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Memórias do Instituto Oswaldo Cruz
Fundação Oswaldo Cruz, Fiocruz
ISSN: 1678-8060 EISSN: 1678-8060
Vol. 110, No. 4, 2015, pp. 510-516
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Bioline Code: oc15065
Full paper language: English
Document type: Editorial
Document available free of charge
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Memórias do Instituto Oswaldo Cruz, Vol. 110, No. 4, 2015, pp. 510-516
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The use of rapid dengue diagnostic tests in a routine clinical setting in a dengue-endemic area of Colombia
Osorio, Lyda; Uribe, Marcela; Ardila, Gloria Ines; Orejuela, Yaneth; Velasco, Margarita; Bonelo, Anilza & Parra, Beatriz
Abstract
There is insufficient evidence of the usefulness of dengue diagnostic tests under routine conditions. We sought
to analyse how physicians are using dengue diagnostics to inform research and development. Subjects attending 14
health institutions in an endemic area of Colombia with either a clinical diagnosis of dengue or for whom a dengue
test was ordered were included in the study. Patterns of test-use are described herein. Factors associated with the
ordering of dengue diagnostic tests were identified using contingency tables, nonparametric tests and logistic regression.
A total of 778 subjects were diagnosed with dengue by the treating physician, of whom 386 (49.5%) were
tested for dengue. Another 491 dengue tests were ordered in subjects whose primary diagnosis was not dengue. Severe
dengue classification [odds ratio (OR) 2.2; 95% confidence interval (CI) 1.1-4.5], emergency consultation (OR
1.9; 95% CI 1.4-2.5) and month of the year (OR 3.1; 95% CI 1.7-5.5) were independently associated with ordering
of dengue tests. Dengue tests were used both to rule in and rule out diagnosis. The latter use is not justified by the
sensitivity of current rapid dengue diagnostic tests. Ordering of dengue tests appear to depend on a combination of
factors, including physician and institutional preferences, as well as other patient and epidemiological factors.
Keywords
dengue; diagnosis; health services; decision making
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