1Assistant Professor, Department of Microbiology, Terna Medical College and Hospital, Nerul, Mumbai, Maharashtra, INDIA.
2Professor and HOD, Department of Microbiology, LTMC and Sion Hospital, Sion. Mumbai, Maharashtra, INDIA.
3Professor and HOD, Department of Microbiology, Seth G.S. Medical College and KEM Hospital, Parel, Mumbai, Maharashtra, INDIA.
Academic Editor : Dr. Aher K.R.
Abstract
Introduction: Early and accurate diagnosis of dengue is important for appropriate therapy. No single test can satisfactorily diagnose dengue at all stages of infection. Tertiary care centres face challenge of diagnosis of dengue using a single sample. Aims: To study diagnostic utility of RT –PCR, NS1 antigen detection along with IgM antibody detection tests using single serum sample per patient. Settings and Design: cross-sectional study. Methods and Material: Serum samples were collected from 181 patients clinically suspected of dengue infection at the time of admission. Samples were tested by using Panbio NS1 antigen ELISA, Real-time reverse transcriptase PCR (RT-PCR) and IgM ELISA. Statistical analysis used: Results were analyzed using Fisher’s exact testResults: Of the 181 patients tested, 72 were positive by any of the three tests i.e. RT-PCR, NS1antigen ELISA or IgM ELISA. Considering PCR as gold standard, the sensitivity, specificity, positive predictive value and negative predictive value of NS1antigen ELISA was 46.15%, 93.51%, 78.26 % and 77.42% and that of combined usage of NS1antigen ELISA along with IgM ELISA was 71.79%, 84.42%, 70% and 85.53% respectively. The sensitivity of NS1antigen ELISA alone and in combination with IgM ELISA was significantly low in comparison with PCR. Conclusions: PCR is the preferred test to diagnose dengue infection in patients with acute stage of infection. In setups lacking PCR facility, NS1antigen ELISA can be used to confirm the diagnosis using single serum sample.
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