| Abstract: | There is insufficient evidence of the usefulness of dengue diagnostic tests underroutine conditions. We sought to analyse how physicians are using dengue diagnosticsto inform research and development. Subjects attending 14 health institutions in anendemic area of Colombia with either a clinical diagnosis of dengue or for whom adengue test was ordered were included in the study. Patterns of test-use aredescribed herein. Factors associated with the ordering of dengue diagnostic testswere identified using contingency tables, nonparametric tests and logisticregression. A total of 778 subjects were diagnosed with dengue by the treatingphysician, of whom 386 (49.5%) were tested for dengue. Another 491 dengue tests wereordered in subjects whose primary diagnosis was not dengue. Severe dengueclassification [odds ratio (OR) 2.2; 95% confidence interval (CI) 1.1-4.5], emergencyconsultation (OR 1.9; 95% CI 1.4-2.5) and month of the year (OR 3.1; 95% CI 1.7-5.5)were independently associated with ordering of dengue tests. Dengue tests were usedboth to rule in and rule out diagnosis. The latter use is not justified by thesensitivity of current rapid dengue diagnostic tests. Ordering of dengue tests appearto depend on a combination of factors, including physician and institutionalpreferences, as well as other patient and epidemiological factors. |
