Diagnosis of Acute Dengue Virus Infection Using Enzyme-Linked Immunosorbent Assay and Real-Time PCR

Gohar Iqbal; Hasnain Javed; Faiz Ahmed Raza; Umar Farooq Gohar; Warda Fatima; Mohsin Khurshid

doi:10.1155/2023/3995366

Diagnosis of Acute Dengue Virus Infection Using Enzyme-Linked Immunosorbent Assay and Real-Time PCR

Can J Infect Dis Med Microbiol. 2023 May 22:2023:3995366. doi: 10.1155/2023/3995366. eCollection 2023.

Authors

Gohar Iqbal¹, Hasnain Javed¹, Faiz Ahmed Raza², Umar Farooq Gohar³, Warda Fatima⁴, Mohsin Khurshid⁵

Affiliations

¹ Provincial Public Health Reference Laboratory, Punjab AIDS Control Program, Primary and Secondary Healthcare Department, Government of the Punjab, Lahore, Pakistan.
² Health Research Institute, National Institutes of Health Research Centre, King Edward Medical University, Lahore, Pakistan.
³ Institute of Industrial Biotechnology, Government College University Lahore, Lahore, Pakistan.
⁴ Institute of Microbiology and Molecular Genetics, University of the Punjab, Lahore, Pakistan.
⁵ Institute of Microbiology, Government College University Faisalabad, Faisalabad, Pakistan.

Abstract

Dengue fever is a viral infection caused by the dengue virus and is a growing concern for public health worldwide, particularly in tropical and subtropical regions. This study aimed to assess the diagnostic accuracy of a commercially available NS1 ELISA kit for dengue fever in Pakistan using multiplex qRT-PCR as the gold standard. The study recruited 1236 suspected cases of dengue fever admitted to public sector hospitals in Lahore, Pakistan. Of the suspected cases, 610 (49.3%) were confirmed positive for DENV infection through qRT-PCR, with all four serotypes detected. DENV-2 was the most prevalent serotype, detected in 95.7% of cases. The NS1 ELISA kit detected 71.1% of the positive cases. However, the diagnostic accuracy of the NS1 ELISA kit was found to be only 64.89%. Of the 610 confirmed cases, 68% were male and 32% were female, with a median age of 30 years. Dengue fever was diagnosed in 91.8% of cases, while 8.2% were diagnosed with dengue hemorrhagic fever (DHF). DHF patients had a higher prevalence of abdominal pain, hemorrhagic manifestations, and thrombocytopenia. The cocirculation of all four DENV serotypes in Lahore is concerning and could lead to more severe forms of the disease, such as DHF or dengue shock syndrome, in the future. The study highlights the low diagnostic accuracy of commercially available NS1 ELISA kits and emphasizes the importance of using molecular methods to confirm acute dengue infections. Given the increasing prevalence of dengue fever in developing countries like Pakistan, more accurate and reliable diagnostic tools are needed for effective disease management and control.