Diagnostic Performance of Dengue NS1 and Antibodies by Serum Concentration Technique
Abstract
:1. Introduction
2. Materials and Methods
2.1. Clinical Specimens
2.2. Quantitative Reverse Transcription Polymerase Chain Reaction (qRT-PCR)
2.3. Serology
2.4. Concentration Method
2.5. Ethical Approval
2.6. Statistical Analysis
3. Results
3.1. Characteristics of the Study Population
3.2. Diagnostic Performance of Tests
3.2.1. ELISA and RDT: Pre-Concentration (Pre-Con) Specimens
3.2.2. ELISA and RDT: Post-Concentrated (Post-Con) Specimens
3.2.3. ELISA and RDT Sensitivity by Day of Onset of Illness: Pre- and Post-Con Specimens
3.3. The Results of False Negative RDT on NS1 Ag and DEV IgM
4. Discussion
5. Conclusions
Author Contributions
Funding
Institutional Review Board Statement
Informed Consent Statement
Data Availability Statement
Acknowledgments
Conflicts of Interest
References
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Total | Dengue PCR-Positive | Dengue PCR-Negative | p-Value | |||||
---|---|---|---|---|---|---|---|---|
N | (%) | N | (%) | N | (%) | |||
Total | 86 | 51 | 35 | |||||
Sex | ||||||||
Female | 34 | 39.5 | 21 | 41.2 | 13 | 37.1 | 0.707 | |
Male | 52 | 60.5 | 30 | 58.8 | 22 | 62.9 | ||
Age Group | ||||||||
15–30 | 40 | 46.5 | 28 | 54.9 | 12 | 34.3 | 0.083 | |
31–45 | 24 | 27.9 | 14 | 27.5 | 10 | 28.6 | ||
46–61 | 22 | 25.6 | 9 | 17.6 | 13 | 37.1 | ||
Day of Illness | ||||||||
1–3 | 44 | 51.2 | 30 | 58.8 | 14 | 40.0 | 0.001 | |
4–6 | 33 | 38.4 | 21 | 41.2 | 12 | 34.3 | ||
7–11 | 9 | 10.5 | 0 | 0 | 9 | 25.7 | ||
Tourniquet test | ||||||||
Not performed | 17 | 19.8 | 14 | 27.5 | 3 | 8.6 | 0.001 | |
Negative | 46 | 53.5 | 19 | 37.3 | 27 | 77.1 | ||
Positive | 23 | 26.7 | 18 | 35.3 | 5 | 14.3 | ||
Dengue Serotype * | ||||||||
1 | 14 | 27.5 | ||||||
2 | 9 | 17.6 | ||||||
3 | 14 | 27.5 | ||||||
4 | 14 | 27.5 | ||||||
Final Diagnosis * | ||||||||
DF | 40 | 78.4 | 0 | 0 | ||||
DHF | 11 | 21.6 | 0 | 0 | ||||
Bacteremia | 0 | 0 | 5 | 14.3 | ||||
Influenza | 0 | 0 | 10 | 28.6 | ||||
Leptospirosis | 0 | 0 | 10 | 28.6 | ||||
Murine typhus | 0 | 0 | 10 | 28.6 |
Sensitivity (95% CI) | Specificity (95% CI) | PPV (95% CI) | NPV (95% CI) | Positive LR (95%CI) | Negative LR (95%CI) | |||||||
---|---|---|---|---|---|---|---|---|---|---|---|---|
Pre-Concentration | Post-Concentration | Pre-Concentration | Post-Concentration | Pre-Concentration | Post-Concentration | Pre-Concentration | Post-Concentration | Pre-Concentration | Post-Concentration | Pre-Concentration | Post-Concentration | |
ELISA-NS1 | 82.4 (69.1–91.6) | 94.3 (80.8–99.3) | 95.5 (84.5–99.4) | 78.6 (63.2–89.7) | 14.4 (3.73–55.7) | 0.19 (0.10–0.34) | ||||||
RDT-NS1 | 76.5 (62.5–87.2) | 80.4 (66.9–90.2) | 100.0 (90.0–100.0) | 100.0 (90.0–100.0) | 100.0 (91.0–100.0) | 100 (91.4–100.0) | 74.5 (59.7–86.1) | 77.8 (62.9–88.8) | NA | NA | 0.24 (0.14–0.39) | 0.20 (0.11–0.34) |
ELISA-IgM | 27.5 (15.9–41.7) | 23.5 (12.8–37.5) | 91.4 (76.9–98.2) | 97.1 (85.1–99.9) | 82.4 (56.6–96.2) | 92.3 (64.0–99.8) | 46.4 (34.3–58.8) | 46.6 (34.8–58.6) | 3.2 (0.99–10.3) | 8.24 (1.12–60.5) | 0.79 (0.65–0.97) | 0.79 (0.67–0.93) |
RDT-IgM | 17.9 (8.4–30.9) | 11.8 (4.44–23.9) | 97.1 (85.1–99.9) | 100.0 (90.0–100.0) | 90.0 (55.5–99.7) | 100.0 (54.1–100.0) | 44.7 (33.3–56.6) | 43.8 (32.7–55.3) | 6.18 (0.82–46.6) | NA | 0.85 (0.74–0.97) | 0.88 (0.80–0.98) |
ELISA-IgG | 86.3 (73.7–94.3) | 86.3 (73.7–94.3) | 5.71 (0.7–19.2) | 5.71 (0.7–19.2) | 57.1 (45.4–68.4) | 57.1 (45.4–68.4) | 22.2 (2.8–60.0) | 22.2 (2.8–60.0) | 0.92 (0.80–1.05) | 0.92 (0.80–1.05) | 2.4 (0.53–10.9) | 2.4 (0.53–10.9) |
RDT-IgG | 66.7 (52.1–79.2) | 62.7 (48.1–75.9) | 25.7 (12.5–43.3) | 34.3 (19.1–52.2) | 56.7 (43.2–69.4) | 58.2 (44.1–71.3) | 34.6 (17.2–55.7) | 38.7 (21.8–57.8) | 0.90 (0.68–1.18) | 0.96 (0.69–1.31) | 1.3 (0.65–2.57) | 1.09 (0.61–1.94) |
RDT-NS1 and RDT-IgM | 78.4 (64.7–88.7) | 82.4 (69.1–91.6) | 97.1 (85.1–99.9) | 100.0 (90.0–100.0) | 97.6 (87.1–99.9) | 100.0 (91.6–100.0) | 75.6 (60.5–87.1) | 79.5 (64.7–90.2) | 27.5 (3.96–190.0) | NA | 0.22 (0.13–0.38) | 0.18 (0.10–0.32) |
Sensitivity | Day of Illness | ||
---|---|---|---|
1–3 N = 44 Sensitivity (95% CI) | 4–6 N = 33 Sensitivity (95% CI) | ||
ELISA-NS1 | |||
Pre-concentration | 83.3 (65.3–94.4) | 81.0 (58.1–94.6) | |
Post-concentration | - | - | |
RDT-NS1 | |||
Pre-concentration | 76.7 (57.7–90.1) | 47.6 (25.7–70.2) | |
Post-concentration | 83.3 (65.3–94.4) | 76.2 (52.8–91.8) | |
ELISA-IgM | |||
Pre-concentration | 13.3 (3.8–30.7) | 47.6 (25.7–70.2) | |
Post-concentration | 16.7 (5.64–34.7) | 33.3 (14.6–57.0) | |
RDT-IgM | |||
Pre-concentration | 3.33 (0.08–17.2) | 38.1 (18.1–61.6) | |
Post-concentration | 3.33 (0.08–17.2) | 23.8 (8.22–47.2) | |
ELISA-IgG | |||
Pre-concentration | 83.3 (65.3–94.4) | 90.5 (69.6–98.8) | |
Post-concentration | 83.3 (65.3–94.4) | 90.5 (69.6–98.8) | |
RDT-IgG | |||
Pre-concentration | 56.7 (37.4–74.5) | 81 (58.1–94.6) | |
Post-concentration | 53.3 (34.3–71.7) | 76.2 (52.8–91.8) | |
RDT-NS1 and RDT-IgM | |||
Pre-concentration | 76.7 (57.7–90.1) | 81.0 (58.1–94.6) | |
Post-concentration | 83.3 (65.3–94.4) | 81.0 (58.1–94.6) |
Dengue PCR-Positive | ||||||
---|---|---|---|---|---|---|
RDT-Positive | RDT-Negative | p-Value | ||||
N | (%) | N | (%) | |||
Total | 40 | 11 | ||||
Sex | ||||||
Female | 18 | 45.0 | 3 | 27.3 | 0.328 * | |
Male | 22 | 55.0 | 8 | 72.7 | ||
Age Group | ||||||
15–30 | 22 | 55.0 | 6 | 54.5 | 0.525 * | |
31–45 | 12 | 30.0 | 2 | 18.2 | ||
46–61 | 6 | 15.0 | 3 | 27.3 | ||
Day of Illness† | ||||||
1 | 5 | 12.5 | 3 | 27.3 | 0.698 * | |
2 | 7 | 17.5 | 2 | 18.2 | ||
3 | 11 | 27.5 | 2 | 18.2 | ||
4 | 10 | 25.0 | 2 | 18.2 | ||
5 | 6 | 15.0 | 1 | 9.1 | ||
6 | 1 | 2.5 | 1 | 9.1 | ||
Tourniquet Test | ||||||
Not performed | 12 | 30.0 | 2 | 18.2 | 0.513 * | |
Negative | 13 | 32.5 | 6 | 54.5 | ||
Positive | 15 | 37.5 | 3 | 27.3 | ||
Dengue Serotype † | ||||||
1 | 12 | 30.0 | 2 | 18.2 | 0.183 * | |
2 | 9 | 22.5 | 0 | 0 | ||
3 | 9 | 22.5 | 5 | 45.5 | ||
4 | 10 | 25.0 | 4 | 36.4 | ||
Final Diagnosis | ||||||
DF | 30 | 75.0 | 10 | 90.9 | 0.418 * | |
DHF | 10 | 25.0 | 1 | 9.1 | ||
Serology | 1.00 | |||||
Primary | 1 | 2.6 | 0 | 0 | ||
Secondary | 38 | 97.4 | 11 | 100 |
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Luvira, V.; Thawornkuno, C.; Lawpoolsri, S.; Thippornchai, N.; Duangdee, C.; Ngamprasertchai, T.; Leaungwutiwong, P. Diagnostic Performance of Dengue NS1 and Antibodies by Serum Concentration Technique. Trop. Med. Infect. Dis. 2023, 8, 117. https://doi.org/10.3390/tropicalmed8020117
Luvira V, Thawornkuno C, Lawpoolsri S, Thippornchai N, Duangdee C, Ngamprasertchai T, Leaungwutiwong P. Diagnostic Performance of Dengue NS1 and Antibodies by Serum Concentration Technique. Tropical Medicine and Infectious Disease. 2023; 8(2):117. https://doi.org/10.3390/tropicalmed8020117
Chicago/Turabian StyleLuvira, Viravarn, Charin Thawornkuno, Saranath Lawpoolsri, Narin Thippornchai, Chatnapa Duangdee, Thundon Ngamprasertchai, and Pornsawan Leaungwutiwong. 2023. "Diagnostic Performance of Dengue NS1 and Antibodies by Serum Concentration Technique" Tropical Medicine and Infectious Disease 8, no. 2: 117. https://doi.org/10.3390/tropicalmed8020117