Comparison of Non Structural Protein 1antigen Detection By Immunochromatography Test and Enzyme Linked Immuno Sorbent Assay and Correlation With Real Time Polymerase Chain Reaction for Early Diagnosis of Dengue with Serotyping and Co Infections of Dengue in And Around Ananthapuramu District

Abstract

Dengue is one of the most important mosquito-borne diseases in the world. The emergence and spread of four Dengue viruses (DENVs) (Serotypes) represent a global pandemic. The four distinct serotypes are, namely, DENV-1, DENV-2, DENV-3 and DENV-4.Early diagnosis of dengue fever is important for effective clinical care and vector control. Different serological tests based on the principle of immunochrotography and Enzyme-Linked Immuno sorbent Assay (ELISA) is commonly used for detection of antigen and antibodies of dengue virus. The performance of these tests depends on the sensitivity and specificity. Hence, the study was undertaken to compare non structural protein-1 (NS1) antigen detection by rapid and ELISA with real-time polymerase chain reaction (RT-PCR) for diagnosis of dengue. Very few dengue serotyping studies have been reported from Andhra Pradesh. In this context, the present study focuses on the circulating serotypes of dengue in Ananthapuramu district, Andhra Pradesh. Infection with two agents might cause overlapping symptoms, confusing the treating physician. Dengue associated co-infections are rarely described and the evidence exists only in the form of few case reports and case series, that too individual co-infections dengue with either bacterial infections like UTI and blood stream infections, chickungunya, malaria, enteric fever, leptospirosis, scrub typhus, hepatitis B, or recently pandemic COVID-19. This co-infections study is important for public health point of view considering types of associated co-infections, severity of the diseases, management issues and prognosis in dengue patients in GGH Ananthapuramu. This diagnostic Prospective study was done on 100 clinically suspected cases of Dengue between July-November 2021 at a tertiary care hospital (GGH) in Ananthapuramu, Andhra Pradesh, India. All the sera samples were collected and tested to NS1 antigen detection test by rapid test, NS1 ELISA, and RT-PCR and also serotypes of DENV-1, 2, 3, 4 were detected from serum samples by RT-PCR test.