Study on the Diagnostic Efficacy of Clinico-Laboratory Parameters in Serologically Diagnosed Cases of Dengue Fever
Journal Title: INTERNATIONAL JOURNAL OF RECENT TRENDS IN SCIENCE AND TECHNOLOGY - Year 2014, Vol 11, Issue 1
Abstract
Background: Dengue fever (DF), is the most common mosquito borne arbo-viral infection in humans. The high mortality associated with DF mandates early diagnosis and therapeutic interventions. Aims: To study the utility of clinic-laboratory parameters in serologically diagnosed cases of DF and to correlate with serological tests with the progression of disease. Material and methods: This is are prospective study done among patients, admitted to a tertiary care facility in South India between 1rstMarch and 31rst August 2013, with the diagnosis of Dengue fever (DF) either by dengue NS1 or Ig-M positive test. Their clinical and laboratory parameters were compared for the diagnostic utility withthat of NS1 or Ig-M dengue tests in relation to the day of performing the tests. Results: 200 serologically diagnosed DF patients were evaluated with 145 positive for NSI antigen and 55 for Ig-M antibody. 114 patients were male and 86 females. Clinical features of fever with headache, body ache and myalgia were present in 90%, whereas retro-orbital pain in only 40 % of cases. High grade fever and headache were the most specific clinical feature(92%). Almost 94% of NS1 positive cases presented within 4 days of onset of fever. Among NS1 positive cases leucopoenia alone had a sensitivity of 55% and specificity 48% with PPV 73%. Thrombocytopenia had sensitivity 89% with PPV 70.45%. Anicteric hepatitis had sensitivity of 75% and specificity 40%. Combination of clinical features with 2 out of four laboratory parameters (high haematocrit, leucopenia, thrombocytopenia, anicteric hepatitis) increased sensitivity to 94%. The chances of developing complications were very less during the first 4 days (3%) and the sensitivity of NS1 was 0-40% after 5 days of symptom, but IGM was 70-100%. Conclusion: During the early stages of disease we observed the diagnostic efficacy of clinico-laboratory parameters is similar to NS1 antigen. In a developing country with limited resources, were DF is endemic the routine use of expensive serological investigations is questionable.
Authors and Affiliations
Sreejith M. G , Peter George
Keywords
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