CLINICOSEROLOGICAL DIAGNOSIS OF DENGUE FEVER

IntroductionDengue is an endemic vector borne viral disease which is transmitted by bite if Aedes mosquito. Diagnosis of Dengue by viral isolation is cumbersome and is not practiced so, ELISA and rapid immunochromatography are mainstay of diagnosis. Aims and objectives1. To assess the occurrence of seropositivity in clinically suspected Dengue patients at Tertiary care hospital. 2. To determine the occurrence of primary and secondary Dengue infection amongst clinically suspected cases of Dengue. 3. To evaluate utility of serodiagnosis and correlate results with clinical and laboratory profile. 4. To evaluate the efficacy of NS1 Antigen (Ag) assay as an early marker for Dengue virus infection. 5. To assess the seasonal pattern of Dengue over the study period at Tertiary care hospital. Material and methodsBlood samples were taken from 350 clinically suspected Dengue cases. Panbio ELISA kits were used for IgM, IgG antibodies and NS1 antigen testing. J Mitra kits were used for Rapid immunochromatographic testing. Results35.43% were serologically positive for Dengue. 16-30 years was most commonly affected age group. Males were more affected than females.Most of the cases were seen in November. Headache was most common symptom. Platelet count was <1,00,000/μL in 73.39% cases. Maximum numbers of cases were of Dengue with warning signs i.e. 54.03%. ELISA was more sensitive than Rapid test. Secondary Dengue was more common than primary Dengue. NS1 proved an important tool for diagnosis of early dengue infection. ConclusionCorrelation of clinical symptoms is necessary along with laboratory tests. Key wordsAedes, Dengue, ELISA, NS1, Platelet, Secondary Dengue © 2021 JETIR February 2021, Volume 8, Issue 2 www.jetir. org (ISSN-2349-5162) JETIR2102084 Journal of Emerging Technologies and Innovative Research (JETIR) www.jetir. org 711 ManuscriptIntroductionDengue is most important arthropod borne viral disease in tropical and subtropical regions of world. Incidence of Dengue has increased dramatically in recent years. It has affected South East Asian region. Countries of South East Asian region are divided into 3 categories. India is included in Category A. Characteristics of Category A are a) Dengue is major public health problem. b) Leading cause of hospitalization and death amongst children. c) Hyperendemicity with all 4 serotypes circulating in urban areas. d) It has also spread to rural areas. Early diagnosis and proper treatment of Dengue is important as it may lead to complications like haemorrhage and shock if not treated and this can lead to high mortality and morbidity. Clinical profile does not always mimic diagnosis. So, confirmation by laboratory tests is very essential. There are laboratory tests which can detect Dengue fever in earlier stages of viremia and prompt treatment can be started in positive patients. Laboratory methods are broadly divided intoMethods for Virus isolation1) Mosquito inoculation. 2) Animal inoculation 3) Cell culture. Serological methods.1) Hemagglutination inhibition 2) Neutralization test 3) Complement fixation 4) ELISA 5) Rapid immunochromatography test (for which many commercial kits are available) 6) Polymerase chain reaction In Maharashtra Dengue has been documented from Nagpur, Parbani, Dhule, Pune. Treatment of Dengue is largely symptomatic, and no vaccines have been licensed. Early detection and proper diagnosis of cases is of utmost importance. This study was undertaken to a) To assess incidence of seropositivity in clinically suspected Dengue fever at tertiary care hospital. b) To determine occurrence of primary and secondary dengue infection amongst clinically suspected cases of Dengue. c) To evaluate utility of serodiagnosis and correlate results with clinical and laboratory profile. d) To evaluate efficacy of NS1 Antigen (Ag) assay as an early marker for Dengue virus infection. e) To assess seasonal pattern of Dengue. Material and methodsPresent study was conducted at a tertiary care teaching hospital in Department of Microbiology after receiving permission from institutional Ethical Committee. Study was carried out over a period from December 2013 to December 2015.