1921
Volume 101, Issue 3
  • ISSN: 0002-9637
  • E-ISSN: 1476-1645

Abstract

Abstract.

There is insufficient evidence on whether dengue rapid diagnostic tests (dRDTs) influence clinical decisions in endemic areas. Therefore, our objective was to evaluate the impact of dRDTs on the prescription of antibiotics and anti-inflammatory drugs by physicians in a dengue-endemic area in Colombia. A retrospective cohort study was conducted with 330 patients in Cali, Colombia, between January 2012 and December 2017. The exposure was defined by the result of the dRDT. The outcomes were prescription of antibiotics and anti-inflammatory drugs after results of dRDT. Incidence and RR with 95% CIs were estimated. Multivariate logistic regression models were fitted separately for each outcome. Antibiotics were prescribed in 3% exposed and 14% unexposed. Anti-inflammatory drugs were prescribed in 1.2% exposed and 7.9% unexposed. A positive dRDT reduced the prescription of anti-inflammatories (AdjOR: 0.06, 95% CI: 0.008–0.5) but, by itself, had no effect on antibiotics (AdjOR: 1.1, 95% CI: 0.2–6); however, in hospitalized patients, a positive result reduced the probability of antibiotic prescription (AdjOR: 0.02, 95% CI: 0.00–0.8). Despite limitations of current dRDTs, they influence treatment decisions. Further studies are needed to assess the effect of dRDTs in patient outcomes and health-care costs.

Loading

Article metrics loading...

The graphs shown below represent data from March 2017
/content/journals/10.4269/ajtmh.19-0222
2019-07-22
2020-08-10
Loading full text...

Full text loading...

/deliver/fulltext/14761645/101/3/tpmd190222.html?itemId=/content/journals/10.4269/ajtmh.19-0222&mimeType=html&fmt=ahah

References

  1. Gyawali N, Bradbury RS, Taylor-Robinson AW, 2016. The epidemiology of dengue infection: harnessing past experience and current knowledge to support implementation of future control strategies. J Vector Borne Dis 53: 293304.
    [Google Scholar]
  2. Instituto Nacional de Salud, 2018. Boletín Epidemiológico Semanal (BES)–Semana Epidemiológica 52 (23 al 29 de diciembre de 2018) [Internet]. Available at: https://www.ins.gov.co/buscador-eventos/BoletinEpidemiologico/2018 Boletín epidemiológico semana 52.pdf. Accessed March 8, 2019.
    [Google Scholar]
  3. Carabali M, Lim JK, Velez DC, Trujillo A, Egurrola J, Lee KS, Kaufman JS, DaSilva LJ, Velez ID, Osorio JE, 2017. Dengue virus serologic prevalence and seroconversion rates in children and adults in Medellin, Colombia: implications for vaccine introduction. Int J Infect Dis 58: 2736.
    [Google Scholar]
  4. Villar LA, Rojas DP, Besada-Lombana S, Sarti E, 2015. Epidemiological trends of dengue disease in Colombia (2000–2011): a systematic review. PLoS Negl Trop Dis 9: 116.
    [Google Scholar]
  5. Martínez-Vega R, Díaz-Quijano FA, Villar-Centeno LA, 2013. Dificultad para el diagnóstico clínico temprano del dengue en un área endémica y su impacto sobre el manejo médico inicial. Rev Med Chil 134: 11531160.
    [Google Scholar]
  6. Organización Panamericana de la Salud, 2010. Guia para la Atención Clínica Integral del Paciente con Dengue. Bogotá, Colombia: Ministerio de la Protección Social, Dirección General de Salud Pública, 45.
    [Google Scholar]
  7. World Health Organization (WHO) and the Special Programme for Research and Tropical Diseases (TDR), 2009. Dengue Guidelines for diagnosis, tretment, prevention and control, Geneva, Switzerland: WHO, 147.
    [Google Scholar]
  8. Goncalves A et al., 2018. Innovative and new approaches to laboratory diagnosis of Zika and dengue: a meeting report. J Infect Dis 217: 10601068.
    [Google Scholar]
  9. Zhang B, Salieb-Beugelaar GB, Nigo MM, Weidmann M, Hunziker P, 2015. Diagnosing dengue virus infection: rapid tests and the role of micro/nanotechnologies. Nanomedicine 11: 17451761.
    [Google Scholar]
  10. Osorio L, Uribe M, Ardila GI, Orejuela Y, Velasco M, Bonelo A, Parra B, 2015. The use of rapid dengue diagnostic tests in a routine clinical setting in a dengue-endemic area of Colombia. Mem Inst Oswaldo Cruz 110: 510516.
    [Google Scholar]
  11. Ahmed NH, Broor S, 2014. Comparison of NS1 antigen detection ELISA, real time RT-PCR and virus isolation for rapid diagnosis of dengue infection in acute phase. J Vector Borne Dis 51:194199.
    [Google Scholar]
  12. Ayukekbong JA, Oyero OG, Nnukwu SE, Mesumbe HN, Fobisong CN, 2017. Value of routine dengue diagnosis in endemic countries. World J Virol 6: 9.
    [Google Scholar]
  13. Pal S, Dauner AL, Mitra I, Forshey BM, Garcia P, Morrison AC, Halsey ES, Kochel TJ, Wu SJ, 2014. Evaluation of dengue NS1 antigen rapid tests and ELISA kits using clinical samples. PLoS One 9: e113411.
    [Google Scholar]
  14. Osorio L, Ramirez M, Bonelo A, Villar LA, Parra B, 2010. Comparison of the diagnostic accuracy of commercial NS1-based diagnostic tests for early dengue infection. Virol J 7: 361.
    [Google Scholar]
  15. Bosch I et al., 2017. Rapid antigen tests for dengue virus serotypes and Zika virus in patient serum. Sci Transl Med 9: eaan1589.
    [Google Scholar]
  16. Baud D, Gubler DJ, Schaub B, Lanteri MC, Musso D, 2017. Review an update on Zika virus infection. Lancet 390: 20992109.
    [Google Scholar]
  17. Van den Bruel A, Cleemput I, Aertgeerts B, Ramaekers D, Buntinx F, 2007. The evaluation of diagnostic tests: evidence on technical and diagnostic accuracy, impact on patient outcome and cost-effectiveness is needed. J Clin Epidemiol 60: 11161122.
    [Google Scholar]
  18. Guyatt GH, Tugwell PX, Feeny DH, Haynes RB, Drummond M, 1986. A framework for clinical evaluation of diagnostic technologies. CMAJ 134: 587594.
    [Google Scholar]
  19. Sackett DL, Haynes RB, 2002. The architecture of diagnostic research. BMJ 324: 539541.
    [Google Scholar]
  20. Ferrante di Ruffano L, Hyde CJ, McCaffery KJ, Bossuyt PMM, Deeks JJ, 2012. Assessing the value of diagnostic tests: a framework for designing and evaluating trials. BMJ 344: e686
    [Google Scholar]
  21. Andries AC, Duong V, Ngan C, Ong S, Huy R, Sroin KK, Te V, Y B, Try PL, Buchy P, 2012. Field evaluation and impact on clinical management of a rapid diagnostic kit that detects dengue NS1, IgM and IgG. PLoS Negl Trop Dis 6: e1993.
    [Google Scholar]
  22. Huits R et al., 2017. Clinical utility of the nonstructural 1 antigen rapid diagnostic test in the management of dengue in returning travelers with fever. Open Forum Infect Dis 4: 16.
    [Google Scholar]
  23. Clemen G, Angel J, Montes C, Tovar J, Osorio L, 2019. Contribución de la prueba rapida NS1 e IgM al diagnostico de dengue en Colombia en el periodo pre-Zika. Infectio 23: 259265.
    [Google Scholar]
  24. Kellstein D, Fernandes L, 2019. Symptomatic treatment of dengue: should the NSAID contraindication be reconsidered? Postgrad Med 131: 109116.
    [Google Scholar]
  25. Bird C, Winzor G, Lemon K, Moffat A, Newton T, Gray J, 2018. A pragmatic study to evaluate the use of a rapid diagnostic test to detect group A Streptococcal pharyngitis in children with the aim of reducing antibiotic use in a UK emergency department. Pediatr Emerg Care Jul 24 [Epub ahead of print]. Available at: https://www.ncbi.nlm.nih.gov/pubmed/30045356.
    [Google Scholar]
  26. Dodd M, Adolphe A, Parada A, Brett M, Culbreath K, Mercier RC, 2018. Clinical impact of a rapid Streptococcal Antigen Test on antibiotic use in adult patients. Diagn Microbiol Infect Dis 91: 339344.
    [Google Scholar]
  27. Boyce RM, Muiru A, Reyes R, Ntaro M, Mulogo E, Matte M, Siedner MJ, 2015. Impact of rapid diagnostic tests for the diagnosis and treatment of malaria at a peripheral health facility in western Uganda: an interrupted time series analysis. Malar J 14: 203.
    [Google Scholar]
  28. Tun ZM, Moorthy M, Linster M, Su YC, Coker RJ, Ooi EE, Low JG, Smith GJ, Tam CC, 2016. Patterns of medication use and factors associated with antibiotic use among adult fever patients at Singapore primary care clinics. Antimicrob Resist Infect Control 5: 47.
    [Google Scholar]
  29. Lim JK, Alexander N, Di Tanna GL, 2017. A systematic review of the economic impact of rapid diagnostic tests for dengue. BMC Health Serv Res 17: 850.
    [Google Scholar]
  30. Tai AYC et al., 2017. Management of dengue in Australian travellers: a retrospective multicentre analysis. Med J Aust 206: 295300.
    [Google Scholar]
  31. Torres-Roman JS, Díaz-Vélez C, Bazalar-Palacios J, Helguero-Santin LM, 2016. Hospital management in patients with Dengue: what challenges do we face in Latin America? Infez Med 24: 359360.
    [Google Scholar]
  32. Robinson ML et al., 2018. Antibiotic utilization and the role of suspected and diagnosed mosquito-borne illness among adults and children with acute febrile illness in Pune, India. Clin Infect Dis 66: 16021609.
    [Google Scholar]
  33. Bandara SMR, Herath HMMTB, 2018. Effectiveness of corticosteroid in the treatment of dengue–a systemic review. Heliyon 4: e00816.
    [Google Scholar]
http://instance.metastore.ingenta.com/content/journals/10.4269/ajtmh.19-0222
Loading
/content/journals/10.4269/ajtmh.19-0222
Loading

Data & Media loading...

  • Received : 21 Mar 2019
  • Accepted : 25 May 2019
  • Published online : 22 Jul 2019

Most Cited This Month

This is a required field
Please enter a valid email address
Approval was a Success
Invalid data
An Error Occurred
Approval was partially successful, following selected items could not be processed due to error