Published in:
Open Access
01-12-2014 | Research article
Dengue NS1 antigen as a marker of severe clinical disease
Authors:
Shiran Ajith Paranavitane, Laksiri Gomes, Achala Kamaladasa, Thiruni N Adikari, Nilanka Wickramasinghe, Chandima Jeewandara, Narangoda Liyanage Ajantha Shyamali, Graham Stuart Ogg, Gathsaurie Neelika Malavige
Published in:
BMC Infectious Diseases
|
Issue 1/2014
Login to get access
Abstract
Background
Early detection of complications significantly reduces dengue associated mortality and morbidity. We set out to determine if the NS1 rapid antigen detection test could be used as a point of care test to predict severe disease.
Methods
186 adult patients with confirmed dengue were enrolled during day 3-8 of illness. Clinical and laboratory parameters were recorded during the course of the illness and NS1 antigen levels were determined using both the Panbio dengue early ELISA (Panbio, Australia) and a NS1 rapid antigen detection kit (SD Bioline, South Korea).
Results
59.1% of patients presented to hospital on day 5-6 of illness when NS1 antigen positivity was significantly (p = 0.008) associated with severe dengue (odds ratio 3.0, 95% CI 1.39 to 6.47) and the NS1 antigen levels were significantly higher (p = 0.03) in those who went on to develop shock. Serum NS1 antigen levels significantly (p < 0.0001) and inversely correlated with the total white cell counts and lymphocyte counts. The bedside NS1 test showed comparable sensitivity (97.4%) and specificity (93.7%) to the laboratory NS1 test in our setting and cohort.
Conclusion
NS1 antigen positivity is associated with a higher risk of developing severe dengue especially when positive beyond day 5 of illness in our cohort, and while further validation studies are required, the test can therefore potentially be used as a bedside point of care test as a warning sign of severe dengue.