BioMed Research International / 2015 / Article / Tab 1

Review Article

Diagnostic Options and Challenges for Dengue and Chikungunya Viruses

Table 1

Diagnostic tests for DENV infection.

Premise of testMethodSample typesSensitivity (%)Specificity (%)AdvantagesDisadvantagesReferences

Detection of virusVirus isolationSerum, plasma, whole blood, and fresh or FFPE tissues71.5–84.2 (mosquito inoculation);  
40.5 (cell line-based)
100Greatest specificity  
Allows for further characterization of isolate
Technical, laborious  
Variable sensitivity  
Narrow window of detection (viremic period)
[3, 9, 10]

Detection of viral antigenNS1 detection via ELISASerum, urine, and CSF54.2–93.4 (serum);  
73.9–76.9 (urine)  
50 (CSF, if neurological symptoms)
71–80 (serum);  
100 (CSF, if neurological symptoms)
Early diagnosis  
Rapid tests available
Does not differentiate between serotypes  
Lower sensitivity in secondary infections

Detection of viral nucleic acidRT-PCRSerum, plasma, whole blood, fresh or FFPE tissues, urine, and saliva48.4–98.2100Rapid turnaround time  
Multiplex available (can identify all serotypes from single sample; less potential for contamination)
Expensive reagents and specialized equipment [3, 9, 14]
Real-time RT-PCR58.9–100100
Isothermal amplification methods (NASBA, LAMP) 98.5 100 Does not require specialized equipment (i.e., thermocyclers)

Detection of host antibody responseMAC-ELISA Serum61.5–9979.9–97.8Detection of IgM is considered diagnosticCross-reactivity among serotypes (not serotype-specific) and with other flaviviruses (false-positives) [3, 9, 14, 15]
IgG ELISACan distinguish primary from secondary infection using paired seraLater diagnosis (need postconvalescent sample)
IgM/IgG ratioDistinguishes between primary from secondary infectionLater diagnosis
IgASerum and saliva93 (serum);  
70–92 (saliva)
88 (serum);  
97 (saliva)
Option for testing saliva (easier sample to obtain)  
Better sensitivity and specificity in secondary infection
Lower sensitivity in primary infection