BioMed Research International / 2015 / Article / Tab 2

Review Article

Diagnostic Options and Challenges for Dengue and Chikungunya Viruses

Table 2

Diagnostic tests for CHIKV infection.

PremiseDiagnostic methodSample typesSensitivity (%)Specificity (%)AdvantagesDisadvantagesReferences

Detection of virusVirus isolation (in vivo or in vitro)Serum, plasma, whole blood, and fresh or FFPE tissuesVariable100Highly specificTechnical, laborious  
Requires biosafety level 3 containment  
May take 1-2 weeks

Detection of viral antigenELISA or immunochromatographic assay (ICA)Serum and CSF85 (serum)  
80 (CSF)
89 (serum)  
87 (CSF)
Early diagnosisCommercial assays not widely available  
Requires biosafety level 3 containment
[16, 17]

Detection of viral nucleic acid RT-PCRSerum and dried blood spots100Up to 100Highly sensitive and specific  
Rapid turnaround time  
Multiplex available
Expensive reagents and specialized equipment [13, 16, 1820]
Real-time RT-PCR100Up to 100Multiplex availableExpensive reagents and specialized equipment
Isothermal amplification methods (RT-LAMP)10095.25Does not require specialized equipment (i.e., thermocyclers)

Detection of host antibody responseELISASerum  
IgM: 17 (serum); 48 (CSF)  
IgG: 45 (serum); 63 (CSF)
IgM: 95 (serum)  
IgG: 53 (serum)
Widely available  
Relatively cheaper and easier to perform  
Rapid bedside tests are available
Possible cross-reactivity with other alphaviruses  
Elevated IgM does not distinguish recent past infection from acute infection
[4, 16, 17, 2022]
IFASerum85–9790–98Sensitive and specific  
Commercially available
Lack the ability to quantify antibodies, are subjective, and require special equipment and training
PRNTSerumVery specific for alphaviruses; gold standard for confirmation of serologic test resultsRequires the use of live virus (requires Biosafety level 3 containment)