Published online Mar 25, 2026. doi: 10.5501/wjv.v15.i1.117079
Revised: January 13, 2026
Accepted: February 4, 2026
Published online: March 25, 2026
Processing time: 106 Days and 1.1 Hours
Dengue fever remains a major cause of acute febrile illness in India, particularly in rural areas where diagnostic facilities are limited. Early detection using point-of-care tests helps guide timely management and reduce unnecessary antibiotic use.
To determine the seroprevalence and clinical profile of dengue infection among acute febrile patients attending a rural tertiary care hospital in Maharashtra.
A prospective cross-sectional study was conducted at Ashwini Rural Medical College Hospital and Research Centre, Solapur from May to October 2025. A total of 320 consecutive patients presenting with acute fever of ≤ 7 days duration prior to hospital presentation were enrolled. Patients of all age groups were included. Serum samples were tested for dengue NS1 antigen and anti-dengue IgM and IgG antibodies using a commercial rapid test (Manufacturer: Meril diagnostics; Meriscreen dengue NS1 antigen and IgM + IgG antibodies). A 10% subset (n = 32) was tested by enzyme-linked immunosorbent assay (ELISA) for quality assurance. Patients were classified as recent dengue (NS1+ and/or IgM+), probable secondary infection (IgM+ IgG+), past exposure (IgG+ IgM-), or negative (NS1- IgM-). Clinical data and outcomes were recorded. Statistical analysis included χ2, Mann-Whitney U, and logistic regression (α = 0.05), adjusting for age, sex, platelet count, total leukocyte count, and presence of rash.
Overall, 28% (90/320) had evidence of recent dengue, while 35% (112/320) showed IgG positivity, and 10% (32/320) had probable secondary infection. Median platelet count was significantly lower in the recent dengue group [78000/mm³; interquartile range (IQR): 55000-110000] compared with non-dengue patients (210000/mm³; IQR: 160000-240000; P < 0.001). The most common symptoms were headache (68%), myalgia (61%), and retro-orbital pain (44%). Antibiotic use prior to testing was 60%; among those diagnosed with dengue, a relative 25% reduction in antibiotic prescriptions was observed following laboratory confirmation. Quality assurance analysis showed rapid test sensitivity of 92%, specificity of 95%, and Cohen’s kappa of 0.85 vs ELISA. Logistic regression identified thrombocytopenia (< 100000/mm³) [adjust odds ratio (aOR) 5.2; 95%CI: 2.4-10.9] and rash (aOR 3.6; 95%CI: 1.8-7.0) as independent predictors of dengue positivity.
A substantial proportion of acute febrile cases in this rural setting were due to dengue, highlighting the utility of NS1/IgM rapid tests for early diagnosis where molecular facilities are unavailable. Integrating rapid dengue testing into routine fever evaluation can improve case detection and rationalize antibiotic use.
Core Tip: This prospective study from a rural tertiary hospital in Maharashtra found that nearly one-third of acute febrile illnesses were due to dengue infection. Rapid NS1/IgM testing showed high diagnostic accuracy (sensitivity 92%, specificity 95%) and led to a clinically meaningful reduction in unnecessary antibiotic use. Incorporating such point-of-care diagnostics in rural healthcare can enable early dengue detection, improve patient management, and strengthen antimicrobial stewardship.