Incidence of dengue in a rural hospital, Chinakakani, Andhra Pradesh, South India and comparison of two commercially available enzyme linked immunosorbent assays with immunochromatographic rapid test

Sumana Prudhivi, Bindu Madhav Yenigalla, Ramesh Babu Myneni

Abstract


Background: Dengue is one of the most serious mosquito borne arboviral infections affecting tropical and subtropical countries in the world. Since there is no immune prophylactic or specific anti-viral therapy available, timely and rapid diagnosis plays a vital role in patients management and implementation of control measures. This work has been taken up
1. To study the incidence of dengue cases in our rural hospital, Chinakakani, South India. 2. To compare the performances of Pan Bio capture ELISA [PanBio], J Mitra Microlisa [J Mitra] and SD BIO dengue duo rapid test [SD RT].

Methods: A total of 1180 serum samples from clinically suspected dengue cases were collected over a period of seven months. All the samples were subjected to NS1 antigen and IgM antibody Pan Bio ELISA. The same were tested for J Mitra Microlisa and SDRT and were compared with Pan Bio. Measure of discrimination i.e. sensitivity and specificity was calculated for each observed test value and an receiver operating characteristic [ROC] curve was constructed to compare the area under curve’s [AUC] of different test kits thereby identifying the test with the best discriminative value.

Results: Out of 1180 samples tested, Pan Bio has shown an incidence rate of 284 [24.06%] (NS1 156+IgM 128), J Mitra 280 [23.72%] (NS1 156 + IgM 124) and SDRT 292 [24.74%] (NS1 156+IgM 136). As far as NS1 is concerned the same 156 samples were positive in all the three tests giving the sensitivity, specificity, positive and negative predictive values 100%. Remaining 1024 samples were negative for NS1. But this was not the case with IgM. AUC of IgM Pan Bio is 0.944 with sensitivity 90.32% and specificity 98.48%. AUC of IgM J Mitra is 0.932 with sensitivity 81.62% and specificity 98.75%. AUC of IgM SD RT is 0.992 with sensitivity 99.2% and specificity 99.1%. ‘Z’ test revealed that there is statistically significant difference between AUC’s of SD RT when compared to Pan Bio (p value: 0.05) and J Mitra (p value 0.0001) The p values explain that SD RT is superior to Pan Bio and J Mitra in classifying between diseased and non-diseased.

Conclusion: High incidence rate was noticed in our region during monsoon and post-monsoon season which calls for timely preventive and control measures. SDRT is a valuable screening test in laboratories with minimal resources.

 


Keywords


Dengue, Capture ELISA, Microlisa, Rapid test, AUROCC analysis

Full Text:

PDF

References


Alcon, S, A Talarmin, M. Debruyne, A. Falconar, V. Deubel and M.Flamand. ELISA specific to dengue virus type 1 non structural protein NSI reveals circulation of the antigen in the blood during the acute phase of disease in patients experiencing primary or secondary infections. J.clin. microbiol. 2002, 40:376-381.

Blacksell, S.D, M.P.Mammen, S Thongpaseuth, R.V.Gibbons, R.G.Jarman, K.Jenjaroen, et al 2008. Evaluation of the panbio dengue virus non –structual 1 antigen detection and immunoglobulin M antibody ELISA for the diagnosis of acute dengue infections in Laos. Diagn Microbiol Infect. Dis.60:43-49.

Dussart P, Labeau B, Lagathu G, Louis P, Nunes MRT Rodrigues SG, et al. Evaluation of an enzyme immuno assay for detection of dengue virus NSI antigen in human serum. Clin vaccine immunol 2006: 13:1185-9.

Ekta Gupta, Lalit Dar, Geetanjali Kapoor and Shoba Broor. The changing epidemiology of dengue in Delhi, India, Virology journal 2006, 3:92.

Fauziah Md Kassim. M Nur Izati, TAR TgRogayah, Y Mohd apandi and Zainah Saat, Use of Dengue NS1 antigen for early diagnosis of dengue virus infection. Virology unit, Institute of Medical Research, Kuala Lumpur, Malaysia Vol:42, No.3, May 2011.

Gazman Mg, kouri G (2002) Dengue, an update lancet infect Dis 2:33-42.

Guha Sapir D, Shimmer B. Dengue fever: new paradigms for a changing epidemiology. Emerging themes in epidemiology, 2005. Open access journal http://www: etc – online. Com/content/2/1/1.

Halstead SB, Nimmannitya S, observations related to pathogenesis of DHF. IV. Relation of disease severity to antibody response and virus recovered. Yale J Biol Med 1970, 42: 311 – 328.

Innis B.L. A.Nisalak, S.Nimmannitya, S.Kusalardchariay, V.Chongswasdi, S.Suntaya Korn et al 1989. An enzyme linked immunosorbent assay to characterize dengue infections where dengue and Japanese encephalitis co-circulate. Am. J. Trop. Med. Hyg. 40: 418-427.

Jayasimha V.L, Thippeswamy M.T.R, Yogesh Babu K.V, Vinod Kumar C.S, Niranjan H.P, Raghukumar K.G, Basavarajappa K.G Dengue : Seroprevalence, comparison of Rapid test with ELISA National journal of Basic Medical Sciences volume III, Issue – I p: 57-60.

Kaplan JE, Eliason DA, Moore M. Epidemiological investigations of dengue infection in mexico 1980. Am J Epidemiology 1983, 117: 335 – 343.

Kabra SK, Jain Y. Pandey Rm Dengue haemorrhagic fever in children in the 1996 Delhi epidemic. Trans R SOC Trop Med Hyg 1999, 93 : 294 – 298.

Kovi Bessoff, mark Deloray, Wellington Sun, and Elizebath Hunsperger, Comparision of two commercially available dengue virus (DENV) NS1 capture ELISA’s using a single clinical sample for diagnosis of acute DENV infection. Clinical and vaccine immunology 2008;15(10):1513-8.

Libraty, D.H, P.R. Young, D. Pickering, T.P. Endy, S.Kalayanarooj. S.Green, et al 2002. High circulating levels of the dengue virus non structural protein NS1 early in dengue illness correlate with the development of dengue haemorrhagic fever. J Infect Dis. 186:1165-1168.

Monique da Rocha Queiroz Lima, Rita Maria Ribeiro nogueria, Hermann Goncalves schatzmayr, Flavia barreto dos santos. Comparision of three commercially available dengue NS1 antigen capture assays for acute diagnosis of dengue in Brazil. July 2010, Vol:4, issue:7, e 738.

Monath TP (1994) Dengue, the risk to developed and developing countries, Proo Natl Aead Sci U.S.A 91, 2395-2400.

Narayan Manjit, Aravind MA.Dengue fever outcome in Chennai-A study of clinical profile and outcome-Indian paediatric-2002 Nov. 17:39:1027-33.

Philippe Dussart, Laure Petit, Bhety labeau, Laetitia Bremand. Evaluation of two new commercial tests for the diagnosis of acute dengue virus infection using NS1 antigen detection in Human serum. Aug: 2008, Vol 2, issue 8, e 280.

Rasul CH. Ahsan HAMN, Epidemiological factors of dengue haemorrhagic fever in Bangladesh. Indian paediatric. 2002. 39:369-372.

Sekaran, S.D.,Ew, C.L., Subramanian, G-, Kanthesh, B.M. Sensitivity of dengue virus NS1 detection in primary and secondary infections. African journal of Microbiology Research 2009;3(3):105-10.

Vanghn DW, Green S, Kalayanarooj S. Innis BL, Nimmanitya S, Suntaya Korn S, et al (1997) Dengue in the early febrile phase: Viraemia and antibody responses. J. Infect. Dis 176:322-330.

World Health Organization, WHO (2002) Dengue and Dengue hemorrhagic fever. Fact sheet No:117. WHO Geneva available at http://www.who.int/ media centre/facts heets/f 117/en/Print.html.

National vector borne disease control programme. Available at www.nubdcp.gov.in/den-cd.html. Accessed 1 September 2014.

P M Ukey, S A Bondade, P V Paunipagar, R M Powar, S l Akulwar. Study of seroprevalance of Dengue Fever in Central India. Indian J Community Med. 2010;35 (4):517-519.

Patel LR. Seroprevalance of Dengue NS1 antigen in teritiary care hospital – Ahmedabad. Indian Journal of Basic & Applied Medical Research 2013;2(7):694-701.