Ing [23]. A straightforward and precise test to diagnose acute dengue situations

    Joe Bowling
    By Joe Bowling
    Pending Moderator Review

    Considering this problem, we evaluated the diagnostic TGR-1202custom synthesis accuracy of three clinical dengue diagnostic criteria (WHO 1997, WHO 2009, INI-FIOCRUZ) and NS1 BioeasyTM immunochromatographic test in an urgent care center throughout a DENV-4 epidemic inside the city of Rio de Janeiro, Brazil.MethodsEthical statementThis prospective cross-sectional diagnostic accuracy study is reported in accordance with the Requirements for Reporting of Diagnostic Accuracy Study PubMed ID:http://www.ncbi.nlm.nih.gov/pubmed/27766426 (STARD) Guideline [24] and was approved by the Research Ethics Committee of the Evandro buyTetrahydrouridine Chagas National Institute of Infectious DiseasesFIOCRUZ, CAAE 0066.0.009.000-11, on March 23, 2012.Enrollment, information, and specimen collectionWe carried out the study inside the city of Rio de Janeiro, Rio de Janeiro, Brazil, from March to April 2013, for the duration of an ongoing dengue epidemic. Contemplating this challenge, we evaluated the diagnostic accuracy of three clinical dengue diagnostic criteria (WHO 1997, WHO 2009, INI-FIOCRUZ) and NS1 BioeasyTM immunochromatographic test in an urgent care center throughout a DENV-4 epidemic within the city of Rio de Janeiro, Brazil.MethodsEthical statementThis prospective cross-sectional diagnostic accuracy study is reported according to the Standards for Reporting of Diagnostic Accuracy Study PubMed ID:http://www.ncbi.nlm.nih.gov/pubmed/27766426 (STARD) Guideline [24] and was approved by the Research Ethics Committee of the Evandro Chagas National Institute of Infectious DiseasesFIOCRUZ, CAAE 0066.0.009.000-11, on March 23, 2012.Enrollment, information, and specimen collectionWe conducted the study inside the city of Rio de Janeiro, Rio de Janeiro, Brazil, from March to April 2013, for the duration of an ongoing dengue epidemic. Adult patients (age >18 years) attending a public urgent care center (Unidade de Pronto Atendimento-UPA 24H) within 72 h of onset of an acuteBuonora et al. BMC Infectious Illnesses (2016) 16:Page 3 offebrile illness without having an evident concentrate of infection were eligible for the study. A trained nurse obtained informed consent and prospectively enrolled the sufferers through organization hours five days per week. An infectious disease doctor collected data on demographic qualities, symptoms and physical signs making use of a summarized version of a previously published and tested semi-structured questionnaire [25]. The tourniquet test was not performed and only spontaneous hemorrhagic manifestations were recorded. We evaluated all patients according to WHO 1997, WHO 2009, and INI-FIOCRUZ clinical criteria defined elsewhere [1, 11, 13, 26]. Blood samples had been collected for total blood count and precise dengue tests which includes NS1 BioeasyTM, RTPCR, Panbio?dengue IgM capture ELISA and dengue IgG ELISA, and PlateliaTM Dengue NS1 Ag-ELISA. Acute dengue-4 circumstances have been confirmed by RT-PCR. Serum samples have been sent for the Flavivirus Laboratory, a regional reference laboratory for dengue and yellow fever at the Oswaldo Cruz Foundation (FIOCRUZ) where they have been frozen at -70 till applying for dengue certain laboratorial tests.Index tests NS1 strip testwarning signs: abdominal discomfort, persistent vomiting, edema, mucosal bleeding, lethargy, hepatomegaly or hemoconcentration linked having a sudden drop in platelet count [1]; and INI-FIOCRUZ: PubMed ID:http://www.ncbi.nlm.nih.gov/pubmed/25645579 presence of conjunctival redness with leukocytes much less than 7500/mm3 or less than 3760 leukocytes/mm3 independently of other signs or symptoms [13]. Hemoconcentration within a single sample was defined by a hematocrit >53 in males or 48 in females [27]. Leukopenia was defined as a total leucocyte count 4500 cells/mm3 [27].Reference tests Dengue viral RNAAll febrile circumstances had been tested by the NS1 BioeasyTM immunochromatographic strip test (BioeasyTM, Normal Diagnostics INC, Korea). This fast test was selected because it has already been utilized inside the state of Rio de Janeiro and in other Brazilian states throughout dengue outbreaks. However, its overall performance had not been previously assessed. In accordance with the manufacturer's instruction, the test might be stored at space temperature and may adequately detect the NS1 within 15 min using 3 drops of entire blood, plasma or serum.