Comparison of two rapid diagnostic tests during a large dengue virus serotype 3 outbreak in the Solomon Islands in 2013

PLoS One. 2018 Aug 10;13(8):e0202304. doi: 10.1371/journal.pone.0202304. eCollection 2018.

Abstract

Dengue virus (DENV) infection causes various clinical presentations, including asymptomatic infection, dengue with or without warning signs and severe dengue. An early and accurate diagnosis of DENV infection during the first few days of illness supports clinical management and significantly reduces dengue-associated mortality and morbidity. However, it is very difficult to confirm DENV infection in endemic regions without qualified dengue diagnostic laboratories. In this study, we evaluated the performance of two commercially available rapid diagnostic tests (RDTs) using serum samples collected in the Solomon Islands during the 2013 DENV-3 outbreak. The sensitivity and specificity of the tests were calculated by comparing the results of DENV nonstructural protein 1 (NS1), IgM and IgG RDTs with those obtained by qRT-PCR. We also compared the results of the DENV IgM/IgG RDT with those obtained using an IgM/IgG capture enzyme-linked immune-sorbent assay (ELISA). The sensitivities of the SD and CTK NS1 RDTs were similar (90.9% and 92.6%), and the specificity of the SD NS1 RDT was significantly higher than that of the CTK NS1 RDT (100% versus 78.8%). The inclusion of IgM and IgG in the RDT did not significantly increase the sensitivity for DENV diagnosis. Compared with the SD IgM RDT, IgM capture ELISA had the same specificity but higher sensitivity. User-friendly RDTs remain the first choice and the most convenient tool in dengue endemic regions, where laboratory facilities and the corresponding infrastructure are lacking. Our study provided important and practical information for comparing the performance and validity of the different RDTs for rapid dengue detection.

Publication types

  • Comparative Study
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adolescent
  • Adult
  • Aedes
  • Aged
  • Aged, 80 and over
  • Animals
  • Cell Line
  • Child
  • Child, Preschool
  • Cricetinae
  • Dengue / diagnosis*
  • Dengue / epidemiology
  • Dengue Virus
  • Diagnostic Tests, Routine / methods*
  • Disease Outbreaks
  • Female
  • Hematologic Tests / methods
  • Humans
  • Infant
  • Male
  • Melanesia / epidemiology
  • Middle Aged
  • Sensitivity and Specificity
  • Young Adult

Grants and funding

This work was supported by the Ministry of Health and Welfare, Taiwan (10212060 and MOHW107-TDU-B-212-123006, https://www.mohw.gov.tw/mp-2.html, to JJT) and National Health Research Institutes, Taiwan (MR-107-PP-40, http://english.nhri.org.tw/NHRI_WEB/nhriw001Action.do, to JJT) and Ministry of Foreign Affairs, Taiwan (No. 0309, https://www.mofa.gov.tw/en/default.html, to JJT) and Centers for Disease Control, Taiwan (MOHW104-CDC-C-114-114901, https://www.cdc.gov.tw/rwd/english, to JJT). The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript.