Retrospective study and evaluation of rapid and ELISA tests for diagnosis of dengue in a tertiary care hospital

Sodani S, Ahirwar S, Mutha A, Hawaldar R


In recent years, Dengue has been emerging as a global health problem with approximately 2.5 billion people being affected by it. For a diagnosis of dengue to be made, a fourfold rise in acute and convalescent sera is required. There are several methods in use for diagnosis of dengue. These include detection of virus by cell culture or immunofluorescence, detection of virus antigen by ELISA or rapid kits, detection of Dengue virus antibody by haemagglutination inhibition, complement fixation, neutralization tests or ELISA and detection of virus nucleic acid by reverse transcriptase (RT-PCR) or real time PCR. However, most of these tests are expensive and time consuming and require expertise to carry out. This retrospective study was carried out in MYH, department of microbiology, M.G.M. medical college and M.Y. hospital, Indore, from June 2014 to May 2015 in 329 patients to evaluate performance of rapid and ELISA kits for diagnosis of Dengue infection. .Out of total 329 samples tested by rapid method, 66 samples were positive only for NS1 antigen, 263 samples were positive for either IgM alone or with IgG antibodies. Out of 66 samples positive for NS1 antigen, only 22 samples were positive by capture ELISA for IgM. Out of 263 samples which showed positive antibodies either IgM or IgG by rapid test, 203 were positive by capture ELISA for IgM, 60 samples showed negative results. For early detection of disease, antigen detection by rapid method is a good choice. But the sensitivity of ELISA in detecting antibodies is good. Thus rapid diagnostic kits used for detection of NS1 antigen can be helpful in acute stage of Dengue infection and for detection of antibodies ELISA is the method of choice.
Keywords: Dengue, ELISA, NS1 antigen, IgG, IgM

Full Text:



Halstead SB. Dengue. Lancet. 2007 Nov 10;370(9599):1644–52.

Bennett SN, Holmes EC, Chirivella M, Rodriguez DM, Beltran M, Vorndam V, Gubler DJ, McMillan WO. Selection-drivenevolutionof emergent dengue virus. Mol Biol Evol. 2003 Oct;20(10):1650–58.

Rice CM, Strauss EG, Strauss JH 1986.Structure of the flavivirus genome, p.279–326.In S.Schlesinger andM. J. Schlesinger the Togaviridae and Flaviviridae. Plenum, New York.

Blok,JS. M.McWilliam, Butler HC, A.J.Gibbs, Weiller BL,Herring AC et al.Comparison of a dengue-2 virusandother viruses.Virology 1992; 187:573–590.

Young,PR., Hilditch PA, .Bletchly C.2000.An antigen captureenzyme-linked mmunosorbent assay reveals highlevels of the dengue virus protein NS1in the sera of infected patients.J.Clin.Microbiol.38:1053–1057

Vijayakumar TS, Chandy S, Sathis N, Abraham M, Abraham P, Sridharan G. Is dengue emerging as a major public health problem? Indian J Med Res2005; 121: 100-7.

Laboratory Guidance and Diagnostic Testing. Centers for Disease Control and Prevention. Available from: http://www., accessed on July 20, 2013.

World Health Organization.Clinical diagnosis. In: Dengue haemorrhagic fever: diagnosis, treatment, preventionandcontrol. 2nd ed.Geneva: WHO, 1997. pp. 12–23.

Singh B.Dengue out breakin2006:failure ofpublichealthsystem? Indian J. Community Med. 2007;32:99–100.

Kumar A,Rao CR,Pandit V,ShettyS, BammigattiC, Samarasinghe CM. Clinical manifestations and trend of dengue cases admitted in a tertiary care hospital,Udupi district, Karnataka. Indian J Community Med. 2010;35:386–90

Sekaran, S.D.,Ew, C.L., Subramaniam, G., Kanthesh, B.M.Sensitivity of dengue virus NS 1 detection in primary and secondary infections . African J of Microbiology research. Vol. 3(3),pp 105-110 march 2009

YukikoHiga.Dengue vectors and their satial distribution.TropMed Health.2011 Dec;39(Suppl 4):17–27. pmc/articles/ PMC3317606/ - accessed 24 February 2014.

Blacksell, S. D., M. P. Mammen, S. Thongpaseuth, R. V. Gibbons, R. G. Jarman, K. Jenjaroen, A. Nisalak, R. Phetsouvanh, P. N. Newton, and N. P. J. Day. 2008. Evaluation of the Pan biodengue virus nonstructural 1 antigen detection and immunoglobulin M antibody enzyme-linked immunosorbent assays for the diagnosis of acute dengue infections in Laos. Diagn.Micrbiol. Infect. Dis.60:43-49

Dussart, P., B. Labeau, G. Lagathu, P. Louis, M. R. Nunes, S. G. Rodrigues, C. Storck-Hermann, R. Cesaire, J. Morvan, M. Flamand, and L. Baril. 2006. Evaluation of an enzyme immunoassay for detection of dengue virus NS1 antigen in human serum.Clin. Vaccine Immunol.13:1185-1189.

Kumarasamy, V., A. H. Wahab, S. K. Chua, Z. Hassan, Y. K. Chem, M. Mohamad,and K. B. Chua. 2007. Evaluation of a commercial dengue NS1 antigen-capture.ELISA for laboratory diagnosis of acute dengue virus infection. J. Virol. Methods140:5-79

Sekaran, S. D., E. C. Lan, K. B. Mahesawarappa, R. Appanna, and G. Subramaniam.2007. Evaluation of a dengue NS1 capture ELISA assay for the rapid detection of dengue. J. Infect. Dev. Ctries.1:182-188.

ShuP,Huang J,2004.Currentadvances indengue diagnosis.ClinDiagnLabImmunol11:642–650.