Author | Buonora, Sibelle Nogueira | |
Author | Passos, Sonia Regina Lambert | |
Author | Carmo, Cleber Nascimento do | |
Author | Quintela, Fernanda Moisés | |
Author | Oliveira, Diana Neves Rodrigues de | |
Author | Santos, Flávia Barreto dos | |
Author | Hökerberg, Yara Hahr Marques | |
Author | Nogueira, Rita Maria Ribeiro | |
Author | Daumas, Regina Paiva | |
Access date | 2017-12-30T12:54:19Z | |
Available date | 2017-12-30T12:54:19Z | |
Document date | 2016 | |
Citation | BUONORA, Sibelle Nogueira et al. Accuracy of clinical criteria and an immunochromatographic strip test for dengue diagnosis in a DENV-4 epidemic. BMC Infectious Diseases, v.16, p. 1-9, 2016. | pt_BR |
ISSN | 1471-2334 | pt_BR |
URI | https://www.arca.fiocruz.br/handle/icict/23831 | |
Language | eng | pt_BR |
Publisher | BioMed Central | pt_BR |
Rights | open access | |
Subject in Portuguese | Dengue | pt_BR |
Subject in Portuguese | Diagnóstico | pt_BR |
Subject in Portuguese | Confiabilidade | pt_BR |
Subject in Portuguese | Sensibilidade | pt_BR |
Subject in Portuguese | Especificidade | pt_BR |
Subject in Portuguese | Sistemas Automatizados de Assistência Junto ao Leito | pt_BR |
Subject in Portuguese | Proteínas não Estruturais Virais | pt_BR |
Title | Accuracy of clinical criteria and an immunochromatographic strip test for dengue diagnosis in a DENV-4 epidemic | pt_BR |
Type | Article | pt_BR |
DOI | 10.1186/s12879-016-1368-7 | |
Abstract | Background: Early 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. Methods: We 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. Results: RT-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.
Conclusions: Although 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. | pt_BR |
Affilliation | Fundação Oswaldo Cruz. Instituto Nacional de Infectologia Evandro Chagas. Laboratório de Epidemiologia Clínica. Rio de Janeiro, RJ, Brasil. | pt_BR |
Affilliation | Fundação Oswaldo Cruz. Instituto Nacional de Infectologia Evandro Chagas. Laboratório de Epidemiologia Clínica. Rio de Janeiro, RJ, Brasil. | pt_BR |
Affilliation | Fundação Oswaldo Cruz. Escola Nacional de Saúde Pública Sergio Arouca. Rio de Janeiro. RJ, Brasil | pt_BR |
Affilliation | Fundação Oswaldo Cruz. Instituto Nacional de Infectologia Evandro Chagas. Laboratório de Epidemiologia Clínica. Rio de Janeiro, RJ, Brasil. | pt_BR |
Affilliation | Fundação Oswaldo Cruz. Instituto Nacional de Infectologia Evandro Chagas. Laboratório de Epidemiologia Clínica. Rio de Janeiro, RJ, Brasil. | pt_BR |
Affilliation | Fundação Oswaldo Cruz. Instituto Oswaldo Cruz. Laboratório de Flavivírus. Rio de Janeiro, RJ, Brasil. | pt_BR |
Affilliation | Fundação Oswaldo Cruz. Instituto Nacional de Infectologia Evandro Chagas. Laboratório de Epidemiologia Clínica. Rio de Janeiro, RJ, Brasil. | pt_BR |
Affilliation | Fundação Oswaldo Cruz. Escola Nacional de Saúde Pública Sergio Arouca. Rio de Janeiro. RJ, Brasil | pt_BR |
Affilliation | Fundação Oswaldo Cruz. Escola Nacional de Saúde Pública Sergio Arouca. Centro de Saúde Escola Germano Sinval Faria. Rio de Janeiro, RJ, Brasil. | pt_BR |
Subject | Dengue | pt_BR |
Subject | Daignosis | pt_BR |
Subject | Accuracy | pt_BR |
Subject | Sensitivity | pt_BR |
Subject | Specificity | pt_BR |
Subject | NS1 | pt_BR |
Subject | Point-of-care systems | pt_BR |