Model parameters for estimating the probability of human deaths caused by rabies virus infection, Cambodia, 2007.

<p>Note: SRDBI: Suspected rabid dog bite injuries; PEP: Post-exposure treatment; IPC: Institut Pasteur in Cambodia.</p

Geographic distribution of rabies in dogs and humans, and incidence of post-exposure treatment, Cambodia, 1998–2007.

<p>Geographic distribution of rabies in dogs and humans, and incidence of post-exposure treatment, Cambodia, 1998–2007.</p

Probability tree for estimating the probability of death following a suspected rabid dog bite injury.

<p>Probability tree for estimating the probability of death following a suspected rabid dog bite injury.</p

Additional file 2: of Evaluation of the performances of six commercial kits designed for dengue NS1 and anti-dengue IgM, IgG and IgA detection in urine and saliva clinical specimens

Concordance between RDTs and IPC ELISAs for NS1, anti-DENV IgG/IgM and anti-DENV IgA detection in saliva and urine. (PDF 29 kb

Positive predictive values of suspected rabid dog characteristics when reported alone - dogs from 14 provinces in Cambodia, 2007.

<p>Positive predictive values of suspected rabid dog characteristics when reported alone - dogs from 14 provinces in Cambodia, 2007.</p

Additional file 1: of Evaluation of the performances of six commercial kits designed for dengue NS1 and anti-dengue IgM, IgG and IgA detection in urine and saliva clinical specimens

Characteristics of the rapid diagnostic tests for NS1, anti-DENV IgG/IgM and anti-DENV IgA detection in saliva and urine according to the manufacturer’s instructions. (PDF 87 kb

Sensitivity of SD Bioline Dengue Duo NS1 test according to antibodies profile.

*<p>P-value refers to the comparison between profile 1 and 2.</p>**<p>P-value refers to the comparison between profile 3 and 4.</p

Field Evaluation and Impact on Clinical Management of a Rapid Diagnostic Kit That Detects Dengue NS1, IgM and IgG

<div><h3>Background</h3><p>Dengue diagnosis is complex and until recently only specialized laboratories were able to definitively confirm dengue infection. Rapid tests are now available commercially making biological diagnosis possible in the field. The aim of this study was to evaluate a combined dengue rapid test for the detection of NS1 and IgM/IgG antibodies. The evaluation was made prospectively in the field conditions and included the study of the impact of its use as a point-of-care test for case management as well as retrospectively against a panel of well-characterized samples in a reference laboratory.</p> <h3>Methodology/Principal Findings</h3><p>During the prospective study, 157 patients hospitalized for a suspicion of dengue were enrolled. In the hospital laboratories, the overall sensitivity, specificity, PPV and NPV of the NS1/IgM/IgG combination tests were 85.7%, 83.9%, 95.6% and 59.1% respectively, whereas they were 94,4%, 90.0%, 97.5% and 77.1% respectively in the national reference laboratory at Institut Pasteur in Cambodia. These results demonstrate that optimal performances require adequate training and quality assurance. The retrospective study showed that the sensitivity of the combined kit did not vary significantly between the serotypes and was not affected by the immune status or by the interval of time between onset of fever and sample collection. The analysis of the medical records indicates that the physicians did not take into consideration the results obtained with the rapid test including for care management and use of antibiotic therapy.</p> <h3>Conclusions</h3><p>In the context of our prospective field study, we demonstrated that if the SD Bioline Dengue Duo kit is correctly used, a positive result highly suggests a dengue case but a negative result doesn't rule out a dengue infection. Nevertheless, Cambodian pediatricians in their daily practice relied on their clinical diagnosis and thus the false negative results obtained did not directly impact on the clinical management.</p> </div

Concordance of the IgM/IgG tests between hospitals' laboratories and IPC.

<p>Concordance of the IgM/IgG tests between hospitals' laboratories and IPC.</p

Sensitivity of individual and combination of tests according to serotype and immune status.

a<p>one-side, 97,5% confidence interval.</p