Is Rapid Dengue Test Necessary at Primary Health Centre? A Study in Bandung City, Indonesia
Journal Title: Journal of Clinical and Diagnostic Research - Year 2019, Vol 13, Issue 7
Abstract
ABSTRACT Introduction: Dengue is one of the most common arthropod-borne viral disease in the tropical and subtropical regions of the world. The disease is a burden in terms of morbidity, mortality and economic aspect. There is no specific drug for dengue infection yet and the availability of a vaccine is limited in most of the Indonesia’s endemic areas. In endemic areas, most of dengue fever cases clinically resemble other diseases such as malaria, typhus, or just flu-like syndrome. Early verification of suspected dengue outbreaks is very important, allowing better public health response that leads to a proper clinical care. Unfortunately, the use of dengue Rapid Diagnostic Tests (RDTs) is still rare at first level of the health care provider in Indonesia, where the country has the policy of a gradual health service supported by the National Health Insurance (NHI). Aim: The study measured the usefulness of dengue RDT at the Primary Health Centre (PHC) in endemic areas. Materials and Methods: DENV NS1 antigen test kit (NS1 RDT) was used to detect dengue fever for all acute fever patients at three sites of PHC which had high dengue case history. Dengue fever 2017 report was used as comparative data for the analysis. The collected data were analysed using an independent t-test. Results: A total of 237 blood samples from patients with acute fever were collected from Sukajadi, Neglasari and Padasuka PHC. Fifty-one samples out of 237 (21.5%) were positive with the DENV NS1 antigen test. The number of reported dengue case before and after the implementation of DENV NS1 antigen test increased significantly (p<0.05) for each PHC; Sukajadi (p=0.01), Neglasari (p=0.01) and Padasuka (p=0.03). Conclusion: NS1 RDT effectively increased the diagnosed and reported cases when used in the PHCs. Hence, we strongly suggest that government should make a policy that supports the use of NS1 RDT at the PHCs for the early detection of dengue infection, since those PHCs are the spearheads in the implementation of health care programs in Indonesia.
Authors and Affiliations
Lia Faridah, Nisa Fauziah, Savira Ekawardhani, Riyadi Riyadi, Kozo Watanabe
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