Dengue Patients Research Articles

Ketepatan Pengkodean Diagnosis Demam Berdarah Dengue Berdasarkan Hasil Pemeriksaan Klinis di Rumah Sakit Singaparna Medika Citrautama

One of the supporting units in the hospital, namely medical records, is a manual / electronic record carried out by health care providers such as diagnosis. One of the medical record activities is to code the disease. Coding is the provision of alphanumeric symbols carried out by the coder. The diagnosis coding provided must be correct in accordance with the codes listed in ICD-10, the correct coding will affect hospital health financing. The research was conducted at Medika Citra Utama Hospital. This study aims to describe the coding procedures and accuracy of disease diagnosis using a cross sectional design. The population of cases in this study were medical records of dengue haemorrhagic fever patients from January to December 2022. The number of samples was 98 medical records. The sampling technique used was simple random sampling. The results of the study of diagnosis coding procedures carried out by the coder have not been in accordance with the steps that have been determined by ICD-10 volume 2 due to the busyness of officers in carrying out other activities and there are 78.6% of medical records that are appropriate and in accordance with the results of clinical examinations, 21.4% of medical records that are not appropriate and do not match the results of clinical examinations resulting in pending claims at the hospital. The conclusion of this study is that coder officers are expected to do coding referring to ICD-Volume 2 and pay attention to clinical examination in order to get accurate coding so that hospital claims are claimed on time.

Surface-enhanced raman spectroscopy with machine learning in non-invasive detection of dengue-NS1 fingerprint

The surface-enhanced Raman spectroscopy (SERS) method exploits the plasmonic effect of nano-sized metallic materials to intensify the Raman scattering of the monochromatic light of analyte molecules. This promotes the sensitivity and specificity of the Raman spectroscopy analysis method. This study integrated SERS with machine learning (ML) to detect dengue fever, a disease infecting more than 40% of the world’s population. Non-structural protein 1 (NS1), detected in the sera of infected dengue patients during the early infection stage, is currently recognised as a biomarker for the early diagnosis of DF. However, no attempts have been made to detect NS1 in the salivary Raman spectra. Given this situation, this study delves into the potential of SERS as an early, non-invasive DF detection technique using salivary NS1. The SERS spectra of saliva samples (n=289) were collected and subsequently classified as positive and negative for DF, using principal component analysis (PCA) integrated with support vector machine (SVM) models. The PCA-SVM model's performance was benchmarked against two clinical diagnostic NS1-enzyme-linked immunosorbent assay (ELISA) tests recommended by the World Health Organization (WHO). The PCA-SVM model outperformed both tests regarding radial basis function kernel (RBF) and cumulative percent variance (CPV; 83.22% accuracy, 88.27% sensitivity, 78.13% specificity). It is encouraging that the sensitivity level of the PCA-SVM model is above the benchmark set by the saliva-based NS1-ELISA tests proposed by the WHO, demonstrating the potential of SERS for the non-invasive detection of DF.

Clinical and Demographic Characteristics of Dengue Patients in Public Sector Hospital

Clinical and Demographic Characteristics of Dengue Patients in Public Sector Hospital

A retrospective analysis on seroprevalence of acute viral hepatitis observed among dengue patients attending a tertiary care centre in central India

PurposeThe present study was conducted retrospectively to assess the frequency of acute viral hepatitis among the clinically suspected dengue cases presented at our tertiary care centre during 2021. MethodsTo determine the presence of acute viral hepatitis; Hepatitis A virus (HAV) and Hepatitis E virus (HEV) infections, 104 specimens were selected from the dengue-suspected clinical specimens received during 2021 on the basis of acute viral hepatitis symptoms. Following this, serological diagnosis was performed on those samples using anti-HAV IgM and anti-HEV IgM ELISA kits. ResultsBased on sero-positivity for IgM antibodies, 3 (5.3%) dengue virus (DENV) seropositive samples were positive for both HAV and HEV, while among DENV seronegative cases, 11 (22.91%) samples were positive for HEV and 1 (2.08%) sample was positive for HAV, pointing towards misdiagnosis due to overlapping symptoms. Additionally, co-infection of HAV & HEV in 1 sample was also observed in this study. ConclusionsThis study revealed the presence of acute hepatitis infections among the dengue cases during monsoon and post-monsoon season. Overlapping of the clinical manifestations of these diseases can create misdiagnosis incidences raising risk for underreporting of the true cases of acute viral hepatitis infection. Dengue-suspected patients with selected symptoms during the monsoon and post-monsoon season should additionally be screened for acute hepatitis infections, as suggested in this study.

Longitudinal serum profiling in Dengue fever patients with different severities by using multiplex flavivirus antigen microarrays

Dengue fever is one of the most common arbovirus-infected diseases and typically progresses through the febrile, critical, and convalescent phases. While most Dengue Fever patients have mild symptoms, a few develop severe symptoms due to hyperimmune responses. However, the role of the humoral responses during the Dengue fever progression, especially in severe cases, is still unclear. Here, we developed multiplex Flavivirus Antigen Microarrays (FAMs) for profiling antibody specificities in different infection phases and Dengue fever severities. The FAMs comprised 17 nonstructural and envelope proteins from Flaviviruses that frequently infect humans, e.g., 4 serotypes of Dengue viruses, Zika virus, Japanese encephalitis virus, West Nile virus, Yellow fever virus, and Tick-borne encephalitis virus. We collected serum samples from Dengue fever patients with different degrees of severity, including mild (n = 17), hospitalized non-severe (n = 21), and severe (n = 19), during febrile (Day < 7) and convalescent (Day > 7) phases. We simultaneously profiled the serum IgG and IgM against multiple antigens on the FAMs to demonstrate the immunological signatures in Dengue fever patients with different severities and two infection stages. Compared to febrile phase, the convalescent phase of mild but not hospitalized cases exhibiting evoked Dengue-specific IgM. In IgG profiling, the convalescent phase showed generally higher immune responses compared to febrile phase. Moreover, in the febrile phase, the hospitalized patients displayed higher IgG levels against 4 serotypes of Dengue viruses, Zika virus, and West Nile virus compared to mild patients, suggesting early and strong humoral responses. This study provides a valuable tool for monitoring antibody specificities and advances our understanding of humoral responses along with Dengue fever severities.

Effect of dengue infection on liver profile and hematological parameters

Dengue fever is endemic in Sri Lanka. Liver damage is common in dengue fever. Understanding the pattern change of the liver profile and haematological parameters is crucial for managing dengue patients and minimising liver damage. The purpose of this study was to determine the pattern change in liver profile and the haematological parameters of dengue patients. Sixty apparently healthy volunteers and 169 acute dengue patients aged 20 or older had their blood samples examined. Liver enzymes, albumin, protein, bilirubin, white blood cell count, platelet count, haematocrit, and haemoglobin were measured. There was an increase in aspartate aminotransferase (105.6 IU/L), alanine aminotransferase (82.6 IU/L), and gamma-glutamyl transferase (68.9 IU/L), which were 3.4, 3.9, and 3.2-fold higher, respectively, than those of the control group, suggesting liver injury. Eighty-four percent of patients had raised levels of aspartate aminotransferase, and 74% of patients had elevated levels of alanine aminotransferase, indicating the prominence of aspartate aminotransferase over alanine aminotransferase. The presence of a positive correlation between the levels of aspartate aminotransferase and alanine aminotransferase indicates that the elevation of enzymes is primarily due to a single cause, liver injury. White blood cells and platelet counts were significantly lower. Platelet count demonstrated a negative correlation with both haematocrit and haemoglobin in dengue patients. In conclusion, aspartate aminotransferase was identified as the most significant marker of dengue-associated liver injury, followed by alanine aminotransferase. Low platelet and white blood cell counts were the major unfavourable changes in dengue patients' haematological characteristics.

Comparison of 2009 and 2011 WHO Guidelines, and Scoring Models for Adult Hospitalized Dengue Infection: A Single Observation in Tangerang, Indonesia

&lt;p&gt;&lt;strong&gt;Background:&lt;/strong&gt; World Health Organization (WHO) published a dengue guideline in 2009 and in 2011 by WHO-SEARO. However, many of dengue cases in early phase do not meet all the criteria by WHO classification. Because of this condition there is a scoring model that was published in 2015, that might help in primary health care. Therefore, a study to compare those diagnostic tools especially in adult dengue patients in Banten is needed.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Aims:&lt;/strong&gt; This study is to know the comparison between 2009 version and 2011 version of dengue diagnostic guidelines by WHO and scoring model version.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Methods and Material:&lt;/strong&gt; This study used a descriptive method with a cross-sectional design at 60 adult dengue patients. Each patient is grouped according to diagnostic tools’ classification and will be analyzed using Chi-square.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Results:&lt;/strong&gt; Results are grouped according to the WHO diagnosis from 2009 and 2011, presumptive model and probable models where there are 46 (77%), 48 (78%), 31(52%), and 15 (25%) of patients diagnosed with dengue infection. Overall, the diagnosis made by the 2009 WHO and the probable models has the most superior sensitivity and specificity values of 84,6% and 25%, and 82,4% and 97,7% respectively compared to other diagnostic tools. However, from the results of positive predictive values, probable models have a higher percentage than the 2009 WHO diagnosis.&lt;/p&gt;&lt;strong&gt;Conclusions:&lt;/strong&gt; The probable model is more sensitive and specific than other diagnostic results. These conclude that probable model is best tool for dengue infection screening in early phase of infection.

Cytokine profiles in dengue fever and dengue hemorrhagic fever: A study from Indonesia.

Recent studies have demonstrated that cytokine dysregulation has a critical role in the pathogenesis of dengue hemorrhagic fever (DHF) and dengue shock syndrome (DSS). The aim of this study was to investigate the association between tumor necrosis factor (TNF- α), interleukin 6 (IL-6), interleukin 10 (IL-10), and interleukin 17 (IL-17) with infection status, and severity of dengue. A prospective cross-sectional study was conducted at three hospitals in Gianyar regency and Denpasar municipality, Bali, Indonesia, from June to December 2022. Sixty-four dengue infected patients were involved. Patients' serum was tested for dengue infection using NS1 antigen rapid test, dengue virus immunoglobulin M (IgM) and immunoglobulin G (IgG) test, and reverse transcription polymerase chain reaction (RT-PCR). Cytokine levels (TNF-α, IL-6, IL-10, and IL-17) were measured using enzyme-linked immunosorbent assay (ELISA). Infection status was determined by combining serological and RT-PCR results, categorizing patients into primary and secondary infections. The present study found that DF patients had lower TNF-α, IL-6, and IL-17 but higher IL-10 levels compared to DHF patients (p<0.001). Elevated TNF-α, IL-6, and IL-17 levels were higher in secondary infection, while IL-10 level was higher in primary infection (p<0.001). In conclusion, cytokines play a crucial role in the interplay between cytokine dysregulation and dengue infection dynamics.

High fluorescent lymphocytes in dengue infection; A navigator for hematopathologists.

Objective: The aim of this research is the early detection of dengue infection on the basis of presence of high fluorescent lymphocyte (HFL) which enables the clinicians to tailor further investigations and early commencement of treatment to prevent complications and thus can reduce mortality and morbidity in dengue patients. Study Design: Prospective Research. Setting: Fauji Foundation Hospital in Rawalpindi. Period: February 2022 to July 2022. Material &amp; Methods: Samples of Full blood counts (FBC) received in Pathology laboratory were processed on automated Hematology analyzer Sysmex XN-series (XN-1000). All the FBCs that were of known dengue patients were excluded from the study. The FBCs with High Fluorescent Lymphocytes on White blood cell differential fluorescence (WDF) scattergram were selected and evaluated. Detection of dengue infection was done by using Dengue Virus ELISA (IgM and IgG) test. Results: Among one hundred samples with High Fluorescence Lymphocyte there were 77% were Dengue Positive. Binomial test did give a significant association of Dengue with High Fluorescence Lymphocyte (p&lt;0.01). Conclusion: We draw the conclusion that presence of high fluorescent lymphocytes helps in the early detection of dengue positive cases.

Point-of-care dengue detection: polydopamine-modified electrode for rapid NS1 protein testing for clinical samples.

Early diagnosis of dengue infection by detecting thedengue virus non-structural protein 1 (DENV-NS1) is important to the patients to initiate speedy treatment. Enzyme-linked immunosorbent assay (ELISA)-based NS1 detection and RT-PCR are time-consuming and too complex to be employed in remote areas of dengue-endemic countries. Meanwhile, those of NS1 rapid test by lateral flow assay suffer from low detection limit. Electrochemical-based biosensors using screen-printed gold electrodes (SPGEs) have become a reliable detection method to convey both ELISA's high sensitivity and rapid test portability. In this research, we developed an electrochemical biosensor for DENV-NS1 detection by employing polydopamine (PDA)-modified SPGE. The electrodeposition of PDA on the surface of SPGE serves as a bioconjugation avenue for anti-NS1 antibody through a simple and low-cost immobilization procedure. The biosensor performance was evaluated to detect DENV-NS1 protein in PBS and human serum through a differential pulse voltammetric (DPV) technique. The developed sensing platform displayed a low limit of detection (LOD) of 1.63pgmL-1 and a wide linear range of 10pgmL-1 to 1ngmL-1 (R2 ∼ 0.969). The sensing platform also detected DEV-NS1 from four different serotypes in the clinical samples collected from dengue patients in India and Indonesia, with acceptable sensitivity, specificity, and accuracy values of 90.00%, 80.95%, and 87.65%, respectively. This result showcased the facile and versatile method of PDA coating onto the surface of screen-printed gold electrodes for a miniaturized point-of-care (PoC) detection device.

Association Between Leucopenia, Transaminitis, Nonstructural Protein One Antigen (Ns1Ag) Level, and Thrombocytopenia in Adult Dengue Patients in a Tertiary Care Hospital: A Cross-Sectional Study.

The dengue virus is present throughout the tropics. Thrombocytopenia is one of the severe manifestations of the dengue virus. We studied the association of thrombocytopenia with serum transaminase level, leucopenia, and nonstructural protein one antigen (Ns1Ag) level. Data were taken retrospectively from hospital records after obtaining ethical committee approval. In the study, we included 102 patients with acute febrile illness with clinical features suggestive of dengue fever (dengue Ns1Ag positive, dengue IgM positive, or both). We excluded patients with thrombocytopenia due to other causes. Patients' demographic, clinical, and laboratory parameters were collected. We also noted episodes of bleeding or the need for a platelet transfusion. We did a statistical analysis to find out the correlation between age, sex, leucopenia, transaminitis, Ns1Ag level, and thrombocytopenia and its severity. Multiple regression analysis was used to find thrombocytopenia predictors among aspartate transaminase (AST), alanine transaminase (ALT), Ns1Aglevel, and leucopenia. AST and ALT correlated inversely with thrombocytopenia, with p-values of 0.012 and 0.027, respectively. Ns1Ag and leucopenia were not associated with thrombocytopenia, with p-values of 0.802 and 0.532, respectively (p-values significant at 0.01<= p<=0.05). Serum AST and ALT levels correlate with thrombocytopenia in dengue fever.

A case report on heart failure prevalence in dengue patients with concurrent fluid leakage syndrome: Unveiling a cardio-leakage co-existence

Dengue fever, a mosquito-borne viral infection, has been a growing global health concern with significant morbidity and mortality. Among the myriad complications that Dengue can manifest, fluid leakage syndrome has emerged as a particularly severe and challenging aspect of the disease. This case study delves into the prevalence of heart failure in patients who not only suffer from Dengue but also concurrently experience fluid leakage syndrome. Through an analysis of clinical data, patient histories, diagnostic criteria, and treatment outcomes, we explore the intricate relationship between these two conditions and their impact on the cardiovascular system. Our findings shed light on the complexities of managing these co-morbid conditions and explore the need for enhanced clinical approaches and awareness in addressing this dual health burden. This case study aims to contribute to the broader understanding of the interplay between Dengue, fluid leakage syndrome, and heart failure, with the ultimate goal of improving patient care and outcomes in such challenging clinical scenarios.

Seroprevalence Study of Dengue at a Tertiary Care Hospital in Jaipur, Rajasthan

Background and Aim: Dengue is one of the most severe mosquito-borne viral infection. In the absence of specific treatments and vaccines for dengue fever (DF), vector control is the only method by which the spread of dengue can be prevented. This study investigates the seroprevalence of DF cases by detecting NS1 antigen and immunoglobulin (Ig)-G and IgM antibody by enzyme-linked immunosorbent assay (ELISA) test. Materials and Methods: This study was carried out in the Department of Microbiology, at a Tertiary Care Hospital, Jaipur (Rajasthan), done between 6 months. Blood samples from clinically suspected cases of dengue were tested immediately for qualitative detection of NS1 Ag, IgM, and IgG antibodies by ELISA. Results: One thousand seven hundred and sixty-three serum samples were tested for dengue NS1 antigen, IgM, and IgG, out of which 1066 were positive for one or more serological parameters. Dengue cases for the NS1 infection are 52.53%, for the IgM infection is 33.39%, and for the IgG infection is 14.07%. Sixty-two percentage positive samples were of male patients and 57% of positive samples were from 19 to 40 years of age group (adult population) (59%). The seasonal trend showed a gradual increase in dengue-positive cases that started in September with a peak in October (46.24%). Conclusion: The monsoon and postmonsoon seasons are times of high virus activity and enhanced vector breeding. The population must thus be constantly monitored to prevent the virus from spreading further, and serological tests are crucial for making an early diagnosis. ELISA is advised for all suspected dengue patients to initiate therapy and decrease the morbidity and fatality rate.

Demographic Profile of Dengue Patient with Comorbidities in 100 Patients in A Tertiary Care Hospital, Bangladesh

Background: In the past decades, incidence of dengue has grown rapidly. There are four types of viruses (DENV-1, DENV-2, DENV-3, DENV-4) belonging to the Flaviviridae family. These mosquitoes breed in areas with standing water, including puddles, water tanks, containers and old tires. Lack of reliable sanitation and regular garbage collection also contribute to the spread of the mosquitoes. Each year, thousands of dengue infections are reported and there are several outbreaks of dengue in several countries including Bangladesh and this imply the global importance of this infection. Objective: To assess the demographic profile of dengue patient with comorbidities in 100 patients in a tertiary care hospital. Methods: A prospective study was done at Department of Medicine, Uttara Adhunik Medical College and Hospital, Uttara, Dhaka, Bangladesh from January 2023 to June 2023. Written consent was taken before including the subject to the study. The study included 100 patients who consented to be a part of the study. The patients were subjected to detailed history and clinical examination. Data were collected from hospital records. All the relevant data regarding history and examination findings of the patients, the laboratory reports were collected. Statistical package for social science (SPSS) version 22, was used for data entry and statistical analysis. Results: Total 100 dengue patients were enrolled in this study. Mean age of all patient was 34.62±16.22 years (12-75 year) with male predominance (54%). Maximum patients were from urban residence (84%), non-smoker (73%), had active lifestyle (63%) and normal body mass index (69%). Overall, 65% patients had no comorbidity and 89% had no concurrent acute illness. Conclusion: Although the results of this study cannot be generalized to other cities of Bangladesh, our findings will allow public health agencies in Bangladesh to concentrate their efforts to battle against dengue.

Penerapan Algoritma Naive Bayes untuk Klasifikasi Demam Berdarah Dengue di RSUD dr. Achmad Darwis

Dengue Hemorrhagic Fever (DHF) is a disease transmitted through the bite of the Aedes Aegypti mosquito. Limapuluh Kota Regency BPS stated that the morbidity rate due to dengue fever was 14.40% per 100,000 population, this figure jumped high from the previous year with a morbidity rate of 3.30% per 100,000 population. The main symptoms of dengue fever are fever that lasts for 2-7 days, pain felt in the muscles and joints accompanied by a rash or no rash, dizziness, and even vomiting blood. Dengue infection can cause various clinical symptoms, ranging from dengue fever, dengue hemorrhagic fever, to dengue shock syndrome. Based on this, there is a need for a classification method that can help and facilitate early diagnosis of dengue fever. The method used is Naive Bayes by classifying dengue positive and dengue negative patients. The aim of this research is to determine the results of the classification of patients suffering from dengue fever, as well as to determine the level of accuracy using the Naive Bayes method. Based on research that has been carried out, the results of the classification of patients are 58 correct and 14 patients classified incorrectly. The accuracy results obtained in this algorithm were quite high, namely 80%, while the sensitivity was 65% and the specificity was 86.5%.

Therapeutic Potential of Carica papaya Linn.: A Comprehensive Review of Its Pharmacological Properties and Health Benefits, with Emphasis on Dengue Fever Healing

For thousands of years, people have used various plant products, foods, spices, and herbs to treat and prevent illnesses. Sri Lankans have been using traditional and folk medicine to satisfy their basic health needs from the earliest days. Carica papaya Linn. (Caricaceae) is a commercially grown exotic plant in Sri Lanka. The entire plant, including the fruits both ripened and green, leaves, roots, peel, seed, and pulp, was used as medicine in traditional medicinal systems. Plant parts of Carica papaya Linn. were frequently used by ancient Sri Lankans to treat diabetes mellitus, hypertension, cancer, dengue fever, skin infections, renal disorders, and infections caused by bacteria, fungi, parasites, and viruses. Dengue fever is the most prevalent and significant arthropod-borne viral disease in humans, and it is extensively spread throughout Sri Lanka. Carica papaya Linn. extracts have been used to treat dengue patients to recover from its complications, which include thrombocytopenia, hemolysis, and leukopenia. Studies reveal that the papaya leaf extract can neutralize plasma with the dengue virus, reduce platelet aggregation, and increase the production of the enzyme ALOX12, which promotes platelet production. Moreover, the extract also upregulates the platelet-activating factor receptor (PTAFR) gene and inhibits serine proteases NS2B and NS3 involved in dengue virus replication. In this review, we have discussed extensively the ethnomedicinal and pharmacological properties of Carica papaya while highlighting its remarkable potency in healing dengue.

Perception of medical specialists on the usability of a dengue mobile application in rural areas: a qualitative study

Introduction. Mobile applications represent a promising alternative for providing support in the management of Dengue patients. However, the usability of these tools in Peru is unknown. Objectives. To evaluate the usability and usage recommendations of the Dengue ONQOY application in managing Dengue patients in rural areas of Peru. Methods. A qualitative study was conducted, which included semi-structured interviews with 8 experts in Dengue management. Data were coded using Atlas. Ti software. Three categories were assessed: (1) informative usability (2) design usability, and (3) recommendations for improvement. Results. Three key aspects were highlighted. (1) The application is perceived as valuable for first- level doctors in peripheral areas with limited Dengue experience due to its personalized approachand academic value. (2) Its ease of use and practicality were emphasized, although connectivity limitations in some areas were noted. (3) Recommendations for improvement included the inclusion of differential diagnoses, additional risk factors, updated references, hydration guidelines, and medication dosages. Conclusions. Dengue ONQOY is considered highly usable by doctors treating Dengue cases at the primary care level in Peru. Despite connectivity limitations and potential design improvements, its development and implementation offer a promising alternative for managing Dengue patients in the country in this field.

Immunological signatures unveiled by integrative systems vaccinology characterization of dengue vaccination trials and natural infection.

Dengue virus infection is a global health problem lacking specific therapy, requiring an improved understanding of DENV immunity and vaccine responses. Considering the recent emerging of new dengue vaccines, here we performed an integrative systems vaccinology characterization of molecular signatures triggered by the natural DENV infection (NDI) and attenuated dengue virus infection models (DVTs). We analyzed 955 samples of transcriptomic datasets of patients with NDI and attenuated dengue virus infection trials (DVT1, DVT2, and DVT3) using a systems vaccinology approach. Differential expression analysis identified 237 common differentially expressed genes (DEGs) between DVTs and NDI. Among them, 28 and 60 DEGs were up or downregulated by dengue vaccination during DVT2 and DVT3, respectively, with 20 DEGs intersecting across all three DVTs. Enriched biological processes of these genes included type I/II interferon signaling, cytokine regulation, apoptosis, and T-cell differentiation. Principal component analysis based on 20 common DEGs (overlapping between DVTs and our NDI validation dataset) distinguished dengue patients by disease severity, particularly in the late acute phase. Machine learning analysis ranked the ten most critical predictors of disease severity in NDI, crucial for the anti-viral immune response. This work provides insights into the NDI and vaccine-induced overlapping immune response and suggests molecular markers (e.g., IFIT5, ISG15, and HERC5) for anti-dengue-specific therapies and effective vaccination development.

Comparative Diagnostic Value of Dengue Infection Using ELFA and Two Commercial Immuno-Chromatography Tests

Dengue Virus (DEN-V) can lead to a broad spectrum of clinical presentations, from mild symptoms to mortality. Based on the presence of antibodies, dengue infection is categorized into primary and secondary dengue. Early diagnosis is crucial for effective treatment of DEN-V infection. Non-Structural Antigen 1 (NS1) and dengue antibodies like immunoglobulin M (IgM) and immunoglobulin G (IgG) anti-dengue are standard assays used for dengue diagnosis. Various immunoassay methods, including Enzyme-Linked Fluorescent Assay (ELFA) and Immuno-Chromatographic Tests (ICT), are employed to detect these antigens and antibodies. This study aimed to compare the diagnostic value between ELFA and two commercial ICTs for detecting NS1 antigen, IgM/IgG anti-dengue. Seventy suspected dengue patients with fever lasting two to seven days at Premier Hospital, Surabaya were enrolled in this study. Blood serum samples from the individuals were tested for NS1 antigen and IgM/IgG anti-dengue using VIDAS® and two commercial ICTs (Boson and SD Bioline). The sensitivity of NS1 antigen assays using ELFA and two ICTs was calculated, as well as the agreement rate between ELFA and both ICTs. ELFA demonstrated high sensitivity (77.97%) for NS1 antigen detection in diagnosing dengue infection compared to two ICTs (76.27% and 45.45%). Using an automated system in ELFA can offer more excellent diagnostic value and objective results and determine the cut-off ratio of IgM/IgG antibodies. All of this comes at a cost comparable to ICT.

Spectrum of Liver Injury in Dengue Fever: Cause or Effect of Severe Dengue?

The study aimed to determine if deranged liver function tests (LFTs) can predict severe dengue or mortality. It included 135 dengue patients, with a mean age of 30.9 ± 12.09 years. Among the patients, 82 (60.7%) were under 30 years of age. Nearly half of the patients (64, 47. 4%) had some degree of liver damage indicated by deranged LFTs, 27 (42.1%) had elevated alanine transaminase (ALT), 7 (10.9%) had increased bilirubin, and 30 (46.9%) had high values of alkaline phosphatase (ALP). However, only elevated ALP levels were positively correlated with mortality (Pearson's R = 0.282, p = <0.05). The mean bilirubin was 11.711 ± 8.602 umol/l, and the mean values of ALT and ALP were 107 ± 240 and 113.571 ± 59.91 IU/L, respectively, which were higher than the normal. The study findings suggested that hepatic derangement is a common occurrence in dengue patients, and increased ALP levels could be an indicator of a higher risk of mortality. These findings can help improve patient care by identifying the potential risk factors for mortality. Key Words: Dengue, Liver function tests, Alanine transaminase, Alkaline phosphatase.