted with combinations of key search terms, including "((Dengue[Title]) AND cost/economic)" and "rapid diagnostic test/assay (or point-of-care)". Articles with insufficient report on cost/economic aspect of dengue RDTs, usually on comparison of different RDTs or assessment of novel rapid diagnostic tools, were excluded. This review has been registered in the PROSPERO International prospective register of systematic reviews (registry #: CRD42015017775). RESULTS Eleven articles were found through advanced search on Pubmed. From Embase and Web of Science, two and 14 articles were obtained, respectively. After removal of duplicate items, title screening was done on 21 published works and 12 titles, including 2 meeting abstracts, were selected for abstract review. For full-text review, by two independent reviewers, 5 articles and 1 meeting abstract were selected. Among these, the abstract was referring to the same study results as one of the articles. After full text review, two studies (two articles and one abstract) were found to report on cost-wise or economic benefits of dengue RDTs and were selected for data extraction. One study found satisfactory performance of IgM-based Panbio RDT, concluding that it would be cost-effective in endemic settings. The second study was a modeling analysis and showed that a dengue RDT would not be advantageous in terms of cost and effectiveness compared to current practice of antibiotics prescription for acute febrile illness. CONCLUSIONS Despite growing use of RDTs in research and clinical settings, there were limited data to demonstrate an economic impact. The available two studies reached different conclusions on the cost-effectiveness of dengue RDTs, although only one of the two studies reported outcomes from cost-effectiveness analysis of dengue and the other was considering febrile illness more generally. Evidence of such an impact would require further quantitative economic studies.
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Affiliation(s)
- Jacqueline Kyungah Lim
- Global Dengue and Aedes-transmitted Diseases Consortium (GDAC), International Vaccine Institute (IVI), SNU Research Park, Gwankak-ro 1, Seoul, Gwanak-gu 151-191 South Korea
- Epidemiology and Public Health Department, London School of Hygiene and Tropical Medicine, London, UK
| | - Neal Alexander
- Epidemiology and Public Health Department, London School of Hygiene and Tropical Medicine, London, UK
| | - Gian Luca Di Tanna
- Centre for Primary Care and Public health, Queen Mary University of London, London, UK
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Vickers I, Harvey K, Nelson K, Brown M, Bullock-DuCasse M, Lindo J. Evaluation of OneStep Dengue NS1 RapiDip™ InstaTest and OneStep Dengue Fever IgG/IgM RapiCard™ InstaTest during the course of a dengue type 1 epidemic. Diagn Microbiol Infect Dis 2017; 89:271-275. [PMID: 29021087 DOI: 10.1016/j.diagmicrobio.2017.08.019] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/24/2017] [Revised: 07/26/2017] [Accepted: 08/22/2017] [Indexed: 10/19/2022]
Abstract
We determined the diagnostic performance of the OneStep NS1 and the OneStep IgG/IgM RDT kits against a panel of samples which comprised of 174 dengue positive and 165 dengue negative sera characterized by three reference enzyme-linked immunosorbent assays (ELISAs). The diagnostic sensitivities of the OneStep kits for the detection of individual biomarkers of NS1, IgM and IgG were 90% (95% CI: 82.1-94.7), 32.4% (95% CI: 24.8-40.8) and 44.4% (95% CI: 38.2-50.7), respectively. The combination of the OneStep IgG/IgM kit with the OneStep NS1 kit demonstrated significantly higher sensitivities for the combined NS1/IgM (96.8%; 95% CI: 90.9-99.3) and NS1/IgM/IgG (99.5%; 95% CI: 97.1-99.9)(P<0.001). In conclusion, the OneStep NS1 kit has high sensitivity and specificity and is highly recommended for use. The low sensitivities for IgG (44.4%) and for IgM (32.4%) of the OneStep IgG/IgM kit when used alone suggest it is best used in combination with the OneStep NS1 kit to enhance its overall diagnostic performance.
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Affiliation(s)
- Ivan Vickers
- Department of Microbiology, The University of the West Indies, Mona, Kingston 7, Jamaica.
| | | | - Kereann Nelson
- Department of Microbiology, The University of the West Indies, Mona, Kingston 7, Jamaica
| | - Michelle Brown
- Department of Microbiology, The University of the West Indies, Mona, Kingston 7, Jamaica
| | | | - John Lindo
- Department of Microbiology, The University of the West Indies, Mona, Kingston 7, Jamaica
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Waggoner JJ, Gresh L, Mohamed-Hadley A, Balmaseda A, Soda KJ, Abeynayake J, Sahoo MK, Liu Y, Kuan G, Harris E, Pinsky BA. Characterization of Dengue Virus Infections Among Febrile Children Clinically Diagnosed With a Non-Dengue Illness, Managua, Nicaragua. J Infect Dis 2017; 215:1816-1823. [PMID: 28863466 PMCID: PMC5853235 DOI: 10.1093/infdis/jix195] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/23/2017] [Accepted: 04/21/2017] [Indexed: 01/25/2023] Open
Abstract
Background We sought to characterize dengue virus (DENV) infections among febrile children enrolled in a pediatric cohort study who were clinically diagnosed with a non-dengue illness ("C cases"). Methods DENV infections were detected and viral load quantitated by real-time reverse transcription-polymerase chain reaction in C cases presenting between January 2007 and January 2013. Results One hundred forty-one of 2892 C cases (4.88%) tested positive for DENV. Of all febrile cases in the study, DENV-positive C cases accounted for an estimated 52.0% of patients with DENV viremia at presentation. Compared with previously detected, symptomatic dengue cases, DENV-positive C cases were significantly less likely to develop long-lasting humoral immune responses to DENV, as measured in healthy annual serum samples (79.7% vs 47.8%; P < .001). Humoral immunity was associated with viral load at presentation: 40 of 43 patients (93.0%) with a viral load ≥7.0 log10 copies/mL serum developed the expected rise in anti-DENV antibodies in annual samples versus 13 of 68 (19.1%) patients with a viral load below this level (P < .001). Conclusions Antibody responses to DENV-positive C cases differ from responses to classic symptomatic dengue. These findings have important implications for DENV transmission modeling, immunology, and epidemiologic surveillance.
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Affiliation(s)
- Jesse J Waggoner
- Department of Medicine, Division of Infectious Diseases and Geographic Medicine
| | | | - Alisha Mohamed-Hadley
- Department of Pathology, Stanford University School of Medicine, Stanford, California
| | - Angel Balmaseda
- National Virology Laboratory, Centro Nacional de Diagnóstico y Referencia, Ministry of Health
| | - K James Soda
- Department of Scientific Computing, Florida State University, Tallahassee
| | - Janaki Abeynayake
- Department of Pathology, Stanford University School of Medicine, Stanford, California
| | - Malaya K Sahoo
- Department of Pathology, Stanford University School of Medicine, Stanford, California
| | - Yuanyuan Liu
- Department of Pathology, Stanford University School of Medicine, Stanford, California
| | - Guillermina Kuan
- Centro de Salud Sócrates Flores Vivas, Ministry of Health, Managua, Nicaragua
| | - Eva Harris
- Division of Infectious Diseases and Vaccinology, School of Public Health, University of California, Berkeley
| | - Benjamin A Pinsky
- Department of Medicine, Division of Infectious Diseases and Geographic Medicine
- Department of Pathology, Stanford University School of Medicine, Stanford, California
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Kajeguka DC, Msonga M, Schiøler KL, Meyrowitsch DW, Syrianou P, Tenu F, Alifrangis M, Mosha FW, Kavishe RA. Individual and environmental risk factors for dengue and chikungunya seropositivity in North-Eastern Tanzania. Infect Dis Health 2017. [DOI: 10.1016/j.idh.2017.04.005] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2022]
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Analytical Tools to Improve Optimization Procedures for Lateral Flow Assays. Diagnostics (Basel) 2017; 7:diagnostics7020029. [PMID: 28555034 PMCID: PMC5489949 DOI: 10.3390/diagnostics7020029] [Citation(s) in RCA: 66] [Impact Index Per Article: 9.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/18/2017] [Revised: 05/20/2017] [Accepted: 05/24/2017] [Indexed: 01/01/2023] Open
Abstract
Immunochromatographic or lateral flow assays (LFAs) are inexpensive, easy to use, point-of-care medical diagnostic tests that are found in arenas ranging from a doctor’s office in Manhattan to a rural medical clinic in low resource settings. The simplicity in the LFA itself belies the complex task of optimization required to make the test sensitive, rapid and easy to use. Currently, the manufacturers develop LFAs by empirical optimization of material components (e.g., analytical membranes, conjugate pads and sample pads), biological reagents (e.g., antibodies, blocking reagents and buffers) and the design of delivery geometry. In this paper, we will review conventional optimization and then focus on the latter and outline analytical tools, such as dynamic light scattering and optical biosensors, as well as methods, such as microfluidic flow design and mechanistic models. We are applying these tools to find non-obvious optima of lateral flow assays for improved sensitivity, specificity and manufacturing robustness.
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