Kalra Charu, Mittal Garima, Gupta Priyanka, Agarwal Rajiv Kumar, Ahmad Sohaib
Microbilogy, Himalayan Institute of Medical Sciences, Swami Rama Himalayan University, Dehradun, IND.
Microbiology, Himalayan Institute of Medical Sciences, Swami Rama Himalayan University, Dehradun, IND.
Cureus. 2024 Aug 12;16(8):e66714. doi: 10.7759/cureus.66714. eCollection 2024 Aug.
Objectives In recent years, Uttarakhand, a state in North India has become one of the prime spots for tourism all over the world. Thereby, a tremendous increase in the epidemics of dengue infection has been observed recently. Secondary dengue causes more severe disease in comparison with primary, thus to differentiate the two is very crucial. We aim to find out the cut-off values of the IgM:IgG ratio for early detection of secondary dengue which could further help clinicians to prevent the complications. Methods A cross-sectional study was conducted over one year involving around 936 suspected cases of dengue. Samples were tested using the commercially available capture enzyme linked Immunosorbent assay (ELISA) method for IgM and IgG. Real-time and nested polymerase chain reaction (PCR) tests were also done to find out the prevalent serotype. IgM:IgG ratio was evaluated by using receiver operating characteristic curve analysis for the differentiation of primary and secondary dengue. Results Among the total 91 serologically confirmed dengue patients, forty-seven (51.6%) were found to be primary, and forty-four (48.4%) were secondary dengue infections with male preponderance. Using the WHO diagnostic criteria, patients with dengue fever (DF) without warning signs added up to 51.6%, with warning signs 42.9% and severe dengue 5.5% of the total cases. The cut-off ratio of IgM:IgG ratio = 1.59 found the best discrimination between primary and secondary infection. Forty out of ninety-one (44%) patients exhibited ratios of > 1.59 whereas the rest fifty-one (56%) exhibited ratios of < 1.59. Dengue virus - 2 (DENV- 2) was found to be the most prevalent serotype. Conclusion Our study recommends the cut-off values for IgM:IgG ratio as 1.59. Therefore it is hoped that this will guide the clinicians to early distinguish between primary and secondary dengue. Furthermore, it can reduce morbidity and mortality because of dengue infections in the future.
目标 近年来，印度北部的北阿坎德邦已成为全球主要的旅游胜地之一。因此，最近观察到登革热感染的流行率大幅上升。与原发性登革热相比，继发性登革热会导致更严重的疾病，因此区分两者非常关键。我们旨在找出IgM:IgG比值的临界值，以便早期检测继发性登革热，这有助于临床医生预防并发症。方法 进行了一项为期一年的横断面研究，涉及约936例疑似登革热病例。使用市售的捕获酶联免疫吸附测定（ELISA）方法检测样本中的IgM和IgG。还进行了实时和巢式聚合酶链反应（PCR）测试，以确定流行的血清型。通过受试者工作特征曲线分析评估IgM:IgG比值，以区分原发性和继发性登革热。结果 在91例血清学确诊的登革热患者中，47例（51.6%）为原发性登革热，44例（48.4%）为继发性登革热感染，男性居多。根据世界卫生组织的诊断标准，无警示体征的登革热患者占总病例的51.6%，有警示体征的占42.9%，严重登革热占5.5%。IgM:IgG比值的临界值为1.59时，对原发性和继发性感染的区分效果最佳。91例患者中有40例（44%）的比值>1.59，其余51例（56%）的比值<1.59。登革病毒-2（DENV-2）是最常见的血清型。结论 我们的研究建议IgM:IgG比值的临界值为1.59。因此，希望这将指导临床医生早期区分原发性和继发性登革热。此外，它可以降低未来登革热感染导致的发病率和死亡率。
