The efficiency of the rapid chikungunya test in a scenario of Zika and dengue cocirculation in the municipality of Rio de Janeiro, Brazil

The municipality of Rio de Janeiro is one of the most affected by the simultaneous circulation of the chikungunya (CHIKV), the Zika (ZIKV) and the dengue viruses (DENV) in Brazil. Although rapid tests are commercially available in the country, there are still doubts about their efficacy in flavivirus cocirculation scenarios. This this study aimed to evaluate the performance and best cut-off point of CHIKV rapid tests in a scenario of cocirculation of Zika and dengue in the Rio de Janeiro. A total of 2,120 volunteers who lived in permanent private households in Rio de Janeiro were included and tested for CHIKV using the rapid test Dual Path Platform (DPP). Of the total number of participants, 769 had venous blood samples collected for diagnostic confirmation by the gold standard plaque reduction neutralization test (PRNT) and tested for CHIKV, DENV and ZIKV. The receiver operating characteristic (ROC) curve was used to calculate sensitivity, specificity, positive and negative predictive values, and the best cut-off point. A total of 15.5% of the samples were identified as having previous exposure to CHIKV according to the rapid test and 20.4% of the samples had previous exposure to CHIKV according to the PRNT. We identified prior exposure to DENV in 89.2% of the samples tested using PRNT and 67.8% to ZIKV. The sensitivity and specificity found for the manufacturer's cut-off point was 96.1% and 97.5%, respectively. The best cut-off point found for the rapid test was >= 14, a result for which the accuracy was 97.7%, with specificity and sensitivity of 97.9% and 96.8%, respectively. It was concluded that the rapid test has high performance to detect CHIKV infection in a scenario of cocirculation of Zika and dengue.