The assay is relatively easy to perform and the interpretation of results is well defined. limitations in using ELISAs in resource limited regions, rapid ICT assays would be useful for the detection of more recent DENV infections. As many patients Paclitaxel (Taxol) present after fever days 5 in the study area, anti-DENV IgM/IgG would be the suitable marker to be detected by rapid ICT assays in such areas. positive predictive value, negative predictive value Of the 765 patients sera tested, 343 and 383 were positive for anti-DENV IgM by the rapid ICT assay and ELISA, respectively. A total of 246 patients sera were positive for anti-DENV IgM by both rapid ICT and ELISA. A total of 285 patients sera were negative for anti-DENV IgM by both rapid ICT and ELISA. A total of 97 patients sera positive for anti-DENV IgM by the rapid ICT assay was negative by the ELISA. A total of 137 patients sera negative for anti-DENV IgM by the rapid ICT assay was positive by the ELISA (Table?1). Mean fever duration at the day of sample collection for testing was 5.5??1.6 days. Of the 765 sera tested, 427 and 460 were positive for anti-DENV IgG by the rapid ICT assay and ELISA, respectively. A total of 373 patients sera were positive for anti-DENV IgG by both rapid ICT and ELISA. A Paclitaxel (Taxol) total of 305 patients sera were negative for anti-DENV IgG by both rapid ICT and ELISA. A total of 54 patients sera positive for anti-DENV IgG by the rapid ICT assay was negative by ELISA. A total of 87 patients sera negative for anti-DENV IgG by the rapid ICT assay was positive by ELISA (Table?1). The PPV for ICT assay for detecting anti-DENV IgG (87.4%) was greater than the ability of the ICT assay for detecting anti-DENV IgM (71.7%) (Table?2). We then compared the detection indices for patients with dengue fever (DF) and dengue haemorrhagic fever (DHF) (Table?2). There were no major differences between sensitivity and specificity of rapid ICT assay for the detection of anti-DENV IgM and IgG in patients with DF or DHF. A rapid and accurate diagnostic method to detect clinically apparent DENV infections is useful for managing dengue patients. Rapid ICT assays have been developed for the detection of anti-DENV IgM and IgG by a number of commercial manufacturers and these assays have been used widely due to the ease of use and rapid turnaround time. However, the detection capability of these assays for different viral markers varies in different geographical settings. Hence, there is a need to evaluate these ICT assays with a reference test for detecting clinically apparent DENV infections. A standard ELISA is commonly used as a comparator to validate rapid assays [2, 5, 7]. In this study, we compared a widely used rapid ICT assay (Cortez, USA) for its ability to detect anti-DENV IgM and IgG with a standard ELISA (Panbio Diagnostics, Australia). Based on our study, detection of anti-DENV IgM by the rapid ICT assay showed a moderate sensitivity and NPV with a high specificity and PPV. Detection of anti-DENV IgG by the rapid ICT assay showed higher accuracy indices than those noted for anti-DENV IgM detection (Table?2). No significant difference was noted (positive predictive value, negative predictive value The ICT assays do not require any specialized equipment or training and the results are available within 25?min making them ideal for resource limited regions. The assay is relatively easy to perform and the interpretation of results is well defined. On the other hand, Blacksell, states that there may be inter-observer variations when ICT assays are used for the detection of common virological markers [1]. Paclitaxel (Taxol) Methods such as virus isolation, viral nucleic acid detection (PCR) and ELISA need a specialized Rabbit Polyclonal to C-RAF laboratory and well trained personnel and these are not usually available in most of the laboratories in resource limited regions. Considering the limitations of using a molecular/ELISA based diagnostic methods, rapid ICT assays are suited for resource limited regions. The rapid ICT assay costs around 4.2 US$ per sample to detect anti-DENV IgM/IgG, however, the ELISA costs around 14.2 US$ per sample to detect anti-DENV IgM/IgG and this shows the cost-effective diagnostic utility of ICT assays in resource limited regions. Rapid assays have the ability to detect and discriminate both anti-DENV IgM.
