A clinico-microbiological study of dengue fever cases in a tertiary care center of navi Mumbai..

Author(s): Gargi Ghosh*, Urhekar A. D., Susmit Kosta

Abstract

Dengue is an endemic viral disease affecting tropical and subtropical regions around the world, predominantly in urban and semiurban areas. Dengue fever (DF) and its more serious forms, dengue hemorrhagic fever (DHF) and dengue shock syndrome (DSS), are becoming important public health problems and were formally included within the disease portfolio of the Indian Development. During 2010, there was an increase in dengue virus infections in Mumbai as compared to 2009. This study determined the socio demographic status of suspected dengue cases from 2010 to 2012 in a tertiary care centre of Navi Mumbai. The comparative outcome of dengue NS1, IgM and IgG ICT, dengue NS1, IgM and IgG ELISA, and RT-PCR for dengue NS1 antigen to assess which of them is better for patient management and prevention of complications like DHF and DSS. Distribution in 320 positive samples were NS1 positive 51.56%, IgM positive 22.81%, IgG positive 12.2%, NS1 + IgM positive10.31%, IgM + IgG positive 2.19% and NS1 + IgM + IgG positive 0.93%.In 100 randomly selected ICT positive cases, there was a gain of 6 (3+3) positive samples by the NS1 Microlisa test as compared to the NS1 immuno chromatography test. In 66 ICT positive samples, there was a gain of 7 (2+5) positive samples by IgM Microlisa and a gain of 1 sample by IgG Microlisa. Out of 30 samples subjected to RT-PCR, all 15 positive Microlisa samples were positive, while 4 out of 15 Microlisa negative samples were positive by the RT-PCR. Overall there was a gain of 4 positive samples by the RT-PCR. As we found RT-PCR to be the gold standard, sensitivity and specificity of NS1 ICT were found to be 91.2% and 78.4%, while that of NS1 ELISA were found to be 75% and 88%. For the early diagnosis of dengue infection, Immuno chromatography test is a good screening test with good sensitivity, while dengue ELISA is more specific and can be used as confirmatory tests in routine laboratory setup. RT-PCR for dengue antigen is the most confirmatory test with highest sensitivity and specificity but is expensive. A combination of the three tests is recommended for dengue diagnosis in laboratories.

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