Clinical and epidemiological significance of RT-PCR and non-structural glycoprotein-1 assays in the diagnosis of dengue virus infections

Abstract

Background: Due to the rapid geographic expansion, dengue has attracted much global attention. Hence, many research outputs have emanated from clinical and epidemiological studies. However, most of these studies, especially those from low- and middle-income countries, heavily relied on enzyme-linked immunosorbent assay (ELISA). Objective: In view of this, we sought to comment and remind dengue researchers within virology, immunology, and epidemiology disciplines regarding the limitations of ELISA proto- cols in establishing diagnosis of dengue virus infections. Subsequently, we provide an update on the current diagnostic algorithm for dengue. Method: Extensive literature search was done using special key words on “PubMed”, “Scopus”, “Web of Science” and “Hinari”. Suitable articles were selected and subjected to scrutiny for inclusion on this study. Result: It was discovered that over 90% of published articles from LMICs inferred about dengue mainly form commercially available serological kits. Without further confirmation using more accurate, sensitive and specific techniques. In some instances (less than 5%), combination of either RNA positive and anti-dengue IgM or dengue NS1 and IgM were used to diagnose acute primary dengue; while presence anti-dengue IgG and dengue RNA were considered non- primary dengue. Conclusion: In view of the limitations of every protocol in diagnosis of dengue, its necessary to utilize appropriate combination tests to differentiate primary from non-primary dengue in order to generate reliable clinical and epidemiological inferences.