A systematic review and meta-analysis on the accuracy of rapid immunochromatographic tests for dengue diagnosis

Macêdo, Jéssica V L; Frías, Isaac A.M.; Oliveira, Maria D.L.; Zanghelini, Fernando; Andrade, César A.S.

doi:10.1007/s10096-022-04485-6

Cited by 8 publications

(5 citation statements)

References 28 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…A combination of the NS1, IgM, and IgG tests could provide a higher level of accuracy for dengue fever diagnosis. Consistent with previous research, pooling all three analytes, or a combination of two or three, bestowed optimal diagnostic performance (sensitivity ~90%, specificity ~89%) and proved to be of great clinical utility in many low-technology settings [57,61,[64][65][66].…”

Section: Plos Neglected Tropical Diseasessupporting

confidence: 82%

Diagnostic accuracy of DPP Fever Panel II Asia tests for tropical fever diagnosis

Dhawan,

Dittrich,

Arafah

et al. 2024

PLoS Negl Trop Dis

View full text Add to dashboard Cite

Background Fever is the most frequent symptom in patients seeking care in South and Southeast Asia. The introduction of rapid diagnostic tests (RDTs) for malaria continues to drive patient management and care. Malaria-negative cases are commonly treated with antibiotics without confirmation of bacteraemia. Conventional laboratory tests for differential diagnosis require skilled staff and appropriate access to healthcare facilities. In addition, introducing single-disease RDTs instead of conventional laboratory tests remains costly. To overcome some of the delivery challenges of multiple separate tests, a multiplexed RDT with the capacity to diagnose a diverse range of tropical fevers would be a cost-effective solution. In this study, a multiplex lateral flow immunoassay (DPP Fever Panel II Assay) that can detect serum immunoglobulin M (IgM) and specific microbial antigens of common fever agents in Asia (Orientia tsutsugamushi, Rickettsia typhi, Leptospira spp., Burkholderia pseudomallei, Dengue virus, Chikungunya virus, and Zika virus), was evaluated. Methodology/Principal findings Whole blood (WB) and serum samples from 300 patients with undefined febrile illness (UFI) recruited in Vientiane, Laos PDR were tested using the DPP Fever Panel II, which consists of an Antibody panel and Antigen panel. To compare reader performance, results were recorded using two DPP readers, DPP Micro Reader (Micro Reader 1) and DPP Micro Reader Next Generation (Micro Reader 2). WB and serum samples were run on the same fever panel and read on both micro readers in order to compare results. ROC analysis and equal variance analysis were performed to inform the diagnostic validity of the test compared against the respective reference standards of each fever agent (S1 Table). Overall better AUC values were observed in whole blood results. No significant difference in AUC performance was observed when comparing whole blood and serum sample testing, except for when testing for R. typhi IgM (p = 0.04), Leptospira IgM (p = 0.02), and Dengue IgG (p = 0.03). Linear regression depicted R2 values had ~70% agreement across WB and serum samples, except when testing for leptospirosis and Zika, where the R2 values were 0.37 and 0.47, respectively. No significant difference was observed between the performance of Micro Reader 1 and Micro Reader 2, except when testing for the following pathogens: Zika IgM, Zika IgG, and B pseudomallei CPS Ag. Conclusions/Significance These results demonstrate that the diagnostic accuracy of the DPP Fever Panel II is comparable to that of commonly used RDTs. The optimal cut-off would depend on the use of the test and the desired sensitivity and specificity. Further studies are required to authenticate the use of these cut-offs in other endemic regions. This multiplex RDT offers diagnostic benefits in areas with limited access to healthcare and has the potential to improve field testing capacities. This could improve tropical fever management and reduce the public health burden in endemic low-resource areas.

show abstract

Section: Plos Neglected Tropical Diseasessupporting

confidence: 82%

Diagnostic accuracy of DPP Fever Panel II Asia tests for tropical fever diagnosis

Dhawan,

Dittrich,

Arafah

et al. 2024

PLoS Negl Trop Dis

View full text Add to dashboard Cite

show abstract

“…No analysis of efficacy in secondary vs primary infection was undertaken. NS1 antigen was not compared in this study, but based on prior work it appears that sensitivity would be at least equivalent if not better, and specificity significantly better [66, 70, 78]. Unless a clear role for IgE in DENV pathogenesis is found giving clinical utility to its measurement, NS1 antigen appears to be a more useful diagnostic test in early infection.…”

Section: Antibody Detectionmentioning

confidence: 96%

“…Four meta-analyses of two commercial NS1 Ag ELISAs and two commercial ICTs on clinical specimens with variable inclusion criteria and comparator specimen found lower pooled sensitivity of approximately 66 % with significant heterogeneity, but higher (77–94 %) pooled sensitivity when only primary infection is considered [75–77]. A more recent meta-analysis of 14 brands of commercially available NS1 ICT found similar pooled sensitivity for NS1, and sensitivity of 90 % if a combination of NS1, IgM and IgG ICT was used [78] Two meta-analyses reported ICTs were more sensitive than ELISA, but this was not a statistically significant difference in one study, and heterogenous comparators were used [75, 76]. Specificity was greater than 97 % [75–79].…”

Section: Ns1 Antigen Detectionmentioning

confidence: 99%

“…A more recent meta-analysis of 14 brands of commercially available NS1 ICT found similar pooled sensitivity for NS1, and sensitivity of 90 % if a combination of NS1, IgM and IgG ICT was used [78] Two meta-analyses reported ICTs were more sensitive than ELISA, but this was not a statistically significant difference in one study, and heterogenous comparators were used [75, 76]. Specificity was greater than 97 % [75–79].…”

Section: Ns1 Antigen Detectionmentioning

confidence: 99%

See 1 more Smart Citation

Dengue: A review of laboratory diagnostics in the vaccine age

Frazer,

Norton

2024

Journal of Medical Microbiology

View full text Add to dashboard Cite

Background. Dengue is an important arboviral infection of considerable public health significance. It occurs in a wide global belt within a variety of tropical regions. The timely laboratory diagnosis of Dengue infection is critical to inform both clinical management and an appropriate public health response. Vaccination against Dengue virus is being introduced in some areas. Discussion. Appropriate diagnostic strategies will vary between laboratories depending on the available resources and skills. Diagnostic methods available include viral culture, the serological detection of Dengue-specific antibodies in using enzyme immunoassays (EIAs), microsphere immunoassays, haemagglutination inhibition or in lateral flow point of care tests. The results of antibody tests may be influenced by prior vaccination and exposure to other flaviviruses. The detection of non-structural protein 1 in serum (NS1) has improved the early diagnosis of Dengue and is available in point-of-care assays in addition to EIAs. Direct detection of viral RNA from blood by PCR is more sensitive than NS1 antigen detection but requires molecular skills and resources. An increasing variety of isothermal nucleic acid detection methods are in development. Timing of specimen collection and choice of test is critical to optimize diagnostic accuracy. Metagenomics and the direct detection by sequencing of viral RNA from blood offers the ability to rapidly type isolates for epidemiologic purposes. Conclusion. The impact of vaccination on immune response must be recognized as it will impact test interpretation and diagnostic algorithms.

show abstract

“…However, these are expensive and not widely available in endemic areas. Point of care tests for dengue IgM have proved useful, particularly during outbreaks, but their sensitivity can be variable and for some kits unacceptably low (reviews suggest between 13.8% and 90%) [ 81 ]. Also of note is the limitation that IgM titre does not reach detectable levels until a week or so after the onset of symptoms.…”

Section: Introductionmentioning

confidence: 99%

The One Health Concept

Pitt,

Gunn

2024

Br J Biomed Sci

View full text Add to dashboard Cite

The concept of One Health has been developed as the appreciation that human health is intricately connected to those of other animals and the environment that they inhabit. In recent years, the COVID-19 pandemic and noticeable effects of climate change have encouraged national and international cooperation to apply One Health strategies to address key issues of health and welfare. The United Nations (UN) Sustainable Development Goals have established targets for health and wellbeing, clean water and sanitation, climate action, as well as sustainability in marine and terrestrial ecosystems. The One Health Quadripartite comprises the World Health Organization (WHO), the World Organization for Animal Health (WOAH—formerly OIE), the United Nations Food and Agriculture Organization (FAO) and the United Nations Environment Programme (UNEP). There are six areas of focus which are Laboratory services, Control of zoonotic diseases, Neglected tropical diseases, Antimicrobial resistance, Food safety and Environmental health. This article discusses the concept of One Health by considering examples of infectious diseases and environmental issues under each of those six headings. Biomedical Scientists, Clinical Scientists and their colleagues working in diagnostic and research laboratories have a key role to play in applying the One Health approach to key areas of healthcare in the 21st Century.

show abstract

A systematic review and meta-analysis on the accuracy of rapid immunochromatographic tests for dengue diagnosis

Cited by 8 publications

References 28 publications

Diagnostic accuracy of DPP Fever Panel II Asia tests for tropical fever diagnosis

Diagnostic accuracy of DPP Fever Panel II Asia tests for tropical fever diagnosis

Dengue: A review of laboratory diagnostics in the vaccine age

The One Health Concept

Contact Info

Product

Resources

About