Please use this identifier to cite or link to this item: https://doi.org/10.1371/journal.pntd.0004477
Title: Laboratory-Enhanced Dengue Sentinel Surveillance in Colombo District, Sri Lanka: 2012-2014
Authors: Tissera H.
Amarasinghe A.
Gunasena S.
DeSilva A.D.
Yee L.W.
Sessions O. 
Muthukuda C.
Palihawadana P.
Lohr W.
Byass P.
Gubler D.J. 
Wilder-Smith A. 
Keywords: immunoglobulin G
immunoglobulin M
nonstructural protein 1
adolescent
adult
aged
Article
child
dengue
Dengue virus 1
Dengue virus 4
enzyme linked immunosorbent assay
female
human
infant
laboratory diagnosis
major clinical study
male
predictive value
quality control
reverse transcription polymerase chain reaction
secondary infection
sensitivity and specificity
sentinel surveillance
serotyping
Sri Lanka
very elderly
virus isolation
clinical laboratory service
dengue
Dengue virus
diagnostic test
evaluation study
genetics
hospital laboratory
isolation and purification
physiology
procedures
virology
Clinical Laboratory Services
Dengue
Dengue Virus
Diagnostic Tests, Routine
Humans
Laboratories, Hospital
Sensitivity and Specificity
Sentinel Surveillance
Sri Lanka
Issue Date: 2016
Publisher: Public Library of Science
Citation: Tissera H., Amarasinghe A., Gunasena S., DeSilva A.D., Yee L.W., Sessions O., Muthukuda C., Palihawadana P., Lohr W., Byass P., Gubler D.J., Wilder-Smith A. (2016). Laboratory-Enhanced Dengue Sentinel Surveillance in Colombo District, Sri Lanka: 2012-2014. PLoS Neglected Tropical Diseases 10 (2) : e0004477. ScholarBank@NUS Repository. https://doi.org/10.1371/journal.pntd.0004477
Abstract: Introduction: Dengue has emerged as a significant public health problem in Sri Lanka. Historically surveillance was passive, with mandatory dengue notifications based on clinical diagnosis with only limited laboratory confirmation. To obtain more accurate data on the disease burden of dengue, we set up a laboratory-based enhanced sentinel surveillance system in Colombo District. Here we describe the study design and report our findings of enhanced surveillance in the years 2012–2014. Methods: Three outpatient clinics and three government hospitals in Colombo District that covered most of the Colombo metropolitan area were selected for the sentinel surveillance system. Up to 60 patients per week presenting with an undifferentiated fever were enrolled. Acute blood samples from each patient were tested by dengue specific PCR, NS1 ELISA and IgM ELISA. A sub-set of samples was sent to Duke-NUS Singapore for quality assurance, virus isolation and serotyping. Trained medical research assistants used a standardized case report form to record clinical and epidemiological data. Clinical diagnoses by the clinicians-in-charge were recorded for hospitalized cases. Results: Of 3,127 febrile cases, 43.6% were PCR and/or NS1 positive for dengue. A high proportion of lab confirmed dengue was observed from inpatients (IPD) (53.9%) compared to outpatient (clinics in hospitals and general practice) (7.6%). Dengue hemorrhagic fever (DHF) was diagnosed in 11% of patients at the time of first contact, and the median day of illness at time of presentation to the sentinel sites was 4. Dengue serotype 1 was responsible for 85% of the cases and serotype 4 for 15%. The sensitivity and specificity of the clinicians’ presumptive diagnosis of dengue was 84% and 34%, respectively. Conclusion: DENV-1, and to a lesser degree DENV-4, infection were responsible for a high proportion of febrile illnesses in Colombo in the years 2012 to 2014. Clinicians’ diagnoses were associated with high sensitivity, but laboratory confirmation is required to enhance specificity. © 2016 Tissera et al.
Source Title: PLoS Neglected Tropical Diseases
URI: https://scholarbank.nus.edu.sg/handle/10635/165386
ISSN: 19352727
DOI: 10.1371/journal.pntd.0004477
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