Diagnostic accuracy of commercially available immunochromatographic rapid tests for diagnosis of dengue in India

Raman Mahajan, Mohit Nair, Ana-Maria Saldanha, Amit Harshana, Alan De Lima Pereira, Nandita Basu, Rama Prasad Goswami, Nemai Bhattacharya, Bhaswati Bandyopadhay, Manideepa SenGupta, Moutusi Day, Laurence Flevaud, Marleen Boelaert, Sakib Burza

    Research output: Contribution to journalA1: Web of Science-article

    Abstract

    Background & objectives: There is limited evidence regarding the accuracy of dengue rapid diagnostic kits despite their extensive use in India. We evaluated the performance of four immunochromatographic Rapid Diagnostic Test (RDTs) kits: Multisure dengue Ab/Ag rapid test (MP biomedicals; MP), Dengucheck combo (Zephyr Biomedicals; ZB), SD bioline dengue duo (Alere; SD) and Dengue day 1 test (J Mitra; JM).Methods: This is a laboratory-based diagnostic evaluation study. Rapid tests results were compared to reference non-structural (NS1) antigen or immunoglobulin M (IgM) enzyme-linked immunosorbent assay (ELISA) results of 241 dengue-positive samples and 247 dengue-negative samples. Sensitivity and specificity of NS1 and IgM components of each RDT were calculated separately and in combination (either NS1 or IgM positive) against reference standard ELISA.Results: A total of 238, 226, 208, and 146 reference NS1 ELISA samples were tested with MP, ZB, SD, and JM tests, respectively. In comparison to the NS1 ELISA reference tests, the NS1 component of MP, ZB, SD, and JM RDTs demonstrated a sensitivity of 71.8%, 85.1%, 77.2% and 80.9% respectively and specificity of 90.1%, 92.8%, 96.1 %, and 93.6%, respectively. In comparison to the IgM ELISA reference test, the IgM component of RDTs showed a sensitivity of 40.0%, 50.3%, 47.3% and 20.0% respectively and specificity of 92.4%, 88.6%, 96.5%, and 92.2% respectively. Combining NS1 antigen and IgM antibody results led to sensitivities of 87.5%, 82.9%, 93.8% and 91.7% respectively, and specificities of 75.3%, 73.9%, 76.5%, and 80.0% respectively.Interpretation & conclusion: Though specificities were acceptable, the sensitivities of each test were markedly lower than manufacturers' claims. These results also support the added value of combined antigen-and antibody-based RDTs for the diagnosis of acute dengue.

    Original languageEnglish
    JournalJournal of Vector Borne Diseases
    Volume58
    Issue number2
    Pages (from-to)159-164
    Number of pages6
    ISSN0972-9062
    DOIs
    Publication statusPublished - 2021

    Keywords

    • Dengue
    • diagnostic accuracy
    • immunochromatography
    • rapid diagnostic test
    • RDT
    • sensitivity
    • specificity
    • India
    • NS1 ANTIGEN

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