Improving dengue diagnosis and case confirmation in children by combining rapid diagnostic tests, clinical, and laboratory variables

Background Dengue is the most widely distributed arboviral disease in tropical and subtropical countries. Most suspected cases are diagnosed according to clinical criteria, early diagnosis difficult. Moreover, underdeveloped countries, several factors continue challenge surveillance of dengue cases. This study aimed design a diagnostic algorithm using rapid tests (RDTs), ELISA tests, hematological variables confirm febrile patients Colombia. Methods Altogether, 505 samples were collected. Serum evaluated by RDTs (IgM IgG antibodies NS1 antigen), capture IgM ELISAs, endpoint hemi-nested RT-PCR assay (qualitative). We statistically analyzed performance individual determine useful ones accurately. Results Individual results for IgM, IgG, yielded lower sensitivity specificity values than reference standard. High obtained after combining (96.3% 96.4%) RDT plus (90.3% 96.2%), respectively. Adjusted odds ratios (aORs) calculated laboratory differentiate from other illnesses (OFI). approach showed that myalgia, abdominal tenderness, platelet count identified with higher differentiated OFI. A positive or combined specific signs symptoms confirmed 81.6% combination findings 90.6% Conclusion Our diagnoses pediatric population alone cannot true needs be complemented tests. also demonstrate usefulness criteria RDTs, suggesting their implementation test improves case confirmation.