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Mata VE, Andrade CAFD, Passos SRL, Hökerberg YHM, Fukuoka LVB, Silva SAD. Rapid immunochromatographic tests for the diagnosis of dengue: a systematic review and meta-analysis. CAD SAUDE PUBLICA 2020; 36:e00225618. [PMID: 32520127 DOI: 10.1590/0102-311x00225618] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/25/2018] [Accepted: 02/18/2020] [Indexed: 11/22/2022] Open
Abstract
Dengue is an important arthropod-borne viral disease in terms of morbidity, mortality, economic impact and challenges in vector control. Benchmarks are expensive, time consuming and require trained personnel. Preventing dengue complications with rapid diagnosis has been based on the testing of easy-to-perform optimized immunochromatographic methods (ICT). This is a systematic meta-analysis review of the diagnostic accuracy of IgA, NS1, IgM and/or IgG ICT studies in suspected cases of acute or convalescent dengue, using a combination of RT-PCR, ELISA NS1, IgM IgG or viral isolation as a reference standard. This protocol was registered in PROSPERO (CRD42014009885). Two pairs of reviewers searched the PubMed, BIREME, Science Direct, Scopus, Web of Science, Ovid MEDLINE JBrigs, SCIRUS and EMBASE databases, selected, extracted, and quality-assessed by QUADAS 2. Of 3,783 studies, we selected 57, of which 40 in meta-analyses according to the analyte tested, with high heterogeneity (I2 > 90%), as expected for diagnostic tests. We detected higher pooled sensitivity in acute phase IgA (92.8%) with excellent (90%) specificity. ICT meta-analysis with NS1/IgM/IgG showed 91% sensitivity and 96% specificity. Poorer screening performance was for IgM/IgG ICT (sensitivity = 56%). Thus, the studies with NS1/IgM/IgG ICT showed the best combined performance in the acute phase of the disease.
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2
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Dengue Fever and Severe Dengue in Barbados, 2008-2016. Trop Med Infect Dis 2020; 5:tropicalmed5020068. [PMID: 32370128 PMCID: PMC7345827 DOI: 10.3390/tropicalmed5020068] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/31/2020] [Revised: 04/26/2020] [Accepted: 04/29/2020] [Indexed: 12/29/2022] Open
Abstract
Analysis of the temporal, seasonal and demographic distribution of dengue virus (DENV) infections in Barbados was conducted using national surveillance data from a total of 3994 confirmed dengue cases. Diagnosis was confirmed either by DENV-specific real time reverse transcriptase polymerase chain reaction (rRT-PCR), or non-structural protein 1 (NS1) antigen or enzyme linked immunosorbent assay (ELISA) tests; a case fatality rate of 0.4% (10/3994) was observed. The prevalence rate of dengue fever (DF) varied from 27.5 to 453.9 cases per 100,000 population among febrile patients who sought medical attention annually. DF cases occurred throughout the year with low level of transmission observed during the dry season (December to June), then increased transmission during rainy season (July to November) peaking in October. Three major dengue epidemics occurred in Barbados during 2010, 2013 and possibly 2016 with an emerging three-year interval. DF prevalence rate among febrile patients who sought medical attention overall was highest among the 10-19 years old age group. The highest DF hospitalisation prevalence rate was observed in 2013. Multiple serotypes circulated during the study period and Dengue virus serotype 2 (DENV-2) was the most prevalent serotype during 2010, whilst DENV-1 was the most prevalent serotype in 2013. Two DENV-1 strains from the 2013 DENV epidemic were genetically more closely related to South East Asian strains, than Caribbean or South American strains, and represent the first ever sequencing of DENV strains in Barbados. However, the small sample size (n = 2) limits any meaningful conclusions. DF prevalence rates were not significantly different between females and males. Public health planning should consider DENV inter-epidemic periodicity, the current COVID-19 pandemic and similar clinical symptomology between DF and COVID-19. The implementation of routine sequencing of DENV strains to obtain critical data can aid in battling DENV epidemics in Barbados.
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Douglas KO, Samuels TA, Gittens-St Hilaire M. Serum LPS Associated with Hantavirus and Dengue Disease Severity in Barbados. Viruses 2019; 11:v11090838. [PMID: 31505806 PMCID: PMC6783883 DOI: 10.3390/v11090838] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/31/2019] [Revised: 09/04/2019] [Accepted: 09/05/2019] [Indexed: 12/25/2022] Open
Abstract
Hantavirus and dengue virus (DENV) infections are caused by RNA viruses which infect immune systems’ cells including monocytes, macrophages and dendritic cells and occur year-round in Barbados. A retrospective serological study (2008–2015) was conducted on hantavirus and dengue patient sera confirmed by IgM and IgG ELISA, NS1 and RT-PCR using Limulus amoebocyte lysate (LAL) kinetic turbidimetric method to determine serum endotoxin levels. Hantavirus patients were categorized into two groups, namely (a) hospitalized and (b) non-hospitalized. Dengue patients were categorized into 3 groups using 2009 WHO dengue guidelines (a) severe dengue (SD), (b) hospitalized non-severe dengue (non-SD) and (c) non-hospitalized non-SD. Statistical analyses were conducted to determine the association of endotoxin levels with hantavirus disease severity based on hospitalization and dengue disease severity. Serum endotoxin levels are associated with hantavirus disease severity and hospitalization and dengue disease severity (p < 0.01). Similar studies have found an association of serum endotoxin levels with dengue disease severity but never with hantavirus infection. Co-detection of hantavirus- and DENV-specific IgM in some patients were observed with elevated serum endotoxin levels. In addition, previous studies observed hantavirus replication in the gut of patients, gastrointestinal tract as a possible entry route of infection and evidence of microbial translocation and its impact on hantavirus disease severity. A significant correlation of serum endotoxin and hantavirus disease severity and hospitalization in hantavirus infected patients is reported for the first time ever. In addition, serum endotoxin levels correlated with dengue disease severity. This study adds further support to the role of endotoxin in both hantavirus and dengue virus infection and disease severity and its role as a possible therapeutic target for viral haemorrhagic fevers (VHFs).
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Affiliation(s)
- Kirk Osmond Douglas
- Faculty of Medical Sciences, University of the West Indies, Cave Hill, BB11000 St. Michael, Barbados.
| | - Thelma Alafia Samuels
- Faculty of Medical Sciences, University of the West Indies, Cave Hill, BB11000 St. Michael, Barbados.
- George Alleyne Chronic Disease Research Centre (GA-CDRC), University of the West Indies, Cave Hill, BB11000 St. Michael, Barbados.
| | - Marquita Gittens-St Hilaire
- Faculty of Medical Sciences, University of the West Indies, Cave Hill, BB11000 St. Michael, Barbados.
- Best-Dos Santos Public Health Laboratory, University of the West Indies, Cave Hill, BB11000 St. Michael, Barbados.
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Parachalil DR, Bruno C, Bonnier F, Blasco H, Chourpa I, McIntyre J, Byrne HJ. Raman spectroscopic screening of high and low molecular weight fractions of human serum. Analyst 2019; 144:4295-4311. [DOI: 10.1039/c9an00599d] [Citation(s) in RCA: 24] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/18/2022]
Abstract
This study explores the suitability of Raman spectroscopy as a bioanalytical tool, when coupled with ultra-filtration and multivariate analysis, to detect imbalances in both high molecular weight and low molecular weight fractions of the same samples of human patient serum, in the native liquid form.
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Affiliation(s)
- Drishya Rajan Parachalil
- FOCAS Research Institute
- Technological University Dublin
- Dublin 8
- Ireland
- School of Physics and Optometric & Clinical Sciences
| | - Clément Bruno
- Université de Tours
- UFR sciences pharmaceutiques
- EA 6295 Nanomédicaments et Nanosondes
- 37200 Tours
- France
| | - Franck Bonnier
- Université de Tours
- UFR sciences pharmaceutiques
- EA 6295 Nanomédicaments et Nanosondes
- 37200 Tours
- France
| | - Hélène Blasco
- CHRU de Tours
- Laboratoire de Biochimie et Biologie Moléculaire
- Tours
- France
- Université de Tours
| | - Igor Chourpa
- Université de Tours
- UFR sciences pharmaceutiques
- EA 6295 Nanomédicaments et Nanosondes
- 37200 Tours
- France
| | - Jennifer McIntyre
- FOCAS Research Institute
- Technological University Dublin
- Dublin 8
- Ireland
| | - Hugh J. Byrne
- FOCAS Research Institute
- Technological University Dublin
- Dublin 8
- Ireland
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Himatt S, Osman KE, Okoued SI, Seidahmed OE, Beatty ME, Soghaier MA, Elmusharaf K. Sero-prevalence of dengue infections in the Kassala state in the eastern part of the Sudan in 2011. J Infect Public Health 2015; 8:487-92. [PMID: 25975993 DOI: 10.1016/j.jiph.2015.04.023] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/08/2014] [Revised: 03/11/2015] [Accepted: 04/03/2015] [Indexed: 11/26/2022] Open
Abstract
Dengue fever is a vector-borne disease that is transmitted to humans by infected Aedes aegypti mosquitoes. The eastern part of the Sudan is one of the regions that is affected by dengue virus circulation. In this study, we estimated the prevalence of dengue infections in the Kassala state in the eastern part of the Sudan. The study objective was to estimate the sero-prevalence of dengue IgG/IgM antibodies in the Kassala locality in 2011. This was a cross sectional community-based study that utilized a multi-stage cluster sampling technique regarding the probability sampling the study participants. Capture ELISA serological techniques were used for both IgM and IgG, with the specific cut-offs for each set by the manufacturer. The prevalence of dengue infection was found to be 9.4% (95% CI: 7.1-12.3). In conclusion, there is evidence that the dengue virus is being transmitted in Kassala. Disease surveillance, including the clinical, serological and entomological components, should be strengthened, and additional epidemiological studies are needed to better understand of the disease burden and effects in the area.
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Affiliation(s)
- Sayed Himatt
- Directorate of Epidemiology and Zoonotic Diseases, Federal Ministry of Health, Khartoum, Sudan
| | - Kamal E Osman
- Al Ribat University, Faculty of the Medicine Community Department, Sudan; Tiabah University, College of Medicine Family and Community Medicine, Saudi Arabia
| | - Somia I Okoued
- Emergency and Humanitarian Action, Federal Ministry of Health, Khartoum, Sudan
| | - Osama E Seidahmed
- Department of Medical Entomology, National Public Health Laboratory, Khartoum, Sudan
| | - Mark E Beatty
- Pediatric Dengue Vaccine Initiative, Republic of Korea
| | - Mohammed A Soghaier
- Directorate of Epidemiology and Zoonotic Diseases, Federal Ministry of Health, Khartoum, Sudan.
| | - Khalifa Elmusharaf
- Department of Epidemiology and Public Health Medicine, The Royal College of Surgeons in Ireland, Bahrain
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Roopashri G, Vaishali MR, David MP, Baig M, Navneetham A, Venkataraghavan K. Clinical and oral implications of dengue Fever: a review. J Int Oral Health 2015; 7:69-73. [PMID: 25859113 PMCID: PMC4377157] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/21/2014] [Accepted: 12/27/2014] [Indexed: 10/25/2022] Open
Abstract
Dengue is a viral infection with fatal potential complications. It is also called as break-bone fever. Worldwide dengue infection is the most common mosquito-borne viral disease. It is caused by vector Aedesa egypti and represents a major public health issue in more than 100 tropical countries. The word dengue is obtained from Swahili phrase Ka-dinga pepo meaning "cramplikeseizure." Dengue viral infections are characterized by abrupt febrile illness, but can also lead to significant morbidity and mortality. Hence, it requires an early and correct diagnosis. Gingival bleeding is the most common oral manifestation of dengue infection. Although oral lesions are uncommon in dengue infections and if manifested, may be mistaken for bleeding disorders. This review emphasizes the significance of oral lesions as it may be the early indicators of dengue hemorrhagic fever.
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Affiliation(s)
- G Roopashri
- Reader, Department of Oral Medicine and Radiology, MR Ambedkar Dental College and Hospital, Bengaluru, Karnataka, India,Correspondence: Dr. Roopashri G. Department of Oral Medicine and Radiology, MR Ambedkar Dental College and Hospital, Bengaluru, Karnataka, India.
| | - M R Vaishali
- Reader, Department of Oral Medicine and Radiology, MR Ambedkar Dental College and Hospital, Bengaluru, Karnataka, India
| | - Maria Priscilla David
- Professor & Head, Department of Oral Medicine and Radiology, MR Ambedkar Dental College and Hospital, Bengaluru, Karnataka, India
| | - Muqeet Baig
- Reader, Department of Oral and Maxillofacial Surgery, MR Ambedkar Dental College and Hospital, Bengaluru, Karnataka, India
| | - Anuradha Navneetham
- Professor & Head, Department of Oral and Maxillofacial Surgery, MR Ambedkar Dental College and Hospital, Bengaluru, Karnataka, India
| | - Karthik Venkataraghavan
- Professor & Head, Department of Pedodontics & Preventive Dentistry, College of Dental Sciences and Research Centre, Ahmedabad, Gujrat, India
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Commercial dengue rapid diagnostic tests for point-of-care application: recent evaluations and future needs? J Biomed Biotechnol 2012; 2012:151967. [PMID: 22654479 PMCID: PMC3357944 DOI: 10.1155/2012/151967] [Citation(s) in RCA: 90] [Impact Index Per Article: 7.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/12/2011] [Accepted: 02/11/2012] [Indexed: 12/16/2022] Open
Abstract
Dengue fever, dengue haemorrhagic fever, and dengue shock syndrome (DF/DHF/DSS) are tropical diseases that cause significant humanitarian and economic hardship. It is estimated that more than 2.5 billion people are at risk of infection and more than 100 countries have endemic dengue virus transmission. Laboratory tests are essential to provide an accurate diagnosis of dengue virus infection so that appropriate treatment and patient management may be administered. In many dengue endemic settings, laboratory diagnostic resources are limited and simple rapid diagnostic tests (RDTs) provide opportunities for point-of-care diagnosis. This paper addresses current issues relating to the application of commercial dengue RDTs for the diagnosis of acute dengue virus infection, recent diagnostic evaluations, and identifies future needs.
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Faruque LI, Zaman RU, Alamgir ASM, Gurley ES, Haque R, Rahman M, Luby SP. Hospital-based prevalence of malaria and dengue in febrile patients in Bangladesh. Am J Trop Med Hyg 2012; 86:58-64. [PMID: 22232452 DOI: 10.4269/ajtmh.2012.11-0190] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022] Open
Abstract
We conducted a nationwide study at six tertiary hospitals from December 2008 through November 2009 to investigate etiologies of febrile illnesses in Bangladesh. Febrile patients meeting a clinical case definition were enrolled from inpatient and outpatient medicine and pediatric units. We assessed 720 febrile patients over 12 months; 69 (9.6%) were positive for IgM antibodies against dengue virus by enzyme-linked immunosorbent assay, and four malaria patients (0.56%) were confirmed with immuno-chromatography and microscopic slide tests. We identified dengue cases throughout the year from rural (49%) and urban areas (51%). We followed-up 55 accessible dengue-infected patients two months after their initial enrollment: 45 (82%) patients had fully recovered, 9 (16%) reported ongoing jaundice, fever and/or joint pain, and one died. Dengue infection is widespread across Bangladesh, but malaria is sufficiently uncommon that it should not be assumed as the cause of fever without laboratory confirmation.
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Affiliation(s)
- Labib I Faruque
- International Centre for Diarrhoeal Disease Research, Bangladesh, Dhaka, Bangladesh.
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Utility of IgM/IgG ratio and IgG avidity for distinguishing primary and secondary dengue virus infections using sera collected more than 30 days after disease onset. CLINICAL AND VACCINE IMMUNOLOGY : CVI 2011; 18:1951-6. [PMID: 21880858 DOI: 10.1128/cvi.05278-11] [Citation(s) in RCA: 32] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
Dengue virus (DV) IgM/IgG ratio and IgG avidity value (AV) can reliably distinguish between primary and secondary DV infections using sera collected within 30 days of disease onset, but little is known about their efficacies using sera collected >30 days after onset. To investigate this issue, we analyzed specimens submitted to our reference laboratory for DV antibody testing. We first classified patients as having primary (n = 55) or secondary (n = 58) infections based on seroconversion patterns in a comparison of two sera collected <30 days apart. We then evaluated IgM/IgG ratios and IgG AVs of the second specimens by using receiver operating characteristic curve analysis. The IgM/IgG ratio that best discriminated primary from secondary infection was 1.32; 95% of 55 primary infections exhibited ratios of >1.32, whereas 93% of 58 secondary infections exhibited ratios of ≤1.32. The discriminatory AV was 0.39; 95% of 41 primary infections exhibited AVs of ≤0.39, whereas 95% of 38 secondary infections exhibited AVs of >0.39. We then evaluated the IgM/IgG ratios and AV for primary-infection patients whose second serum samples were collected ≥30 days after the first serum samples; only 56% of 27 sera exhibited ratios of >1.32, whereas 81% of 21 sera exhibited AVs of ≤0.39. Assuming that the first specimens were collected within a week after symptoms appeared, these findings indicate that IgG AV is superior to the IgM/IgG ratio for distinguishing primary from secondary DV infections when using samples collected more than 5 weeks after disease onset.
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Dengue virus immunoglobulin M detection in a reference laboratory setting during the 2010 dengue virus outbreak on Caribbean islands. CLINICAL AND VACCINE IMMUNOLOGY : CVI 2011; 18:1104-7. [PMID: 21613462 DOI: 10.1128/cvi.05096-11] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/31/2022]
Abstract
A large outbreak of dengue virus (DV) infections occurred on Caribbean islands during 2010, with cases peaking during the second half of the year. In conjunction with the outbreak, we observed an unprecedented spike in the number of sera submitted for DV antibody testing between June and December 2010, with a concomitant increase in the number of IgM-positive specimens, indicative of acute DV infection. Analysis of the place of residence of the IgM-positive patients identified from June to December of 2010 revealed that 58.1% were residents of Caribbean islands (Puerto Rico and the U.S. Virgin Islands), whereas 40.6% were residents of the U.S. mainland or Hawaii. The U.S. residents represented 42 states plus the District of Columbia, but most (53%) were from just 3 states (California, Florida, and New York). In comparison to the Caribbean IgM-positive patient group, the U.S. IgM-positive patient group contained proportionately more adults 21 to 60 years old and fewer individuals <21 years old. These findings indicate that the 2010 Caribbean DV outbreak affected many U.S. residents (mostly adults, presumably travelers) from diverse geographic areas and emphasize the potential for a viremic DV-infected returning traveler to spark a local DV outbreak by introducing DV into a community with competent mosquito vectors.
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Gurugama P, Garg P, Perera J, Wijewickrama A, Seneviratne SL. Dengue viral infections. Indian J Dermatol 2010; 55:68-78. [PMID: 20418983 PMCID: PMC2856379 DOI: 10.4103/0019-5154.60357] [Citation(s) in RCA: 53] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
Abstract
Dengue viral infections are one of the most important mosquito-borne diseases in the world. Presently dengue is endemic in 112 countries in the world. It has been estimated that almost 100 million cases of dengue fever and half a million cases of dengue hemorrhagic fever (DHF) occur worldwide. An increasing proportion of DHF is in children less than 15 years of age, especially in South East and South Asia. The unique structure of the dengue virus and the pathophysiologic responses of the host, different serotypes, and favorable conditions for vector breeding have led to the virulence and spread of the infections. The manifestations of dengue infections are protean from being asymptomatic to undifferentiated fever, severe dengue infections, and unusual complications. Early recognition and prompt initiation of appropriate supportive treatment are often delayed resulting in unnecessarily high morbidity and mortality. Attempts are underway for the development of a vaccine for preventing the burden of this neglected disease. This review outlines the epidemiology, clinical features, pathophysiologic mechanisms, management, and control of dengue infections.
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Affiliation(s)
| | - Pankaj Garg
- From the Children's Hospital at Westmead, Westmead, NSW, Australia
| | - Jennifer Perera
- From the Department of Microbiology, University of Colombo, Colombo, Sri Lanka
| | | | - Suranjith L Seneviratne
- From the Department of Clinical Immunology, St. Mary's Hospital and Imperial College, London, UK.
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Evaluación de la utilidad de la prueba rápida de casete por inmunocromatografía para el diagnóstico de dengue en una región endémica colombiana. BIOMEDICA 2009. [DOI: 10.7705/biomedica.v29i4.139] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
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Misra UK, Kalita J. Seizures in encephalitis: predictors and outcome. Seizure 2009; 18:583-7. [PMID: 19581112 DOI: 10.1016/j.seizure.2009.06.003] [Citation(s) in RCA: 41] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/04/2009] [Revised: 06/01/2009] [Accepted: 06/05/2009] [Indexed: 11/29/2022] Open
Abstract
BACKGROUND Seizures are common in encephalitis but there is paucity of comprehensive studies evaluating predictors of seizures. AIM To evaluate the frequency and predictors of seizures in encephalitis patients and its effect on outcome. METHODS In a prospective hospital based study, the patients with encephalitis were evaluated clinically and presence of seizure, its type and duration were noted. Patients' consciousness was assessed by Glasgow coma scale (GCS) score and neurological findings were recorded. Blood count, serum chemistry, electroencephalography (EEG), cranial MRI and CSF examination were done. The diagnosis of encephalitis was based on ELISA and PCR and grouped into herpes, Japanese, dengue and nonspecific encephalitis. Hospital mortality and 3-month outcome were noted. RESULTS 148 patients with encephalitis whose median age was 26 (range 1-75) years were included. Seizures occurred in 63 (42.6%) patients; 18 of whom had status epilepticus. Seizures were more common in herpes (75%) followed by Japanese (54%) encephalitis. The predictors of seizure in encephalitis were age, GCS score and cortical involvement on MRI. 61% children had seizures compared to 36.6% adults and 53.3% with cortical involvement on MRI had seizure compared to 14.3% without. Seizures were not related to mortality but associated with poor outcome. CONCLUSION In encephalitis, seizures occur in 42.6% patients especially in children with low GCS score and having cortical involvement on MRI.
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Affiliation(s)
- U K Misra
- Department of Neurology, Sanjay Gandhi Post Graduate Institute of Medical Sciences, Raebareily Road, Lucknow 226014, India.
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14
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New dengue antibody assay with unique differential detection of IgG and IgM antibodies. Clin Biochem 2009; 42:180-4. [DOI: 10.1016/j.clinbiochem.2008.10.017] [Citation(s) in RCA: 13] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/23/2008] [Revised: 09/25/2008] [Accepted: 10/25/2008] [Indexed: 11/18/2022]
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Development of a more efficient algorithm for identifying false-positive reactivity results in a dengue virus immunoglobulin M screening assay. CLINICAL AND VACCINE IMMUNOLOGY : CVI 2008; 15:1304-6. [PMID: 18562562 DOI: 10.1128/cvi.00157-08] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
Of 2,692 sera screened for dengue virus immunoglobulin M by using a mu-capture enzyme-linked immunosorbent assay (ELISA), 954 had equivocal (index from 0.90 to 1.10) or positive (index of >1.10) results and were retested using a background subtraction (BS) ELISA that identifies screen false positives. No false positives were found among 427 sera with screen ELISA indices of >6.00; thus, retesting this specimen subset by BS ELISA is unnecessary.
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16
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Blacksell SD, Doust JA, Newton PN, Peacock SJ, Day NPJ, Dondorp AM. A systematic review and meta-analysis of the diagnostic accuracy of rapid immunochromatographic assays for the detection of dengue virus IgM antibodies during acute infection. Trans R Soc Trop Med Hyg 2006; 100:775-84. [PMID: 16551470 DOI: 10.1016/j.trstmh.2005.10.018] [Citation(s) in RCA: 38] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/26/2005] [Revised: 10/07/2005] [Accepted: 10/25/2005] [Indexed: 11/25/2022] Open
Abstract
A meta-analysis of rapid (</=60 min) dengue diagnostic assays was conducted to determine accuracy and identify causes of between-study heterogeneity. A systematic review identified 302 potentially suitable studies, of which 11 were selected for meta-analysis. All selected studies evaluated the immunochromatographic test (ICT) manufactured by Panbio Pty Ltd. Individual study results for sensitivity ranged from 0.45 to 1.0, specificity 0.57-1.0, diagnostic odds ratio 4.5-1287, and positive:negative likelihood ratios 2.3-59 and 0.01-0.56, respectively. Results indicated that the ICT evaluated in the selected studies can both rule in and rule out disease but is more accurate when samples are collected later in the acute phase of infection. Limitations of this meta-analysis were significant between-study heterogeneity caused by inconsistencies in evaluation methodologies, and the evaluation of only the Panbio ICT. It is recommended that additional, standardized evaluations are required for other dengue ICTs.
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Affiliation(s)
- Stuart D Blacksell
- Centre for Clinical Vaccinology and Tropical Medicine, Nuffield Department of Clinical Medicine, Churchill Hospital, University of Oxford, Oxford, UK
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Blacksell SD, Newton PN, Bell D, Kelley J, Mammen MP, Vaughn DW, Wuthiekanun V, Sungkakum A, Nisalak A, Day NPJ. The comparative accuracy of 8 commercial rapid immunochromatographic assays for the diagnosis of acute dengue virus infection. Clin Infect Dis 2006; 42:1127-34. [PMID: 16575730 DOI: 10.1086/501358] [Citation(s) in RCA: 93] [Impact Index Per Article: 5.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/04/2005] [Accepted: 12/07/2005] [Indexed: 11/03/2022] Open
Abstract
BACKGROUND The serological diagnosis of acute dengue virus infection relies on the detection of dengue-specific immunoglobulin M (IgM) antibodies. Immunochromatographic tests are rapid diagnostic tests (RDTs) that can be performed at the bedside, but they have not been fully validated for diagnosis of dengue infection. METHODS More than 20 RDTs for diagnosis of acute dengue infection are commercially available. Of these, 8 were selected for evaluation of performance by use of characterized dengue and nondengue serum specimens, and results were compared with those of a previously published dengue IgM/IgG enzyme-linked immunosorbent assay in conjunction with dengue virus serotyping by reverse-transcriptase polymerase chain reaction. RESULTS Assay sensitivities were low, ranging from 6.4% (95% confidence interval [CI], 4.0%-9.7%) to 65.3% (95% CI, 59.9%-70.5%), and specificities ranged from 69.1% (95% CI, 61.4%-76.0%) to 100% (95% CI, 97.8%-100%). Of the 8 tests, only 2 had sensitivities of >50%, the level considered to be clinically useful, and, of these, 1 had relatively low specificity (69.1%). Samples collected early in the infection were less likely to test positive than those collected later. A thermal stability study demonstrated a loss in performance of some RDTs when they were stored at a high ambient temperature for 3 months. CONCLUSIONS Users of RDTs for dengue should be aware that many of these tests have a diagnostic accuracy that falls well below the manufacturers' claims. If an acute specimen yields a negative result, a convalescent serum sample should be tested to confirm the result. No RDT adequately differentiated primary and secondary dengue infections, and the tests should not be used for this purpose.
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Affiliation(s)
- Stuart D Blacksell
- Centre for Clinical Vaccinology and Tropical Medicine, Nuffield Department of Clinical Medicine, Churchill Hospital, University of Oxford, Oxford, United Kingdom.
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Shu PY, Huang JH. Current advances in dengue diagnosis. CLINICAL AND DIAGNOSTIC LABORATORY IMMUNOLOGY 2005; 11:642-50. [PMID: 15242935 PMCID: PMC440621 DOI: 10.1128/cdli.11.4.642-650.2004] [Citation(s) in RCA: 173] [Impact Index Per Article: 9.1] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Affiliation(s)
- Pei-Yun Shu
- Division of Laboratory Research and Development, Center for Disease Control, Department of Health, Taipei, Taiwan, Republic of China
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Abstract
Dengue viral infections are one of the most important mosquito borne diseases in the world. They may be asymptomatic or may give rise to undifferentiated fever, dengue fever, dengue haemorrhagic fever (DHF), or dengue shock syndrome. Annually, 100 million cases of dengue fever and half a million cases of DHF occur worldwide. Ninety percent of DHF subjects are children less than 15 years of age. At present, dengue is endemic in 112 countries in the world. No vaccine is available for preventing this disease. Early recognition and prompt initiation of appropriate treatment are vital if disease related morbidity and mortality are to be limited. This review outlines aspects of the epidemiology of dengue infections, the dengue virus and its mosquito vector, clinical features and pathogenesis of dengue infections, and the management and control of these infections.
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Affiliation(s)
- G N Malavige
- Department of Clinical Immunology, A Floor, West Block, Queens Medical Centre, University Hospital, Nottingham NG7 2UH, UK
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Mairuhu ATA, Wagenaar J, Brandjes DPM, van Gorp ECM. Dengue: an arthropod-borne disease of global importance. Eur J Clin Microbiol Infect Dis 2004; 23:425-33. [PMID: 15148655 DOI: 10.1007/s10096-004-1145-1] [Citation(s) in RCA: 62] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
Abstract
Dengue viruses cause a variable spectrum of disease that ranges from an undifferentiated fever to dengue fever to the potentially fatal dengue shock syndrome. Due to the increased incidence and geographical distribution of dengue in the last 50 years, dengue is becoming increasingly recognised as one of the world's major infectious diseases. This article will review clinical and diagnostic aspects of dengue virus infections. It also presents our current knowledge of the pathophysiology of severe dengue and addresses the importance of dengue virus infections in those travelling to parts of the world where dengue is endemic.
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Affiliation(s)
- A T A Mairuhu
- Department of Internal Medicine, Slotervaart Hospital, Louwesweg 6, 1066 EC Amsterdam, The Netherlands.
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Raengsakulrach B, Nisalak A, Maneekarn N, Yenchitsomanus PT, Limsomwong C, Jairungsri A, Thirawuth V, Green S, Kalayanarooj S, Suntayakorn S, Sittisombut N, Malasit P, Vaughn D. Comparison of four reverse transcription-polymerase chain reaction procedures for the detection of dengue virus in clinical specimens. J Virol Methods 2002; 105:219-32. [PMID: 12270655 DOI: 10.1016/s0166-0934(02)00104-0] [Citation(s) in RCA: 32] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
The sensitivity of dengue virus identification by mosquito inoculation and four reverse transcription-polymerase chain reaction (RT-PCR) procedures (Am. J. Trop. Med. Hyg. 45 (1991) 418 (H); J. Clin. Microbiol. 29 (1991) 2107 (M); J. Clin. Microbiol. 30 (1992) 545 (L); and Southeast Asian J. Trop. Med. Public Health 27 (1996) 228 (Y)) were compared using coded clinical specimens derived from areas in Thailand where all four dengue serotypes circulate. The sensitivity of virus detection in serologically confirmed dengue cases was 54, 52, 60, 79, and 80% for mosquito inoculation, procedures H, M, L and Y, respectively. In comparison to clinical specimens which yielded virus isolates by mosquito inoculation, there was relatively low sensitivity in detecting each of the four dengue serotypes by PCR: procedure H-dengue 4 (25%), procedure M-dengue 3 (73%), procedure L-dengue 1 (70%), and procedure Y-dengue 1 (79%). Dengue virus was detectable by RT-PCR for more days of illness and in the presence of dengue-specific antibody when compared to virus isolated in mosquitoes. Procedures L and Y were more sensitive than mosquito inoculation or procedures H and M in detecting all four dengue serotypes in clinical specimens and may be the RT-PCR methods of choice for virus surveillance or research use.
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Affiliation(s)
- Boonyos Raengsakulrach
- Department of Virology, US Army Medical Component, Armed Forces Research Institute of Medical Sciences, Bangkok, Thailand.
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Abdulkader RCRM, Daher EF, Camargo ED, Spinosa C, da Silva MV. Leptospirosis severity may be associated with the intensity of humoral immune response. Rev Inst Med Trop Sao Paulo 2002; 44:79-83. [PMID: 12048544 DOI: 10.1590/s0036-46652002000200005] [Citation(s) in RCA: 31] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
Leptospirosis severity may be increasing, with pulmonary involvement becoming more frequent. Does this increase result from an intense immune response to leptospire? Notice that renal failure, thrombocytopenia and pulmonary complications are found during the immune phase. Thirty-five hospitalized patients with Weil's disease had 5 blood samples drawn, from the 15th day to the 12th month of symptoms, for ELISA-IgM, -IgG and -IgA specific antibody detection. According their 1st IgG titer, the patients were divided into: group 1 (n = 13) titer > 1:400 (positive) and group 2 (n = 22) titer < or =1:400 (negative). Early IgG antibodies in group 1 showed high avidity which may indicate reinfection. Group 1 was older, had worse pulmonary and renal function, and fever for a longer period than group 2. Throughout the study, IgG and IgA titers remained higher in group 1. In conclusion, the severity of Weil's disease may be associated with the intensity of the humoral immune response to leptospire.
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Affiliation(s)
- Regina C R M Abdulkader
- Hospital das Clínicas, Faculdade de Medicina, Universidade de São Paulo, São Paulo, SP, Brasil.
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Levett PN, Branch SL, Whittington CU, Edwards CN, Paxton H. Two methods for rapid serological diagnosis of acute leptospirosis. CLINICAL AND DIAGNOSTIC LABORATORY IMMUNOLOGY 2001; 8:349-51. [PMID: 11238220 PMCID: PMC96061 DOI: 10.1128/cdli.8.2.349-351.2001] [Citation(s) in RCA: 53] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
Leptospirosis is a common and underdiagnosed zoonosis. Two rapid assays for serological diagnosis of acute leptospirosis in diagnostic laboratories, the immunoglobulin M (IgM)-dipstick assay and the indirect hemagglutination assay (IHA), were evaluated and compared with standard assays. Sera were examined from 104 patients admitted to a hospital for investigation in a leptospirosis diagnostic protocol. Specimens for serology were taken on days 1 and 4 of the patients' hospital stay. Antibodies were detected using an IgM-enzyme-linked immunosorbent assay (ELISA), microscopic agglutination test (MAT), an IgM-dipstick assay, and an IHA. Fifty-one patients were found to have leptospirosis. The sensitivity of the IgM-dipstick assay was 98%, its specificity was 90.6%, its positive predictive value was 90.9%, and its negative predictive value was 98%. The sensitivity of the IHA was 92.2%, its specificity was 94.4%, its positive predictive value was 95.9%, and its negative predictive value was 92.7%. The standard IgM-ELISA and MAT, were positive in the first samples tested from 67 and 55% of the cases, respectively, and the rapid IgM-dipstick assay and IHA were positive in 71 and 49%, respectively, in the first sample tested. Both rapid assays are highly sensitive and specific. Neither requires specialized equipment, and both are suitable for use in diagnostic laboratories.
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Affiliation(s)
- P N Levett
- School of Clinical Medicine & Research, University of the West Indies, Bridgetown, Barbados.
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