Dengue is major public health problem, globally. Timely verification of suspected dengue outbreaks allows for public health response leading to initiation of appropriate clinical care. Because the clinical presentation of dengue is non-specific, dengue diagnosis would benefit from a sensitive rapid diagnostic test (RDT). We evaluated the diagnostic performance of an RDT that detects dengue virus (DENV) non-structural protein 1 (NS1) and anti-DENV IgM during suspected acute febrile illness (AFI) outbreaks in four countries. Real time RT-PCR and anti-DENV IgM ELISA were used to verify RDT results. Anti-DENV IgM RDT sensitivity and specificity ranged from 55.3-91.7% and 85.3-98.5%, respectively, and NS1 sensitivity and specificity ranged from 49.7-92.9% and 22.2-89.0%, respectively. Sensitivity varied by timing of specimen collection and DENV serotype. Combined test results moderately improved the sensitivity. Use of RDTs identified dengue as the cause of AFI outbreaks where reference diagnostic testing was limited or unavailable.
June 8, 2016