Online ISSN: 2515-8260

Keywords : Dengue

Comparative Analysis of Ns1 Antigen and IGM Antibody by ELISA of Clinically Suspected Dengue Fever Cases in a Tertiary Care Centre

T. Mounica, D. Lavanya, N. Padma Priya

European Journal of Molecular & Clinical Medicine, 2022, Volume 9, Issue 7, Pages 2604-2607

Background: Dengue virus is the most common Arbovirus in India. It is transmitted by female mosquito -Aedes aegypti. It is a major public health problem world-wide, especially in tropical and sub-tropical areas. Approximately 100-400 million dengue cases occur every year according to World Health Organization (WHO). Hence early diagnosis of dengue is essential to prevent complications and mortality.
Material and Methods: A total of 94 cases with clinically suspicious of dengue fever were included. Blood samples from the OP/IP patients with <9 days fever were collected under aseptic conditions. Serum was separated by centrifugation and subjected to detection of dengue NS1 antigen and IgM antibodies by ELISA.
Results: Out of 94 samples, 23 were positive for dengue infection.  Out of 23, NS1 antigen was present in 7(30.4%) samples, IgM antibody was present in 4 (17.4%) samples, and both NS1 & IgM antibody were present in 12 (52.2%) samples. The sensitivity and specificity of NS1 antigen - 87.5%&82.5%, for IgM - 80%&79.7%, for NS1 antigen + IgM antibody - 92.3% and 87.6% respectively.
Conclusion: NS1 ELISA test method is an effective method for early detection of dengue fever. Early detection will help in treatment at appropriate time to prevent complications.  However, the combination of NS1 Ag test and IgM Ab test by ELISA detected high sensitivity and specificity which provides strong evidence for detection of clinically suspected dengue infection.


Dr. Ashok Kumar Dash

European Journal of Molecular & Clinical Medicine, 2022, Volume 9, Issue 4, Pages 3694-3697

Background: Dengue is a febrile illness caused by infection with 1 of 4 dengue viruses transmitted by the Aedes mosquito. The present study was conducted to assess ECG manifestation of dengue fever.
Materials & Methods: 82 dengue fever patients were enrolled in study. Clinical features and ECG changes such as sinus bradycardia, sinus tachycardia, non- specific ST changes and RBBB were recorded.
Results: Out of 82 patients, males were 50 and females were 32. We observed that common clinical features were fever in 75, myalgia in 23, headache in 41, abdominal pain in 32, rashes in 15, arthritis in 17, palpitations in 20 and diarrhoea in 5 cases. We found that common ECG changes were sinus tachycardia in 6, sinus bradycardia in 30, non- specific ST changes in 12 and RBBB in 4 cases. The difference was significant (P< 0.05).
Conclusion: Common ECG abnormality in patients with dengue fever was sinus bradycardia.


Rishabh Parashar, R.K. Bhimwal, Ashwani Kumar Vyas, Sudhir Mehta

European Journal of Molecular & Clinical Medicine, 2022, Volume 9, Issue 4, Pages 1713-1724

Introduction: Endothelial activation and dysfunction is a central process in the pathogenesis of tropical diseases and von-Willebrand Factor levels have been linked with damage to the endothelium. The purpose of the study is to evaluate von Willebrand Factor in tropical diseases-Scrub typhus, Dengue, Chikungunya, Malaria and its association with clinical outcome. vWF can be used as a novel prognostic marker of clinical outcome.
Methodology: Hospital-based prospective observational analytic study on36 subjects of each disease. Inclusion Criteria: Confirmed cases of Scrub typhus (IgM positive), Dengue (NS1/IgM positive), Chikungunya (IgM positive) and Malaria (slide positive/rapid antigen detection/severe malaria). Exclusion criteria: Patients with von-Willebrand disease, Thrombotic Thrombocytopenic Purpura, and other conditions characterized by vascular damage, including nephritis, myocardial infarction, sepsis, diabetic angiopathy, peripheral vascular disease. Complete history with the examination was done. Investigations including CBC, PBF, RBS, RFT, LFT, vWF activity were done.
Observation and Results: In our study, we observed that vWF levels were elevated in91% patients of malaria, 89% patients of dengue, 75% patients of chikungunya, 88% patients of scrub typhus. We also found that 6, 3, and 3 out of 36 patients died in Malaria, Dengue, and Scrub typhus respectively with mean vWF was 414.67 IU/dl, 420 IU/dl, and 420 IU/dl respectively against alive cases where mean vWF was 259.97 IU/dl, 272.97 IU/dl, and 233.94 IU/dl. There is a statistically significant difference in vWF among alive and dead cases.
Conclusion: Raised vWF shows the association of von- Willebrand Factor activity and its association with the complications in these tropical diseases. von- Willebrand Factor level can be used as a novel prognostic marker of clinical outcome.


Nilam Bhasker, Bharti Parashar, Meeta Agnihotri

European Journal of Molecular & Clinical Medicine, 2022, Volume 9, Issue 4, Pages 3349-3358

Introduction: Nowadays, platelet counting is employed as a routine method owing to the emergence of dengue fever from the past few decades. Manual methods yield varying outcomes while sometimes automated methods produce inappropriate outcomes. Hence, the goal of this study is to evaluate the diagnostic accuracy of manual modality of platelet count with respect to automated analyzers. Additionally, this study was also analyzed the correlation between manual and automated analyzer.
Materials and Methods: The current study was carried out in the Department of Pathology, Employee’s State Insurance corporation (ESIC) Hospital, Sarojini Nagar, Lucknow (U.P.) on a group of 600 patients (375 female and 225 male) including both indoor and outdoor settings  from 1st November to 30th November, 2021 in a one month duration. The blood samples were collected in tubes containing K3-EDTA (tri-potassium ethylenediamine-tetra-acetic acid). Manual method of platelet counting was performed by slide method with Leishman stain while automated counting was carried out by using Mindray BC-6200, 5 part auto-hematology analyzer.
Results: A total of 600 patients have studied with the mean platelet count in automated analyzer was 1.16±0.99 ×103 /µL and by manual method with Leishman stain was 1.23±1.03 lacs /mm3. A positive correlation was observed between automated analyzer and manual platelet count (r=0.837, p=0.00).     
Conclusion: When the platelet counts are very low, manual method of platelet counting should be done carefully to exclude clumping or irregular distribution of platelets. 


Dr. Srividya Yeruva,Dr. Sowjanya Rakam,Dr.Pravallika Mallipeddi

European Journal of Molecular & Clinical Medicine, 2022, Volume 9, Issue 4, Pages 1546-1553

Introduction: Dengue virus infection has emerged as a notable public health problem in recent decades . Laboratory evaluation of  dengue  Serological markers and  platelet count help in early diagnosis and can be used as predictor to reduce the morbidity and mortality of dengue disease.
Aim: Aim of  this  study is  to evaluate  Dengue  serological  markers for early diagnosis of cases  and to study  the correlation between  serological markers  and  platelet count  in dengue positive cases .
Materials and Methods: This was a cross-sectional prospective study  conducted  in  the Tertiary  health care centre , Hyderabad..  All clinically suspected cases of dengue, reported  to various outpatient departments, emergency services and admitted patients in the Hospital were included for this study,  from  July to   September   2018 . The Chi-Square test and statistical software Epi info and MS excel was used to find out the statistical significance of the estimate.
Results:   Among  700 blood  samples were  received from clinically suspected case of dengue , 125 (17.85%)  cases  were detected dengue positive  out of which  65 (52%) cases showed platelet count less than 1 lakh. . In confirmed dengue cases, thrombocytopenia is more consistently found in  dengue  positive cases  with only IgM  and only NS1 positive cases compared to other serological groups.
Conclusion: Detection of  dengue specific serological markers along with platelet count  in the diagnosis of dengue, increases the early diagnosis so as to avoid complications significantly and can be used as prognostic marker to reduce the morbidity and moratlity of dengue disease.

Detection and phylogeny of Wolbachia in field-collected Aedes albopictus and Aedes aegypti from Manila City, Philippines

Maria Angenica F. Regilme, Tatsuya Inukai, and Kozo Watanabe .

European Journal of Molecular & Clinical Medicine, 2022, Volume 9, Issue 3, Pages 3060-3073

Wolbachia is the most common bacterial endosymbiont of arthropods, such as the medically important Aedes albopictus. Recent reports also detected in Aedes aegypti. This study collected 12 adults Ae. albopictus and 359 Ae. aegypti from 183 households in a dengue-prone area, Manila, Philippines, between June and September 2017. Aedes larvae (n = 509) were also collected from 17 water containers from 11 households. The DNA of the Aedes larvae and adults were screened for the presence of Wolbachia using the wsp and 16S markers, following optimized polymerase chain reaction (PCR) conditions, and sequenced. Our results showed that 12 out of 12 (100%) adult Ae. albopictus and3 out of 359 (0.84%) adult Ae. aegypti were Wolbachia positive, whereas all larvae tested negative for Wolbachia (0/509; 0%). The wsp marker revealed six Wolbachia-positive Ae. albopictus belonging to supergroups A (n = 2) and B (n = 4). The 16S marker showed Wolbachia in ten Ae. albopictus and 3 Ae. albipictus,most sequences were in supergroup A (n = 11) and two in supergroup B. Our results revealed Wolbachia supergroups in field-collected Ae. albopictus and Ae. aegypti with implications for a successful Wolbachia mass release programs.

Assessment of maternal and fetal complications of dengue fever in pregnancy

Swati Sheoran, Vini Gupta, Antima Singh

European Journal of Molecular & Clinical Medicine, 2022, Volume 9, Issue 3, Pages 231-235

Background:Dengue is the most prevalent mosquito-borne viral disease affecting humans.
The present study was conducted to assess maternal and fetal complications of dengue
fever in pregnancy.
Materials & Methods: 96 antenatal patients diagnosed with dengue fever clinically and
serologically were included. Parameters such as parity, gestational age, symptoms at the
time of diagnosis, platelet count and haematocrit at the time of diagnosis were recorded.
Details regarding ICU admission need for transfusion and medical examination was
recorded. Maternal and fetal complications were also recorded.
Results: Gestational age at diagnosis (weeks) <12 was seen among 5, 12-20 in 8, 20-28 in
14, 28-34 in 16, 34-37 in 20 and >37 in 33. Trimester I was seen in 7, II in 23 and III in
66. Platelet count <20000 was seen in 10, 21000-50000 in 22, 51000- 100000 in 20, 1
lakh- 1.5 lakh in 32 and >1.5 lakh in 12. Fetal complications were IUGR in 3, fetal
malformation in 2, meconium- stained amniotic fluid in 8 and fetal distress in 5. Neonatal
outcome was prematurity in 11, low birth weight in 34, ICU admission in 5 and vertical
transmission in 6. The difference was significant (P< 0.05).
Conclusion: There were significant maternal and fetal outcome in pregnant women
suffering from dengue fever. Hence, there is need to have close monitoring of

Serological Evidence of Co-infection of Dengue, Leptospirosis and Scrub Typhus in Patients Presenting with Acute Febrile Illness in a Tertiary care Hospital

Rupinder Bakshi, Satinder Kaur, Tanveer Kaur, Ritika Ghai, Karashdeep Kaur, Ramanpreet Kaur, Jaspreet Kaur, Palika Sharma, Amritpal Kaur, Harbhajan Singh

European Journal of Molecular & Clinical Medicine, 2022, Volume 9, Issue 3, Pages 2009-2020

Background: Acute febrile illness (AFI)is specified as sudden onset of fever of unknown
origin lasting for 1-14 days. AFI may be caused by pathogens like bacteria, viruses,
parasites, and fungi leading to infectious diseases. Dengue is a vector-borne viral disease
that is transmitted by Aedes aegypti mosquitoes. Dengue NS1 Ag is released into the
blood during viral replication in infected patients and is detectable from the first day
after fever. As NS1 Ag can be identified promptly, it acts as a beneficial biomarker for
the early detection of dengue, allowing rapid management of dengue fever.
Materials and Methods: A retrospective study was carried out on blood samples of
patients presenting with acute febrile illness in OPD/IPD of a tertiary care hospital from
September 2019- December 2019. Out of 694 samples, the samples which were 2 mL in
quantity, non-hemolytic, non-lipemic, maintained in cold chain along with complete
demographic data were selected for the present study i.e. n=270.
Results: Blood samples of 270 patients who presented with acute febrile illness and met
with our inclusion criteria were tested for dengue NS1 antigen/IgM antibodies based on
their fever history. Out of 270, 120 patients tested positive for dengue.
Conclusion: To conclude, patients in tropical countries presenting in the post-monsoon
season with acute febrile illness not responding to appropriate and adequate therapy
aimed for a suspected tropical infection such as dengue should be evaluated for
concurrent infections with other microorganisms.

Clinical study of dengue fever in children of 1-12 years age group at a tertiary hospital

Dr. Asadkhan S Pathan, Dr. Shivprasad K Mundada,Dr. Asadkhan S Pathan .

European Journal of Molecular & Clinical Medicine, 2022, Volume 9, Issue 2, Pages 1353-1359

Background: Dengue infections vary in severity, ranging from influenza like self-limiting illness to life threatening dengue hemorrhagic fever (DHF) and dengue shock syndrome (DSS). Present study was aimed to study dengue fever in 1-12 years age group at a tertiary hospital.


Ashna Maheshwari, Jitendra Kumar Gupta, Munish Kumar Kakkar, Gunjan Agarwal, Priya Marwah

European Journal of Molecular & Clinical Medicine, 2022, Volume 9, Issue 1, Pages 1161-1167

Background: Dengue fever is a major public health problem with morbidity and mortality and the recent epidemic showed variable clinical presentations with unpredictable clinical progression and outcome. Increasing work is being done to identify a biomarker that may predict the various clinical phenotype or complications.
Materials and Methods: This was a prospective study conducted in the department of Pediatrics in a tertiary care hospital. Patients with clinically suspected dengue fever underwent dengue serology tests. Patients were followed till 48 hours post defervescence of fever or settling of any other ongoing concern. Data analysis was done using Windows SPSS software version 20 and P value less than 0.05 was considered statistically significant.
Results: A total of 200 patients were enrolled in the study. Maximum number of cases (48%) was in the age group of 11 to 15 years. Commonest symptom was fever in 100% cases. NS1 antigen was positive in 96% cases. Severe dengue patients were significantly more in age group of 6 to 10 years (58.2%) Children with dengue with warning signs had significantly raised levels of SGOT, SGPT and CPK.
Conclusion: Biochemical markers may help to identify and appropriately manage the high risk children of dengue fever with warning signs thus reducing morbidity and mortality due to dengue fever.


Dr.Taruni, Dr. S.L. Annapoorna

European Journal of Molecular & Clinical Medicine, 2021, Volume 8, Issue 4, Pages 872-877

Introduction: Dengue fever, a mosquito-borne disease that occurs in tropical and subtropical
areas of the world, is considered to be a significant threat for the mankind in both developing
and developed countries.It causes a wide spectrum of illness from mild asymptomatic illness to
severe fatal dengue hemorrhagic fever/dengue shock syndrome. Its impact today is thirty times
>50 years ago. Global incidence of dengue has drastically upped in the last few years.
Materials and Methods: The study was carried out in the department of microbiology at
Government general hospital,siddipet fpr a period of one year , that is from January 2019 to
December 20219. Blood was collected from each patient suspected to be suffering from
dengue, at least 3 days after onset of fever. Serum was tested for the presence of dengue NS1
antigen and antihuman IgM antibodies using Panbio Dengue Early enzyme-linked
immunosorbent assay (ELISA) kit and National Institute of Virology. Results: A total of
2251 were tested over a period of one years i.e. from January 2019 to December 2019. Out of
which 592 (26.29%) were sero-positive for dengue with symptoms of classical dengue fever.
IgM in 349(58.9%) NS1- 243 (41.04%). Conclusion: As vaccines or antiviral drugs are not
available for dengue viruses, the only effective way to prevent dengue is to control the
mosquito vector, Aedes aegypti and prevent its bite.

Analysis of the Dengue Infection, Occurrence and Hematological Profile of Dengue Patients in Dhaka City

Mohammad Zakerin Abedin; Md. Sifat Uz Zaman; Tasnim Ahmad; Md. Abdullah Al Maruf; Md Babul Aktar; Md. Fayez Ahmed; Md. Abu Sayeed Imran; Rubait Hasan; Pinki Akter; Md. Ekhlas Uddin

European Journal of Molecular & Clinical Medicine, 2021, Volume 8, Issue 3, Pages 1572-1578

In the tropical and subtropical area, dengue virus is mostly found. To the determination of the occur-rence of dengue viral infection and hematological profile of dengue infected peoples in the Dhaka city. A sum of 255 samples of blood from both sex and different age groups were collected in this research. Dengue nonstructural protein 1 (NS1) and complete blood count (CBC) test were performed for the study. During this study period, total 255 samples were tested. Among these, 67samples were diagnosed as positive. Seroprevalence of dengue was 26.30%. Out of 67 positive dengue patients, 41 (61.2 %) were male and 26 (38.8 %) were female. Dengue infection was observed more in 21 to 30years age group followed by above 40years and 16 to 20years but observed less in of 1st day to 5years followed by 11 -15years, then 6 -10years and 31 - 40years. It was seen that the >40years of age group had the maximum unit of cases having low platelet count followed by 21-30years and it was also seen that 21-30years of age group had the maximum range of cases having low WBC count followed by above 40years of age group. In our research, we showed thrombocytopenia (100000 - 150,000/μl) with leucopenia (White Blood Cells, WBC <5000/μl) in 8(26.6%) cases and thrombocytopenia (100000-150,000/μl) without leucopenia in 9 (24.3%) cases but thrombocytopenia (<100000/μl) with leucopenia (White Blood Cells (WBC) < 5000/μl) in 5(16.7%) cases and thrombocytopenia (<100000/μl) without leucopenia in 6 (16.2%) cases. Among 67 positive cases, we found that (26.6%) had DF and (16.7%) had DHF according to WHO classification. For validating more reliability, this research needs further work.

Relationship Between Platelet, Hematocrit and Leukocyte with Dengue Severity in Bengkulu City, Indonesia

Dessy Triana; Annelin Kurniati; Gayatri Ghea Wirastari

European Journal of Molecular & Clinical Medicine, 2020, Volume 7, Issue 10, Pages 2305-2311

Establishing the correct diagnosis of the clinical stage and the severity of dengue patients is very important to determine the prognosis. Examination of platelets, hematocrit and leukocytes for each clinical stage of dengue can help group and manage patients based on their clinical degree. This study aimed to determine the relationship between platelet, hematocrit and leukocyte examination results with the clinical degree of dengue based on WHO. This study used a cross-sectional study design with a sampling technique using consecutive sampling from July-November 2020 in 5 hospitals at Bengkulu City with total sample of 35 patients. The results found a strong relationship between hematocrit levels and the degree of severity of dengue (p = 0.001; r = 0.637). However, there was no significant relationship between the number of platelets (p = 0.826; r = -0.039) and leukocytes (p = 0.554; r = -0.103) with the severity of dengue. Laboratory tests are crucial to establish the clinical degree of dengue and disease’s prognosis.