A study on early diagnosis of dengue by clinical features and serological markers in a tertiary care hospital

Abstract

Background: Arboviruses pose a major threat to the public's health. In tropical and subtropical areas of the world, they are usually connected with epidemics that have significant negative economic and social effects. High rates of morbidity and mortality are caused by the dengue virus (DENV), which is transmitted to humans by mosquitoes of the Aedes family.1 Objectives 1. To find out the role of NS1 antigen for early detection of dengue virus infection versus IgM ELISA. 2. To study the clinical features in early stage of dengue infection. Material & Methods Study Design: A prospective hospital based observational study. Study area: Department of General Medicine, Government Medical College, Kadapa, Andhra Pradesh. Study Period: 1 year. Study population: The study was comprised of adult patients presenting with clinical features suggestive of dengue infection. ample size: A total of 100 adult patients presenting with clinical features suggestive of dengue infection were selected for the study. Sampling method: Simple random technique. Study tools and data collection procedure: Patients were interviewed for demographic data such as age sex and occupation were noted. Histories of similar complaints in past and current treatment were noted. Patients were subjected to a thorough physical examination, vitals (pulse rate, blood pressure and respiratory rate) and other clinical signs and symptoms of dengue fever. Systemic examination was
carried out. These findings were recorded on a predesigned and pretested proforma. Results: In the present study 70 patients tested positive for IgM ELISA. Of these, 65 were positive for NS1 antigen test while five were negative. The sensitivity of NS1 in predicting dengue infection compared to IgM ELISA was 92.86% and specificity was 90% with 95.59% positive predictive value and 84.38% negative predictive value (p<0.001). Conclusion: Thus we conclude that dengue infection, which poses a serious public health problem, can be diagnosed early with the help of clinical features like retro-orbital pain, myalgia, bleeding manifestations, thrombocytopenia, SGOT greater than SGPT that is supported by detection of NS1 antigen