期刊论文详细信息
BMC Infectious Diseases
Accuracy of clinical criteria and an immunochromatographic strip test for dengue diagnosis in a DENV-4 epidemic
Research Article
Rita Maria Ribeiro Nogueira1  Flavia Barreto dos Santos1  Regina Paiva Daumas2  Sonia Regina Lambert Passos3  Sibelle Nogueira Buonora3  Yara Hahr Marques Hökerberg3  Diana Neves Rodrigues de Oliveira3  Fernanda Moisés Quintela3  Cleber Nascimento do Carmo4 
[1] Flavivirus Laboratory, Oswaldo Cruz Institute, Oswaldo Cruz Foundation, Rio de Janeiro, Brazil;Germano Sinval Faria Teaching Primary Care Center, National School of Public Health, Oswaldo Cruz Foundation, Rio de Janeiro, Brazil;Laboratory of Clinical Epidemiology, Evandro Chagas National Institute of Infectious Diseases, Oswaldo Cruz Foundation, Rio de Janeiro, Brazil;National School of Public Health, Oswaldo Cruz Foundation, Rio de Janeiro, Brazil;
关键词: Dengue;    Accuracy;    Sensitivity;    Specificity;    Diagnosis;    Point-of-care systems;    NS1;   
DOI  :  10.1186/s12879-016-1368-7
 received in 2015-08-19, accepted in 2016-01-22,  发布年份 2016
来源: Springer
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【 摘 要 】

BackgroundEarly diagnosis of dengue infection is important for decision-making and timely implementation of therapeutic measures. Although rapid NS1 assays have been used for dengue diagnosis since 2008, their performance in DENV-4 cases has not yet been fully assessed.MethodsWe evaluated the accuracy of NS1 Bioeasy™ immunochromatographic strip test and of three clinical criteria for dengue diagnosis. Patients presenting at an emergency care center within 72 h of an acute febrile illness during the 2013 DENV-4 epidemic in Rio de Janeiro were consecutively enrolled for clinical and laboratory evaluation. We classified patients as suspected dengue or not according to three clinical criteria: WHO 2009, WHO 1997, and INI-FIOCRUZ. Dengue diagnosis was defined by RNA detection using RT-PCR and the negative cases were negative for all dengue serotypes and also Platelia™ NS1 ELISA. We obtained accuracy indices for NS1 Bioeasy™ alone and in combination with the clinical criteria.ResultsRT-PCR for DENV-4 was positive in 148 out of 325 patients. Positive likelihood ratio, sensitivity, and specificity of NS1 Bioeasy™ with WHO 2009, WHO 1997, and INI-FIOCRUZ criteria were 22.6 (95 % CI 7.2–70.6), 40.6 % (95 % CI 32.3–49.3), and 98.2 % (95 % CI 94.9–99.6); 18.3 (95 % CI 6.8–49.2), 44.2 (95 % CI 35.8–52.9), 97.6 (95 % CI 94.0–99.3); 26.2 (95 % CI 6.5–106.5), 29.7 (95 % CI 22.4–37.8), 98.9 (95 % CI 96.0–99.9), respectively. WHO 1997 clinical criteria presented high sensitivity to rule out disease, but extremely low specificity. INI-FIOCRUZ had moderate sensitivity and specificity, and could target a group to a more specific test.ConclusionsAlthough the large rates of false negative results using NS1 Bioeasy™ rapid test advise against its use for triaging (rule out) purposes in DENV-4 epidemics, it could be used as a confirmatory tool in a bedside algorithm.

【 授权许可】

CC BY   
© Buonora et al. 2016

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【 参考文献 】
  • [1]
  • [2]
  • [3]
  • [4]
  • [5]
  • [6]
  • [7]
  • [8]
  • [9]
  • [10]
  • [11]
  • [12]
  • [13]
  • [14]
  • [15]
  • [16]
  • [17]
  • [18]
  • [19]
  • [20]
  • [21]
  • [22]
  • [23]
  • [24]
  • [25]
  • [26]
  • [27]
  • [28]
  • [29]
  • [30]
  • [31]
  • [32]
  • [33]
  • [34]
  • [35]
  • [36]
  • [37]
  • [38]
  • [39]
  • [40]
  • [41]
  • [42]
  • [43]
  • [44]
  • [45]
  • [46]
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