Early Diagnosis Of Dengue Fever Research Articles

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%.

Comparison of rapid dengue NS1, qualitative ELISA, and quantitative ELISA result

Background: Non-structural glycoprotein-1 (NS1) is a useful biomarker for early diagnosis of dengue fever. NS-1 antigen ELISA can be used for the early diagnosis of dengue fever in the acute stage. Quantitative methods are better for epidemic settings due to high false negative rates in qualitative ELISA. Methods: The study was initiated after approval from the institutional ethics council (IEC/DISS/17118). Study examined 280 patients with dengue symptoms who presented to the hospital's OPDs and IPDs. Patients were tested using qualitative ELISA, and those with Leptospira antibody, malaria, or Chikungunya IgM antibody were excluded. Age, gender, symptoms, comorbidities, total leucocyte count, platelet count, and risk category were all patient-related parameters. Patient-related parameters were recorded, and data was collected using Microsoft excel and analysed statistically. Results: Most patients aged 2-40 with male predominance had fever, chills, and body aches, 243 (86.8%) tested positive for ELISA NS1. Quantitative ELISA test showed a statistically significant correlation with rapid antigen NS1 result (p=0.015). Its AUC was 0.883 (p=0.0001), and its cut-off was (>109.1) with 96.9% sensitivity and 13.64% specificity. The AUC of quantitative ELISA NS1 against qualitative ELISA NS1 was 0.853 which was statistically significant (p<0.0001). At the cut-off >74.34, the test's sensitivity was 92.59% and specificity was 75.68%. Conclusions: Qualitative ELISA NS1 test is better than rapid antigen test for screening due to its higher specificity and similar sensitivity.

The application of automated cell population data for early diagnosis of dengue fever

The application of automated cell population data for early diagnosis of dengue fever

Evaluation of Ultrasonography as an Adjunct for Diagnosis of Dengue Fever Among Children

Introduction: This study aims to evaluate the role of ultrasonography (USG) for early diagnosis of clinically suspected dengue fever before it becomes serologically positive and usefulness of USG in predicting severity of the disease. Methods: Prospective observational study conducted at a tertiary care hospital from April 2020 to March 2021, 70 cases of clinically suspected dengue within the age group of 6 months to 15 years presenting with fever for less than 5days underwent whole abdomen and chest ultrasonography. For seropositive cases, ultrasonography findings and their utility in early diagnosis and prediction of disease severity was analyzed along with their correlation to the clinical and laboratory profiles.Results:75.8% had primary dengue and 24.2% had secondary dengue. 94% cases demonstrated ultrasonography features suggestive of dengue like hepatomegaly (81%), ascites (63.8%), splenomegaly (56.9%), gall bladder wall thickness (46.6%), Cholecystitis (44.8%) and Pleural effusion (41.4%). Ascites and pleural effusion correlated well with clinical severity (p<0.05). Ascites also had significant correlation with increased hematocrit (p=0.040) and thrombocytopenia (p=0). Significant correlation was observed between pleural effusion with decreased platelet count ((p=0.004) and decreased serum sodium levels (p=0.044). Gall bladder wall thickening >5mm correlated well with disease severity. USG showed 94.3% sensitivity, 16.67% specificity and 81.43% of diagnostic accuracy in the seropositive cases of this study. Conclusion: Ultrasonography is useful not only as an adjuvant for early diagnosis of Dengue fever but also as a marker of disease severity.

Role Of Ultrasound For The Diagnosis Of Complications Of Dengue Fever In Gujrat

Background : The purpose of this study is to evaluate if ultrasonography may be used as an useful addition to clinical and radiology profiles in diagnosing dengue fever and predicting virus severity by comparing imaging findings. The difference in sonographic characteristics observed in patients of various ages was also investigated. 
 Objective : The goal of this study is to determine role of ultrasound for diagnosis of complications of dengue fever in Gujrat 
 Materials and Methods: This is a retrospective study. From October and December 2021, 79 patients who were serologically confirmed with dengue fever were referred for ultrasound scanning of the abdomen at Aziz bhatti shaheed hospital Gujrat, and the imaging data were evaluated. The statistical kit for social science (spss) is used for data analysis.
 Results: out of 76 positive dengue patients there are 71(89.9%) male and 8(10%) are female .48 (60.8%) patients showed splenomegaly, 24(30%) patients showed ascites in which 8 (10%) have pelvic ascites and 16 (20.3%) abdominal ascites, 63 (79.7%) patients showed edematous GB wall thickening, 21(26.6%) showed pleural effusion while 18 (22.8 %) have bilateral pleural effusion and 3 (3.8%) have right sided. 
 Conclusion: In patients presenting with fever and concomitant symptoms, sonographic signs of thickening GB wall, pleural effusion (bilateral or right side), ascites, and splenomegaly should strongly help in early diagnosis of dengue fever, especially during an outbreak. 

Rapid screening of dengue fever using research parameters from new generation hematological analyzers.

The early diagnosis of dengue fever and its differentiation from other causes of acute febrile illness is essential for a better outcome. The new generation automated hematology analyzers provide parameters like high fluorescence lymphocyte count (HFLC) and leukocyte cell population data (CPD) representing various leukocytes. We tried to analyze the utility of these parameters in the rapid screening of dengue fever. The HFLC and the leukocytic CPD from the Sysmex XN1000 analyzer were obtained for 299 cases presenting with acute febrile illness, which included 97 dengue-positive and 202 cases dengue-negative controls. Additionally, 100 healthy controls were also included. The Receiver operative curves (ROC) were drawn to obtain a cut-off value for these parameters for discriminating among the dengue-positive and dengue-negative subgroups and healthy controls. The dengue-positive cases showed a significantly increased HFLC among the different groups of controls. The median (range) HFLC% was 1.9(0.30-6.55), 0.20(0.10-0.70), and 0.10(0.0-0.30) in the cases that were positive for dengue, negative for dengue, and healthy controls, respectively. The ROC analysis revealed HFLC% at a cut-off value of 1.75 which can discriminate between dengue-positive and dengue-negative patients, with 52% sensitivity, 90% specificity, 72% positive predictive value (PPV), and 80% negative predictive value (NPV). The regression analysis revealed LY-X, LY-Z, Ly-WX, LY-WZ, and MO-X as independent predictors for dengue fever. The HFLC and CPD obtained from Sysmex XN1000 hematology analyzer are valuable tools in rapidly screening dengue infection from other febrile illnesses in routine practice.

Case Report: False-Positive Dengue Non-Structural Protein 1 Antigen in a Patient with COVID-19 Infection

Abstract: Early diagnosis of dengue fever and COVID-19 is made very easy due to technological advancements. The non-structural protein 1 antigen test strips are widely used in various regions; however, false-positive events have begun to be reported in the dengue-endemic areas with the COVID-19 pandemic, even though statistically non-structural protein 1 antigens are very specific to dengue infection. We reported a case of the false-positive non-structural protein 1 test in a patient with COVID-19 infection.

A LEGO inspired fiber probe analytical platform for early diagnosis of Dengue fever.

Based on the concept of LEGO toys, a fiber probe analytical platform (FPAP) was developed as a powerful diagnostic tool offering higher sensitivity in detection of infectious agents compared to established methods. Using the form and the function of LEGO toys, this protocol describes a fiber-based, 96-well plate, which suspends a new class of chemically-designed, electrospun fibers within the assay. This clamping strategy allows both sides of the developed fiber mats to interact with biomolecules within the assay thus benefiting from the tailored chemical and physical properties of these fiber-based bioreceptors in attracting the biomolecules to the surface. The fabrication method of FPAP involves one-step electrospinning of the chemically designed fibers, 3D printing of the LEGO-like probing segments, and assembly of the device followed by ELISA procedure. FPAP follows the same principles of operation as that of a conventional enzyme linked immunosorbent assay (ELISA), therefore, it can be run by lab technicians, expert in ELISA. FPAP was used for early diagnosis of Dengue fever and provided an 8-fold higher sensitivity while the limit of detection (LOD) was recorded to be in femto-gram per milliliter range which is significantly low when compared to other existing techniques or conventional assay. This platform allows different types of paper/fiber bio-receptive platforms to be incorporated within the design that promises simultaneous recognition of multiple infectious agents.

Utility of NS1 antigen as an early serological marker in the diagnosis of dengue

Introduction: Dengue infection is one of the most common arboviral infection in India transmitted by the aedes mosquitoes. Early diagnosis of the infection is often missed if only the antibodies are tested. In this scenario detection of the NS1 antigen has gained importance which has very high specificity and can be detected from the first day of fever. Rapid immunochromatographic tests for the detection of both NS1 antigen as well as the IgM and IgG antibodies have been extensively used in the diagnosis of dengue infection because of the ease of performing when compared to ELISA testing. The present study aims in identifying various dengue markers in the early diagnosis of dengue fever. Materials and Methods: All the suspected dengue samples obtained in the Department of Microbiology were tested by rapid immunochromatography test for the detection of NS1 and IgM/IgG antibodies. Platelet counts were detected by automated analyzer and history and duration of fever has been taken. Results: A total of 1021 samples were tested for dengue infection out of which 158(15.4%) were positive for one or more of the dengue serology markers. Out of the 158, 85(53.79%) were positive only for NS1 antigen indicating the infection in the early stage, 60(37.97%) samples showed only IgM dengue antibodies and 6(3.79%) samples showed only IgG antibodies. Two serological markers are seen in 7 samples, out of which 4(2.53%) samples were positive for NS1+ IgM antibodies and the remaining 3(1.89%) samples for IgM+IgG antibodies. Majority of the cases were in the age group of 16-30 years and males were predominantly affected when compared to females. Decreased platelet count was observed in 62 out of 158 cases (39.2%). Maximum NS1 positivity was observed form 2nd to 7th day of fever where as IgM positivity was maximum between 7th to 9th day. Conclusion: Early diagnosis of dengue infection is warranted by the detection of NS1 antigen. Detection of NS1 antigen along with the IgM/IgG will ide

Laser-cut paper-based device for the detection of dengue non-structural NS1 protein and specific IgM in human samples.

The incidence of flavivirus infections has increased dramatically in recent decades in tropical and sub-tropical areas worldwide, affecting hundreds of millions of people each year. Dengue viruses are typically transmitted by mosquitoes and can cause a wide range of symptoms from flu-like fever to organ impairment and death. Although conventional diagnostic tests can provide early diagnosis of acute dengue infections, access to these tests is often limited in developing countries. Consequently, there is an urgent need to develop affordable, simple, rapid, and robust diagnostic tools that can be used at 'Point of Care' settings. Early diagnosis is crucial to improve patient management and reduce the risk of complications. In the present study, a novel laser-cut device made of glass-fiber paper was designed and tested for the detection of the dengue Non Structural 1 (NS1) viral protein and specific IgM in blood and plasma. The device, called PAD, was able to detect around 25 ng/mL of NS1 protein in various sample types in 8 minutes, following a few simple steps. The PAD was also able to detect specific IgM in human plasmas in less than 10 minutes. The PAD appears to have all the potential to assist health workers in early diagnosis of dengue fever or other tropical fevers caused by flaviviruses.

Approach to Early Diagnosis of Dengue Fever Based on Clinical Features and Biochemical Markers

Approach to Early Diagnosis of Dengue Fever Based on Clinical Features and Biochemical Markers

Ultrasound is Not Useful as a Screening Tool for Dengue Fever.

SummaryBackgroundDengue fever is a tropical disease that is transmitted by female Aedes Aegypti mosquitos. Early diagnosis is necessary to reduce the mortality and morbidity associated with the disease. A combination of clinical, laboratory, and sonography findings can be potentially helpful in making an early diagnosis of dengue fever. There is paucity of literature on the use of ultrasound for dengue fever screening; hence, the primary objective of the study was to evaluate the utility of ultrasound as a screening tool in dengue fever.Material/MethodsA total of 160 patients of suspected dengue fever were included in the study. They underwent ultrasound examinations in order to search for thickening of the gallbladder wall, pleural effusion, and ascites. On the basis of ultrasound findings, 65 cases were positive and 95 cases were negative for dengue fever. Serological tests were also used for diagnosing dengue fever, 93 cases were seropositive and 67 cases were seronegative. The ultrasonically diagnosed cases were compared with serologically diagnosed cases, and appropriate descriptive statistical analyses were applied.ResultsThe ultrasound findings included gall bladder wall thickening in 66 patients (41.2%). The sensitivity, specificity, and positive predictive value of ultrasound in diagnosing dengue fever were 58%, 84%, and 83%, respectively. The negative predictive value and accuracy were 59% and 68.8%, respectively.ConclusionsThe present study suggests that increased gall bladder wall thickness, pleural effusion, ascites, hepatomegaly, and splenomegaly are highly suggestive of dengue fever in clinically suspected cases. However, ultrasound should not be used as a screening tool, as negative ultrasound findings cannot rule out dengue fever due to the low sensitivity of this examination.

Dengue fever in cancer patients: Retrospective analysis

AimDengue fever and its complications are poorly described in the cancer patients. Moreover, diagnosis of dengue fever is a challenge in these patients. There is extremely limited number of such cases reported in the literature till date. MethodsWe undertook a retrospective observational study of 28 cases of dengue fever in cancer patients in a tertiary care center in India. 19 (67.85%) patients were of solid neoplasm and 9 (32.14%) patients of hematological malignancy. ResultsDelay in diagnosis of dengue occurred by a mean of 7.9 days (range 5–15 days). Twenty (71.42%) patients presented with persistent fever and myalgia, in rest 8 (28.57%) patients fever had subsided at the time of presentation. Sixteen (57.14%) patients had simple dengue fever, 9 (32.14%) patients had dengue hemorrhagic fever while 3 patients (10.71%) presented with dengue shock syndrome. At presentation, 10 (35.71%) patients had a platelet count <20,000/cumm. Thirteen (46.42%) patients received platelet transfusion. Mean number of units of platelets transfused were 6.36 (range 2–12). In comparison to patients with solid neoplasms more number of patients with hematological malignancies presented with dengue hemorrhagic fever (66.66%). Next chemotherapy delayed in 16 patients. The median duration of delay was 12 days (range 5–27 days). All patients recovered and none of the patient died from dengue infection. ConclusionIn majority of adult cancer patient, dengue fever follows a benign course. Still, early diagnosis of dengue fever may help physicians in modifying treatment decisions about the judicious use of antifungal and antibiotic therapies.

Can Radiology Play a Role in Early Diagnosis of Dengue Fever?

Background:Dengue fever (DF) is a viral hemorrhagic fever causing severe morbidity and mortality in affected patients.Aims:The purpose of our study was to evaluate the changing trends in radiological findings in DF, to find if ultrasound is useful in the diagnosis of DF during an epidemic in absence of serological tests, and also to investigate the effects of DF in pregnancy.Materials and Methods:A prospective study was conducted in 2013 comprising of 400 patients who were serologically positive for dengue. Out of these, radiological investigations were conducted for 107 patients who were analyzed.Results:Out of the 107 patients, 85 patients underwent ultrasound, 12 computed tomography (CT) scans of brain or paranasal sinuses, and 21 chest radiography. The maximum numbers of patients (79%) were in the age group of 20-50 years. The most common ultrasound finding was hepatomegaly that was seen in 62% of the patients. Other findings were splenomegaly (45%), gallbladder (GB) wall edema (45%), right-sided pleural effusion (37%), bilateral pleural effusion (22%), and ascites (36%). Out of 10 pregnant patients, 5 had oligohydramnios, 2 had intrauterine growth restriction, 2 had intrauterine fetal demise, and 5 had a normal antenatal ultrasound.Conclusion:Ultrasound findings of hepatosplenomegaly, GB wall edema, right-sided or bilateral pleural effusion, and ascites in patients presenting with signs and symptoms of DF during an epidemic are virtually diagnostic of DF. There have been recent changing trends with hepatosplenomegaly being the more common manifestation, in comparison to ascites and GB wall edema. DF also has catastrophic effects in pregnancy such as oligohydramnios and intrauterine fetal demise.

Recombinase Polymerase Amplification Assay for Rapid Diagnostics of Dengue Infection.

BackgroundOver 2.5 billion people are exposed to the risk of contracting dengue fever (DF). Early diagnosis of DF helps to diminish its burden on public health. Real-time reverse transcription polymerase amplification assays (RT-PCR) are the standard method for molecular detection of the dengue virus (DENV). Real-time RT-PCR analysis is not suitable for on-site screening since mobile devices are large, expensive, and complex. In this study, two RT-recombinase polymerase amplification (RT-RPA) assays were developed to detect DENV1-4.Methodology/Principal FindingsUsing two quantitative RNA molecular standards, the analytical sensitivity of a RT-RPA targeting the 3´non-translated region of DENV1-4 was found to range from 14 (DENV4) to 241 (DENV1-3) RNA molecules detected. The assay was specific and did not cross detect other Flaviviruses. The RT-RPA assay was tested in a mobile laboratory combining magnetic-bead based total nucleic acid extraction and a portable detection device in Kedougou (Senegal) and in Bangkok (Thailand). In Kedougou, the RT-RPA was operated at an ambient temperature of 38°C with auxiliary electricity tapped from a motor vehicle and yielded a clinical sensitivity and specificity of 98% (n=31) and 100% (n=23), respectively. While in the field trial in Bangkok, the clinical sensitivity and specificity were 72% (n=90) and 100%(n=41), respectively.Conclusions/SignificanceDuring the first 5 days of infection, the developed DENV1-4 RT-RPA assays constitute a suitable accurate and rapid assay for DENV diagnosis. Moreover, the use of a portable fluorescence-reading device broadens its application potential to the point-of-care for outbreak investigations.

English

BACKGROUND: In India, Dengue epidemics are becoming more frequent and are straining the limited resources of the public health system. Diagnosing dengue early is challenging because the initial symptoms of dengue infection are often non-specific. It is for this reason diagnosing dengue infection early becomes important. AIM: To evaluate the role of NS1 antigen for early detection of dengue fever. SETTING AND DESIGN: Prospective Study done in a tertiary care hospital between January 2013 to September 2014. MATERIAL AND METHODS: Patients in the age group between 6 months to 14 yrs with onset of fever up to 7 days and patients fulfilling the WHO clinical criteria of diagnosis dengue fever. STATISTICAL ANALYSIS: sensitivity, specificity, PPV and NPV. RESULTS: Of the 143 patients enrolled, 100 were serologically proved to have dengue illness and the rest 43 were non dengue patients. Of the 100 dengue patients NS1, IgM and IgG was positive in 62, 53 and 15 patients respectively. The sensitivity, specificity, PPV and NPV of NS1 Ag were found to be 62%, 100%, 100% and 53% respectively. CONCLUSION: The present study showed that dengue serological tests have a significant role in the early diagnosis of dengue fever. Hence it is recommended to do the serological tests (NS1 and IgM) early in all suspected dengue cases so that we can diagnose early and initiate necessary treatment.

Distinguishing Dengue from Other Infections

Early diagnosis of dengue fever can improve patient outcomes and help prevent further spread of the virus. Investigators recently analyzed data for

Dengue Fever Scoring System: New Strategy for the Early Detection of Acute Dengue Virus Infection in Taiwan

Dengue fever is an important public health problem in Southern Taiwan. The purpose of this study was to develop a dengue scoring system using a three-stage process, which may be used as a guidance tool for the early diagnosis of dengue fever. A retrospective study was conducted to identify factors useful for the early diagnosis of dengue fever. We assessed the clinical and laboratory features of 89 adult patients with dengue from 2002 to 2004 at a community-based hospital. They were compared with 14 patients with scrub typhus, 104 with Q fever, and 35 with murine typhus, which might present similar symptoms and signs as dengue infection. A scoring system was designed after analysis of the retrospective study and with the assistance of 10 expert clinicians. For the second stage, we evaluated efficiency in differentiating dengue fever from Q fever, scrub typhus and murine typhus in three hospitals from 2002 to 2005. For the third stage, we prospectively used the dengue scoring system for 498 cases that clinically were suspected as having dengue infection in the city of Kaohsiung from January 2006 to September 2006. The performance of the scoring system was 88.1% sensitivity, 94.9% specificity, 95.7% positive predictive value (PPV), and 86.1% negative predictive value (NPV). Evaluation of the scoring system at the third stage revealed 90.7% sensitivity, 86.9% specificity, 81.4% PPV, and 93.6% NPV. The dengue scoring system had a high NPV that might be helpful in the early diagnosis of dengue fever in adults before laboratory data are available.

A Prospective Clinical Study on the Use of Reverse Transcription-Polymerase Chain Reaction for the Early Diagnosis of Dengue Fever

Laboratory testing for dengue virus is used to confirm the diagnosis of dengue virus infection and to differentiate dengue from other febrile tropical illnesses. There are few data on the clinical use of reverse transcription-polymerase chain reaction (RT-PCR) for diagnosis of dengue virus infection. We prospectively evaluated 121 consecutive patients with possible dengue who had samples submitted for RT-PCR, IgM serology, and virus culture. Results were compared with the final discharge diagnosis. Semi-nested RT-PCR was performed using genus- and serotype-specific NS3 consensus primers. Results of 112 patients were available for the final analysis. The RT-PCR was positive in 40 of 62 patients with dengue. Patients who were RT-PCR-positive alone showed a mean of 4.4 days to RT-PCR positivity compared with 5.9 days in patients who were RT-PCR-negative and IgM serology-positive (P = 0.03, Mann-Whitney U-test). The sensitivity, specificity, negative predictive value, and positive predictive value were 70, 100, 84, and 100%, respectively, for samples analyzed within 5 days of illness onset. The RT-PCR also provided epidemiological data regarding the prevailing dengue virus serotypes: 25 with Den-2, eight with Den-3, and seven with Den-1 infection. We propose an algorithm of dengue testing that uses RT-PCR within 5 days of illness onset, whereas IgM capture enzyme-linked immunosorbent assay is preferred for those presenting later.

Evaluation of the use of RT-PCR for the early diagnosis of dengue fever

RT-PCR was used to diagnose dengue virus infections confirmed serologically in 26 returning travellers. RT-PCR was positive for three (75%) of four samples taken on or before day 3 of the illness, for 15 (78.9%) of 19 samples taken between days 4 and 7, and for none of three samples tested on or after day 8 (p 0.0337). When applied early, RT-PCR seems to be a useful tool for the diagnosis of dengue fever.