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Fulltext A Colorimetric Enzyme-Linked Immunosorbent Assay (ELISA) Detection Platform for a Point-of-Care Dengue Detection System on a Lab-on-Compact-Disc

Thiha A, Ibrahim F

Sensors (Basel), 2015;15(5):11431-41.
PMID: 25993517 DOI: 10.3390/s150511431

The enzyme-linked Immunosorbent Assay (ELISA) is the gold standard clinical diagnostic tool for the detection and quantification of protein biomarkers. However, conventional ELISA tests have drawbacks in their requirement of time, expensive equipment and expertise for operation. Hence, for the purpose of rapid, high throughput screening and point-of-care diagnosis, researchers are miniaturizing sandwich ELISA procedures on Lab-on-a-Chip and Lab-on-Compact Disc (LOCD) platforms. This paper presents a novel integrated device to detect and interpret the ELISA test results on a LOCD platform. The system applies absorption spectrophotometry to measure the absorbance (optical density) of the sample using a monochromatic light source and optical sensor. The device performs automated analysis of the results and presents absorbance values and diagnostic test results via a graphical display or via Bluetooth to a smartphone platform which also acts as controller of the device. The efficacy of the device was evaluated by performing dengue antibody IgG ELISA on 64 hospitalized patients suspected of dengue. The results demonstrate high accuracy of the device, with 95% sensitivity and 100% specificity in detection when compared with gold standard commercial ELISA microplate readers. This sensor platform represents a significant step towards establishing ELISA as a rapid, inexpensive and automatic testing method for the purpose of point-of-care-testing (POCT) in resource-limited settings.

Matched MeSH terms: Dengue/diagnosis*
Fulltext A comparative evaluation of dengue diagnostic tests based on single-acute serum samples for laboratory confirmation of acute dengue

Chua KB, Mustafa B, Abdul Wahab AH, Chem YK, Khairul AH, Kumarasamy V, et al.

Malays J Pathol, 2011 Jun;33(1):13-20.
PMID: 21874746

A prospective study was carried out to evaluate the sensitivity of dengue NS1 antigen-capture ELISA in comparison with dengue virus isolation, conventional RT-PCR and real-time RT-PCR for laboratory confirmation of acute dengue based on single-acute serum samples. Four primary healthcare centres were involved to recruit patients with clinical diagnosis of dengue illness. Patient's demographic, epidemiological and clinical information were collected on a standardized data entry form and 5 ml of venous blood was collected upon consent. In the laboratory, six types of laboratory tests were performed on each of the collected acute serum sample. Of the 558 acute serum samples collected from 558 patients with clinical diagnosis of dengue from mid-August 2006 to March 2009, 174 serum samples were tested positive by the dengue NS1 antigen-capture ELISA, 77 by virus isolation, 92 by RT-PCR and 112 by real-time RT-PCR. A total of 190 serum samples were tested positive by either one or a combination of the four methods whereas, only 59 serum samples were tested positive by all four methods. Thus, based on single-acute serum samples, 190 of the 558 patients (34.1%) were laboratory-confirmed acute dengue. The overall test sensitivity was 91.6%, 40.5%, 48.4% and 58.9% for dengue NS1 antigen-capture ELISA, virus isolation, conventional RT-PCR and real-time RT-PCR respectively. Statistically, dengue NS1 antigen-capture ELISA was the most sensitive and virus isolation was the least sensitive test for the laboratory confirmation of acute dengue based on single-acute serum specimens. Real-time RT-PCR was significantly more sensitive than the conventional RT-PCR.

Matched MeSH terms: Dengue/diagnosis*
A dot enzyme immunoassay for dengue 3 virus: comparison with the haemagglutination inhibition test

Cardosa MJ, Noor Sham S, Tio PH, Lim SS

Southeast Asian J. Trop. Med. Public Health, 1988 Dec;19(4):591-4.
PMID: 3238470

A dot enzyme immunoassay (DEIA) was used to determine the levels of antibody to dengue 3 virus in the acute and convalescent sera of febrile patients with a clinical diagnosis of dengue fever or dengue haemorrhagic fever. The antibody titres were compared with titres determined by the haemagglutination inhibition (HI) test. The results of the study showed that, besides being more simple to perform, the DEIA is in order of magnitude more sensitive than the HI test. Furthermore, the data suggest that it is possible to use a single dilution as a cutoff point to predict with reasonable accuracy, if a patient has had a recent dengue infection. The DEIA test for antibodies to dengue virus is an appropriate technology highly suitable for rapid diagnosis and surveillance in developing countries.

Matched MeSH terms: Dengue/diagnosis*
A fever from the tropics

Gherardin T

Aust Fam Physician, 2000 Mar;29(3):259.
PMID: 10785992

Shirley is a 42 year old woman who has rung you 5 days after returning from a 3 week resort holiday in Malaysia and Thailand. You saw her before her trip and administered a hepatitis A vaccine and advised her that she did not require anti malarial drugs as she was only going to large cities and beach resorts. She says she has had a high fever, headache and body aches for several days and that she feels exhausted, but is well enough to come to the surgery. When you see her later that morning, she looks fairly well, although she is moving rather gingerly. She says she has been resting, is drinking lots of fluids, has some anorexia, but no other significant symptoms. Examination reveals a temperature of 38 degrees C and she has a fine morbilliform rash on her body, limbs and neck. There are no other abnormal findings.

Matched MeSH terms: Dengue/diagnosis*
Fulltext A two-year review on epidemiology and clinical characteristics of dengue deaths in Malaysia, 2013-2014

Woon YL, Hor CP, Hussin N, Zakaria A, Goh PP, Cheah WK

PLoS Negl Trop Dis, 2016 05;10(5):e0004575.
PMID: 27203726 DOI: 10.1371/journal.pntd.0004575

BACKGROUND: Dengue infection is the fastest spreading mosquito-borne viral disease, which affects people living in the tropical and subtropical countries. Malaysia had large dengue outbreaks in recent years. We aimed to study the demographics and clinical characteristics associated with dengue deaths in Malaysia.

METHODS: We conducted a retrospective review on all dengue deaths that occurred nationwide between 1st January 2013 and 31st December 2014. Relevant data were extracted from mortality review reports and investigational forms. These cases were categorized into children (<15 years), adults (15-59 years) and elderly (≥60 years) to compare their clinical characteristics.

RESULTS: A total of 322 dengue deaths were reviewed. Their mean age was 40.7±19.30 years, half were females and 72.5% were adults. The median durations of first medical contact, and hospitalization were 1 and 3 days, respectively. Diabetes and hypertension were common co-morbidities among adults and elderly. The most common warning signs reported were lethargy and vomiting, with lethargy (p = 0.038) being more common in children, while abdominal pain was observed more often in the adults (p = 0.040). But 22.4% did not have any warning signs. Only 34% were suspected of dengue illness at their initial presentation. More adults developed severe plasma leakage (p = 0.018). More than half (54%) suffered from multi-organ involvement, and 20.2% were free from any organ involvement. Dengue deaths occurred at the median of 3 days post-admission. Dengue shock syndrome (DSS) contributed to more than 70% of dengue deaths, followed by severe organ involvement (69%) and severe bleeding (29.7%).

CONCLUSION: In Malaysia, dengue deaths occurred primarily in adult patients. DSS was the leading cause of death, regardless of age groups. The atypical presentation and dynamic progression of severe dengue in this cohort prompts early recognition and aggressive intervention to prevent deaths.

TRIAL REGISTRATION: National Medical Research Registry (NMRR, NMRR-14-1374-23352).

Matched MeSH terms: Dengue/diagnosis; Severe Dengue/diagnosis
Fulltext Aberrant monocyte responses predict and characterize dengue virus infection in individuals with severe disease

Yong YK, Tan HY, Jen SH, Shankar EM, Natkunam SK, Sathar J, et al.

J Transl Med, 2017 05 31;15(1):121.
PMID: 28569153 DOI: 10.1186/s12967-017-1226-4

BACKGROUND: Currently, several assays can diagnose acute dengue infection. However, none of these assays can predict the severity of the disease. Biomarkers that predicts the likelihood that a dengue patient will develop a severe form of the disease could permit more efficient patient triage and allows better supportive care for the individual in need, especially during dengue outbreaks.
METHODS: We measured 20 plasma markers i.e. IFN-γ, IL-10, granzyme-B, CX3CL1, IP-10, RANTES, CXCL8, CXCL6, VCAM, ICAM, VEGF, HGF, sCD25, IL-18, LBP, sCD14, sCD163, MIF, MCP-1 and MIP-1β in 141 dengue patients in over 230 specimens and correlate the levels of these plasma markers with the development of dengue without warning signs (DWS-), dengue with warning signs (DWS+) and severe dengue (SD).
RESULTS: Our results show that the elevation of plasma levels of IL-18 at both febrile and defervescence phase was significantly associated with DWS+ and SD; whilst increase of sCD14 and LBP at febrile phase were associated with severity of dengue disease. By using receiver operating characteristic (ROC) analysis, the IL-18, LBP and sCD14 were significantly predicted the development of more severe form of dengue disease (DWS+/SD) (AUC = 0.768, P

Matched MeSH terms: Dengue/diagnosis; Severe Dengue/diagnosis
Fulltext Acute dengue in a neonate secondary to perinatal transmission

Chin PS, Khoo AP, Asmah Hani AW, Chem YK, Norizah I, Chua KB

Med J Malaysia, 2008 Aug;63(3):265-6.
PMID: 19248708 MyJurnal

We report a newborn baby girl with acute dengue due to vertical transmission. A 31 year old factory worker of 38+ week gestation, gravida 5 para 3+1, developed acute dengue fever two days prior to delivery. She delivered a normal term baby girl by spontaneous vaginal delivery and recovered uneventfully without peripartum haemorrhage despite the presence of thrombocytopenia. The baby girl developed low grade fever on day four of post-natal life and except for the transient thrombocytopenia, also recovered uneventfully following three days of mild illness. The clinical diagnosis of acute dengue virus infection was confirmed by laboratory tests.

Matched MeSH terms: Dengue/diagnosis*
Fulltext An evaluation of the World Health Organization's 1997 and 2009 dengue classifications in hospitalized dengue patients in Malaysia

Zakaria Z, Zainordin NA, Sim BL, Zaid M, Haridan US, Aziz AT, et al.

J Infect Dev Ctries, 2014 Jul;8(7):869-75.
PMID: 25022297 DOI: 10.3855/jidc.4283

INTRODUCTION: The latest revised version of the World Health Organization's dengue classification was released in 2009. A handful of studies have taken initiatives to evaluate the old and revised guidelines to determine early signs and symptoms of severe dengue. This retrospective study aimed to compare the classification of dengue using both the 1997 and 2009 guidelines in a selected cohort of dengue patients from Peninsular Malaysia between 2008 and 2012.
METHODOLOGY: Adult dengue patients were recruited from tertiary hospitals in two different states, Selangor and Kelantan, in Peninsular Malaysia. Their clinical manifestations were assessed.
RESULTS: A total of 281 confirmed dengue patients were enrolled; the mean duration of illness at admission was five days. Of these, 88.6%, 10.7%, and 0.7% were classified according to the 1997 guidelines as having dengue fever (DF), dengue hemorrhagic fever (DHF), and dengue shock syndrome (DSS), respectively. When the WHO 2009 guidelines were applied, 17.1%, 78.3%, and 4.6% were classified as dengue without warning signs, dengue with warning signs, and severe dengue, respectively.
CONCLUSIONS: Our data suggests that the revised WHO 2009 guidelines stratify a much larger proportion of patients into a category that requires a higher level of medical and nursing care.

Matched MeSH terms: Dengue/diagnosis*; Severe Dengue/diagnosis
Analysis of significant factors for dengue infection prognosis using the self organizing map

Faisal T, Ibrahim F, Taib MN

Annu Int Conf IEEE Eng Med Biol Soc, 2008;2008:5140-3.
PMID: 19163874 DOI: 10.1109/IEMBS.2008.4650371

This study presents a new approach to determine the significant prognosis factors in dengue patients utilizing the self-organizing map (SOM). SOM was used to visualize and determine the significant factors that can differentiate between the dengue patients and the healthy subjects. Bioimpedance analysis (BIA) parameters and symptoms/signs obtained from the 210 dengue patients during their hospitalization were used in this study. Database comprised of 329 sample (210 dengue patients and 119 healthy subjects) were used in the study. Accordingly, two maps were constructed. A total of 35 predictors (17 BIA parameters, 18 symptoms/signs) were investigated on the day of defervescence of fever. The first map was constructed based on BIA parameters while the second map utilized the symptoms and signs. The visualized results indicated that, the significant BIA prognosis factors for differentiating the dengue patients from the healthy subjects are reactance, intracellular water, ratio of the extracellular water and intracellular water, and ratio of the extracellular mass and body cell mass.

Matched MeSH terms: Dengue/diagnosis*
Antibodies against prM protein distinguish between previous infection with dengue and Japanese encephalitis viruses

Cardosa MJ, Wang SM, Sum MS, Tio PH

BMC Microbiol, 2002 May 5;2:9.
PMID: 12019028

In Southeast Asia, dengue viruses often co-circulate with other flaviviruses such as Japanese encephalitis virus, and due to the presence of shared antigenic epitopes it is often difficult to use serological methods to distinguish between previous infections by these flaviviruses.

Matched MeSH terms: Dengue/diagnosis*
Applications of biotechnology in parasitic diseases in Malaysia

Mak JW, Yong HS, Lim PK, Tan MA

Southeast Asian J. Trop. Med. Public Health, 1988 Mar;19(1):7-9.
PMID: 3406806

Biotechnological tools are being used in malaria, filariasis and dengue research. The main emphasis has been on the production of reagents for immunodiagnosis and research. In this respect monoclonal antibodies (McAbs) against various species and stages of the above pathogens have been produced. It is hoped that these McAbs will be useful not only in immunodiagnosis but also for seroepidemiological applications. A DNA probe against Brugia malayi has been tested in Malaysia and was found to be sensitive and specific.

Matched MeSH terms: Dengue/diagnosis
Fulltext Bioimpedance Vector Analysis in Diagnosing Severe and Non-Severe Dengue Patients

Khalil SF, Mohktar MS, Ibrahim F

Sensors (Basel), 2016 Jun 18;16(6).
PMID: 27322285 DOI: 10.3390/s16060911

Real-time monitoring and precise diagnosis of the severity of Dengue infection is needed for better decisions in disease management. The aim of this study is to use the Bioimpedance Vector Analysis (BIVA) method to differentiate between healthy subjects and severe and non-severe Dengue-infected patients. Bioimpedance was measured using a 50 KHz single-frequency bioimpedance analyzer. Data from 299 healthy subjects (124 males and 175 females) and 205 serologically confirmed Dengue patients (123 males and 82 females) were analyzed in this study. The obtained results show that the BIVA method was able to assess and classify the body fluid and cell mass condition between the healthy subjects and the Dengue-infected patients. The bioimpedance mean vectors (95% confidence ellipse) for healthy subjects, severe and non-severe Dengue-infected patients were illustrated. The vector is significantly shortened from healthy subjects to Dengue patients; for both genders the p-value is less than 0.0001. The mean vector of severe Dengue patients is significantly shortened compare to non-severe patients with a p-value of 0.0037 and 0.0023 for males and females, respectively. This study confirms that the BIVA method is a valid method in differentiating the healthy, severe and non-severe Dengue-infected subjects. All tests performed had a significance level with a p-value less than 0.05.

Matched MeSH terms: Severe Dengue/diagnosis*
Biosensing enhancement of dengue virus using microballoon mixers on centrifugal microfluidic platforms

Aeinehvand MM, Ibrahim F, Harun SW, Djordjevic I, Hosseini S, Rothan HA, et al.

Biosens Bioelectron, 2015 May 15;67:424-30.
PMID: 25220800 DOI: 10.1016/j.bios.2014.08.076

Dengue is the current leading cause of death among children in several Latin American and Asian countries. Due to poverty in areas where the disease is prevalent and the high cost of conventional diagnostic systems, low cost devices are needed to reduce the burden caused by dengue infection. Centrifugal microfluidic platforms are an alternative solution to reduce costs and increase the availability of a rapid diagnostic system. The rate of chemical reactions in such devices often depends on the efficiency of the mixing techniques employed in their microfluidic networks. This paper introduces a micromixer that operates by the expansion and contraction of a microballoon to produce a consistent periodical 3D reciprocating flow. We established that microballoons reduced mixing time of 12 μl liquids from 170 min, for diffusional mixing, to less than 23 s. We have also tested the effect of the microballoon mixers on the detection of the dengue virus. The results indicate that employing a microballoon mixer enhances the detection sensitivity of the dengue virus by nearly one order of magnitude compared to the conventional ELISA method.

Matched MeSH terms: Dengue/diagnosis
Fulltext C-reactive protein as a potential biomarker for disease progression in dengue: a multi-country observational study

Vuong NL, Le Duyen HT, Lam PK, Tam DTH, Vinh Chau NV, Van Kinh N, et al.

BMC Med, 2020 02 17;18(1):35.
PMID: 32063229 DOI: 10.1186/s12916-020-1496-1

BACKGROUND: Dengue infection can cause a wide spectrum of clinical outcomes. The severe clinical manifestations occur sufficiently late in the disease course, during day 4-6 of illness, to allow a window of opportunity for risk stratification. Markers of inflammation may be useful biomarkers. We investigated the value of C-reactive protein (CRP) measured early on illness days 1-3 to predict dengue disease outcome and the difference in CRP levels between dengue and other febrile illnesses (OFI).
METHOD: We performed a nested case-control study using the clinical data and samples collected from the IDAMS-consortium multi-country study. This was a prospective multi-center observational study that enrolled almost 8000 participants presenting with a dengue-like illness to outpatient facilities in 8 countries across Asia and Latin America. Predefined severity definitions of severe and intermediate dengue were used as the primary outcomes. A total of 281 cases with severe/intermediate dengue were compared to 836 uncomplicated dengue patients as controls (ratio 1:3), and also 394 patients with OFI.
RESULTS: In patients with confirmed dengue, median (interquartile range) of CRP level within the first 3 days was 30.2 mg/L (12.4-61.2 mg/L) (uncomplicated dengue, 28.6 (10.5-58.9); severe or intermediate dengue, 34.0 (17.4-71.8)). Higher CRP levels in the first 3 days of illness were associated with a higher risk of severe or intermediate outcome (OR 1.17, 95% CI 1.07-1.29), especially in children. Higher CRP levels, exceeding 30 mg/L, also associated with hospitalization (OR 1.37, 95% CI 1.14-1.64) and longer fever clearance time (HR 0.84, 95% CI 0.76-0.93), especially in adults. CRP levels in patients with dengue were higher than patients with potential viral infection but lower than patients with potential bacterial infection, resulting in a quadratic association between dengue diagnosis and CRP, with levels of approximately 30 mg/L associated with the highest risk of having dengue. CRP had a positive correlation with total white cell count and neutrophils and negative correlation with lymphocytes, but did not correlate with liver transaminases, albumin, or platelet nadir.
CONCLUSIONS: In summary, CRP measured in the first 3 days of illness could be a useful biomarker for early dengue risk prediction and may assist differentiating dengue from other febrile illnesses.

Matched MeSH terms: Severe Dengue/diagnosis*
Fulltext Case series of naturally acquired Plasmodium knowlesi infection in a tertiary teaching hospital

Azira NM, Zairi NZ, Amry AR, Zeehaida M

Trop Biomed, 2012 Sep;29(3):398-404.
PMID: 23018503 MyJurnal

Plasmodium knowlesi is a simian malaria parasite and is recently recognized as the fifth malaria parasite infecting humans. Manifestation of the infection may resemble other infection particularly dengue fever leading to inappropriate management and delay in treatment. We reported three cases of naturally acquired P. knowlesi in Hospital Universiti Sains Malaysia, Kubang Kerian, Kelantan, Malaysia. Clinical manifestations were quite similar in those cases. Microscopically, the diagnosis might be challenging. These cases were confirmed by polymerase chain reaction method which serves as a gold standard.

Matched MeSH terms: Dengue/diagnosis
Challenges in reducing dengue burden; diagnostics, control measures and vaccines

Lam SK

Expert Rev Vaccines, 2013 Sep;12(9):995-1010.
PMID: 24053394 DOI: 10.1586/14760584.2013.824712

Dengue is a major public health concern worldwide, with the number of infections increasing globally. The illness imposes the greatest economic and human burden on developing countries that have limited resources to deal with the scale of the problem. No cure for dengue exists; treatment is limited to rehydration therapy, and with vector control strategies proving to be relatively ineffective, a vaccine is an urgent priority. Despite the numerous challenges encountered in the development of a dengue vaccine, several vaccine candidates have shown promise in clinical development and it is believed that a vaccination program would be at least as cost-effective as current vector control programs. The lead candidate vaccine is a tetravalent, live attenuated, recombinant vaccine, which is currently in Phase III clinical trials. Vaccine introduction is a complex process that requires consideration and is discussed here. This review discusses the epidemiology, burden and pathogenesis of dengue, as well as the vaccine candidates currently in clinical development.

Matched MeSH terms: Dengue/diagnosis
Fulltext Classifying dengue: a review of the difficulties in using the WHO case classification for dengue haemorrhagic fever

Bandyopadhyay S, Lum LC, Kroeger A

Trop Med Int Health, 2006 Aug;11(8):1238-55.
PMID: 16903887 DOI: 10.1111/j.1365-3156.2006.01678.x

BACKGROUND: The current World Health Organisation (WHO) classification of dengue includes two distinct entities: dengue fever (DF) and dengue haemorrhagic fever (DHF)/dengue shock syndrome; it is largely based on pediatric cases in Southeast Asia. Dengue has extended to different tropical areas and older age groups. Variations from the original description of dengue manifestations are being reported.
OBJECTIVES: To analyse the experience of clinicians in using the dengue case classification and identify challenges in applying the criteria in routine clinical practice.
METHOD: Systematic literature review of post-1975 English-language publications on dengue classification.
RESULTS: Thirty-seven papers were reviewed. Several studies had strictly applied all four WHO criteria in DHF cases; however, most clinicians reported difficulties in meeting all four criteria and used a modified classification. The positive tourniquet test representing the minimum requirement of a haemorrhagic manifestation did not distinguish between DHF and DF. In cases of DHF thrombocytopenia was observed in 8.6-96%, plasma leakage in 6-95% and haemorrhagic manifestations in 22-93%. The low sensitivity of classifying DHF could be due to failure to repeat the tests or physical examinations at the appropriate time, early intravenous fluid therapy, and lack of adequate resources in an epidemic situation and perhaps a considerable overlap of clinical manifestations in the different dengue entities.
CONCLUSION: A prospective multi-centre study across dengue endemic regions, age groups and the health care system is required which describes the clinical presentation of dengue including simple laboratory parameters in order to review and if necessary modify the current dengue classification.

Matched MeSH terms: Dengue/diagnosis; Severe Dengue/diagnosis
Fulltext Clinical and immunological markers of dengue progression in a study cohort from a hyperendemic area in Malaysia

Rathakrishnan A, Klekamp B, Wang SM, Komarasamy TV, Natkunam SK, Sathar J, et al.

PLoS One, 2014;9(3):e92021.
PMID: 24647042 DOI: 10.1371/journal.pone.0092021

With its elusive pathogenesis, dengue imposes serious healthcare, economic and social burden on endemic countries. This study describes the clinical and immunological parameters of a dengue cohort in a Malaysian city, the first according to the WHO 2009 dengue classification.

Matched MeSH terms: Dengue/diagnosis
Fulltext Clinical diagnosis of early dengue infection by novel one-step multiplex real-time RT-PCR targeting NS1 gene

Kim JH, Chong CK, Sinniah M, Sinnadurai J, Song HO, Park H

J Clin Virol, 2015 Apr;65:11-9.
PMID: 25766980 DOI: 10.1016/j.jcv.2015.01.018

BACKGROUND: Dengue is a mosquito-borne disease that causes a public health problem in tropical and subtropical countries. Current immunological diagnostics based on IgM and/or nonstructural protein 1 (NS1) antigen are limited for acute dengue infection due to low sensitivity and accuracy.
OBJECTIVES: This study aimed to develop a one-step multiplex real-time RT-PCR assay showing higher sensitivity and accuracy than previous approaches.
STUDY DESIGN: Serotype-specific primers and probes were designed through the multiple alignment of NS1 gene. The linearity and limit of detection (LOD) of the assay were determined. The assay was clinically validated with an evaluation panel that was immunologically tested by WHO and Malaysian specimens.
RESULTS: The LOD of the assay was 3.0 log10 RNA copies for DENV-1, 2.0 for DENV-3, and 1.0 for DENV-2 and DENV-4. The assay showed 95.2% sensitivity (20/21) in an evaluation panel, whereas NS1 antigen- and anti-dengue IgM-based immunological assays exhibited 0% and 23.8-47.6% sensitivities, respectively. The assay showed 100% sensitivity both in NS1 antigen- and anti-dengue IgM-positive Malaysian specimens (26/26). The assay provided the information of viral loads and serotype with discrimination of heterotypic mixed infection.
CONCLUSIONS: The assay could be clinically applied to early dengue diagnosis, especially during the first 5 days of illness and approximately 14 days after infection showing an anti-dengue IgM-positive response.

Matched MeSH terms: Dengue/diagnosis*
Fulltext Clinical evaluation of dengue and identification of risk factors for severe disease: protocol for a multicentre study in 8 countries

Jaenisch T, Tam DT, Kieu NT, Van Ngoc T, Nam NT, Van Kinh N, et al.

BMC Infect Dis, 2016 Mar 11;16:120.
PMID: 26968374 DOI: 10.1186/s12879-016-1440-3

The burden of dengue continues to increase globally, with an estimated 100 million clinically apparent infections occurring each year. Although most dengue infections are asymptomatic, patients can present with a wide spectrum of clinical symptoms ranging from mild febrile illness through to severe manifestations of bleeding, organ impairment, and hypovolaemic shock due to a systemic vascular leak syndrome. Clinical diagnosis of dengue and identification of which patients are likely to develop severe disease remain challenging. This study aims to improve diagnosis and clinical management through approaches designed a) to differentiate between dengue and other common febrile illness within 72 h of fever onset, and b) among patients with dengue to identify markers that are predictive of the likelihood of evolving to a more severe disease course.

Matched MeSH terms: Dengue/diagnosis

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