Comparison of PanBio Dengue Duo enzyme-linked immunosorbent assay (ELISA) and MRL dengue fever virus immunoglobulin M capture ELISA for diagnosis of dengue virus infections in southeast Asia

The performances of the MRL dengue fever virus immunoglobulin M (IgM) captu re enzyme-linked immunosorbent assay (ELISA) and the PanBio Dengue Duo IgM capture and IgG capture ELISA were compared. Eighty sera from patients with dengue virus infections, 24 sera from patients with Japanese encephalitis (JE), and 78 sera from patients with nonflavivirus infections, such as mala ria, typhoid, leptospirosis, and scrub typhus, mere used. The MRL test show ed superior sensitivity for dengue virus infections (94 versus 89%), while the PanBio test showed superior specificity for JE (79 versus 25%) and othe r infections (100 versus 91%). The PanBio ELISA showed better overall perfo rmance, as assessed by the sum of sensitivity and specificity (F value). Wh en dengue virus and nonflavivirus infections were compared, F values of 189 and 185 were obtained for the PanBio and MRL tests, respectively, while wh en dengue virus infections and JE were compared, F values of 168 and 119 we re obtained. The results obtained,vith individual sera in the PanBio and MR L IgM ELISAs showed good correlation, but this analysis revealed that the c utoff value of the MRL test was set well below that of the PanBio test. Com paring the sensitivity and specificity of the tests at different cutoff val ues (receiver-operator analysis) revealed that the MRL and PanBio IgM ELISA s performed similarly in distinguishing dengue virus from nonflavivirus inf ections, although the PanBio IgM ELISA showed significantly better distinct ion between dengue virus infections and JE. The implications of these findi ngs for the laboratory diagnosis of dengue are discussed.