A comparison of serological diagnostic techniques in Dengue fever

Abstract

INTRODUCTION: The Dengue Duo IgM and IgG Rapid Strip test (PanBio Pvt. Ltd., Brisbane, Australia) is a commercially available immunochromatographic test. The Armed Forces Research Institute of Medical Sciences (AFRIMS), Bangkok Thailand, has developed an in-house anti-dengue/anti-JE IgM and IgG reference enzyme-linked immunosorbent assay (ELISA). OBJECTIVE: To compare the usefulness of the AFRIMS ELISA and PanBio Dengue Duo IgM and IgG Rapid Strip test (PanBio Strip test) in the diagnosis of dengue infections. MATERIALS AND METHOD: 93 non-bacterial undifferentiated fever cases and 50 suspected dengue fever cases were screened for dengue and JE virus infections by the AFRIMS ELISA and also by the PanBio Strip test for dengue. All cases positive for dengue antibodies by either test were also tested by the Haemagglutination Inhibition test. RESULTS: Results were considered conclusive when at least 2 or all 3 of the above tests agreed. The AFRIMS ELISA had a sensitivity of 91.7% and specificity of 100% while the PanBio Strip test has a sensitivity of 93.8% and specificity of 96.8% in diagnosing dengue infections. 91.7% primary and 91.4% secondary infections were correctly classified by the AFRIMS ELISA. The PanBio Strip test identified 100% primary infections and 65.7% of secondary infections. CONCLUSIONS: The PanBio Strip test has a sensitivity and specificity comparable to the AFRIMS ELISA in diagnosing dengue infections although it tends to underestimate the number of secondary infections.