Dengue disease diagnosis: A puzzle to be solved
<p>Dengue is an infection caused by dengue virus and is the most<br />important arthropod transmitted viral disease in the world,<br />causing near 100 million cases and 50 000 fatalities each year.<br />Health authorities believe that these numbers will grow in<br />coming years. In Colombia, almost 600 municipalities are in<br />regions with Aedes aegypti circulation, and the presence of four<br />dengue serotypes has been demonstrated. Despite the increasing<br />knowledge about disease pathogenesis and the dengue virus,<br />some technical or scientific difficulties with diagnosing dengue<br />remain, negatively affecting both public health surveillance<br />and the appropriate attention to patients in health settings and<br />hospitals. This paper reviews the principles and developments<br />of the current diagnostic techniques for dengue, pointing out<br />the difficulties with making accurate dengue diagnoses and case<br />confirmations in public health and specialized laboratories. The<br />principles and limitations of MAC-ELISA, IgG serology, viral<br />NS1 detection and viral isolation by cell culture are presented.<br />In addition, the review of immunochromatography techniques<br />(rapid diagnostic tests) that have been put forward to help the<br />point-of-care diagnosis is proposed. This paper is intended to<br />bring forward some points of view about the issues related to<br />dengue diagnosis and contribute to improve the discussion<br />surrounding the strategies and techniques needed for reducing<br />the impact of the disease and favoring its control.</p>