Publicado

2014-10-01

Dengue disease diagnosis: A puzzle to be solved

El diagnóstico en dengue: un rompecabezas a resolver

DOI:

https://doi.org/10.15446/revfacmed.v62n4.45593

Palabras clave:

Dengue, Diagnóstico, Flavivirus, Serología, Vigilancia (en)
Dengue, diagnóstico, Flavivirus, serología, vigilancia en dengue (es)

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Autores/as

  • Jaime Eduardo Castellanos Grupo de Virología, Universidad El Bosque. Bogotá, Colombia. Grupo de Patogénesis Infecciosa, Facultad de Odontología, Universidad Nacional de Colombia. Bogotá, Colombia.
  • Carolina Coronel-Ruíz Grupo de Virología, Universidad El Bosque. Bogotá, Colombia.
Dengue is an infection caused by dengue virus and is the most important arthropod transmitted viral disease in the world, causing near 100 million cases and 50 000 fatalities each year. Health authorities believe that these numbers will grow in coming years. In Colombia, almost 600 municipalities are in regions with Aedes aegypti circulation, and the presence of four dengue serotypes has been demonstrated. Despite the increasing knowledge about disease pathogenesis and the dengue virus, some technical or scientific difficulties with diagnosing dengue remain, negatively affecting both public health surveillance and the appropriate attention to patients in health settings and hospitals. This paper reviews the principles and developments of the current diagnostic techniques for dengue, pointing out the difficulties with making accurate dengue diagnoses and case confirmations in public health and specialized laboratories. The principles and limitations of MAC-ELISA, IgG serology, viral NS1 detection and viral isolation by cell culture are presented. In addition, the review of immunochromatography techniques (rapid diagnostic tests) that have been put forward to help the point-of-care diagnosis is proposed. This paper is intended to bring forward some points of view about the issues related to dengue diagnosis and contribute to improve the discussion surrounding the strategies and techniques needed for reducing the impact of the disease and favoring its control.

La infección por el virus de dengue es la enfermedad viral transmitida por insectos más importante del mundo que genera grandes gastos a los sistemas de salud. En Colombia, en más de 600 municipios está presente el mosquito vector y se ha detectado la circulación de los cuatro serotipos del virus, haciendo previsible que la incidencia y prevalencia sigan aumentando. Aunque se han hecho grandes avances y desarrollos para entender la enfermedad, existen vacíos científicos y técnicos que dificultan su correcto diagnóstico y que debilitan tanto la vigilancia en salud pública como la correcta atención en las instituciones prestadoras de salud. En este documento se revisan los principios e interpretaciones de las herramientas de laboratorio disponibles para el diagnóstico de dengue, haciendo énfasis en las dificultades existentes para la correcta definición de los casos desde el laboratorio general y especializado. Se explican los fundamentos y limitaciones de las técnicas de ELISA de captura de anticuerpos IgM, serología para IgG, detección del antígeno viral NS1, aislamiento viral en cultivos celulares y las pruebas más recientes basadas en la inmunocromatografía –pruebas rápidas–. La revisión se propone, además de aportar a la discusión sobre las dificultades para el diagnóstico en dengue, ofrecer una idea actualizada sobre cómo abordar el diagnóstico tanto en los laboratorios de salud pública como en los laboratorios especializados y contribuir así a mejorar los estándares de atención de los pacientes, reducir el impacto de la enfermedad y favorecer su control.

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Cómo citar

El diagnóstico en dengue: un rompecabezas a resolver. (2014). Revista De La Facultad De Medicina, 62(4), 617-629. https://doi.org/10.15446/revfacmed.v62n4.45593

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