Diagnostic biologique de la dengue

Area of Science:

• * Arbovirology
• * Infectious Diseases
• * Medical Diagnostics

Background:

• * Dengue is a significant arboviral disease with a wide spectrum of clinical presentations, ranging from asymptomatic to fatal outcomes.
• * The absence of effective antiviral treatments or vaccines underscores the critical need for accurate and timely diagnosis.
• * Effective dengue diagnosis is essential for both clinical management and public health surveillance.

Purpose of the Study:

• * To evaluate diagnostic methods for dengue virus infection based on the timing of clinical sign appearance.
• * To identify the most effective diagnostic tool for severe dengue cases in clinical settings.

Main Methods:

• * Review of diagnostic methods including RT-PCR, serology (EIA), NS1 antigen detection, and viral isolation.
• * Assessment of diagnostic accuracy, specificity, sensitivity, and serotype identification capabilities.
• * Consideration of the time-dependency of diagnostic test performance relative to disease onset.

Main Results:

• * Direct tests, particularly RT-PCR, are preferred within the first seven days of fever for sensitive and specific viral serotype identification.
• * Real-time PCR is expected to supersede conventional RT-PCR with the availability of standardized assays for all four serotypes.
• * Serology (EIA) is useful after seven days but lacks serotype discrimination and exhibits high cross-reactivity; NS1 antigen detection has limited clinical sensitivity.

Conclusions:

• * Viral detection via RT-PCR remains the optimal method for rapid diagnosis of severe dengue infections in clinical settings.
• * Despite necessary improvements, RT-PCR offers the best balance of speed, sensitivity, and specificity for early dengue diagnosis.
• * Continued development of standardized real-time PCR assays is recommended for comprehensive serotype identification.