Clinical and epidemiological significance of RT-PCR and non-structural glycoprotein-1 assays in the diagnosis of dengue virus infections

ABSTRACT Background: Due to the rapid geographic expansion, dengue has attracted much global attention. Hence, many research outputs have emanated from clinical and epidemiological studies. However, most of these studies, especially those from low- and middle-income countries, heavily relied on enzyme-linked immunosorbent assay (ELISA). Objective: In view of this, we sought to comment and remind dengue researchers within virology, immunology, and epidemiology disciplines regarding the limitations of ELISA protocols in establishing diagnosis of dengue virus (DENV) infections. Subsequently, we provided an update on the current diagnostic algorithm for dengue. Method: Extensive literature search was done using special key words on “PubMed”, “Scopus”, “Web of Science” and “Hinari”. Suitable articles were selected and subjected to scrutiny for inclusion in this study. Result: It was discovered that over 90% of published articles from LMICs inferred about dengue mainly from available commercial serological kits, without further confirmation using more accurate, sensitive and specific protocols. In some instances (less than 5%), combination of either RNA positive and anti-DENV IgM or dengue NS1 and anti-DENV IGM were used to diagnose acute primary dengue; while presence anti-DENV IgG and DENV RNA were considered non-primary dengue. Conclusion: In view of the limitations of every protocol used for investigations of dengue virus infections, its necessary to utilize appropriate combination tests to differentiate primary from non-primary dengue in order to generate reliable clinical and epidemiological inferences.