Rational use of diagnostics for acute dengue infection

Abstract

Introduction: Large numbers of suspected cases of dengue are admitted to hospital for monitoring and care. Considering the ongoing limitations on health budgets, we assessed the sensitivity and implications of NS1/IgM/IgG lateral flow immunochromatographic assay (LFIA) and reverse transcriptase polymerase chain reaction (RT-PCR) in the management of hospitalised patients with acute undifferentiated febrile illness (AUFI). Methods: We prospectively recruited 151 patients admitted to a district hospital in the Western Province within seven days of fever onset. Data were collected on presumed diagnosis, investigations and treatment on admission. Serum samples were separated and stored at -80°C pending LFIA for NS1, IgM and IgG and RT-PCR. Sensitivity was compared to a composite gold standard of RT-PCR and/or NS1 positivity.