NS1-based tests with diagnostic utility for confirming dengue infection: a meta-analysis.

Abstract

OBJECTIVES:

Non-structural protein 1 (NS1)-based tests may offer a larger window of opportunity for dengue diagnosis and could constitute a very useful diagnostic tool. The aim of this study was to establish the overall accuracy of NS1-based tests for diagnosing dengue infection.

METHODS:

A meta-analysis was conducted including 18 studies published up to October 1, 2012 identified using PubMed, ISI Web of Science, Google Scholar, and the Chinese National Knowledge Infrastructure (CNKI) database.

RESULTS:

For the single NS1-based tests - ELISA (Panbio Dengue Early ELISA Kit, Dengue NS1 Ag ELISA Kit, and Platelia Dengue NS1 Ag-ELISA Kit) and immunochromatography (Dengue NS1 Ag STRIP Kit and SD BIOLINE Dengue Duo Strip Kit) - the summarized sensitivities and specificities were 67% (95% confidence interval (CI) 59-74%) and 99% (95% CI 97-99%), and 71% (95% CI 61-79%) and 99% (95% CI 98-100%), respectively. The hierarchical summary receiver operating characteristics (HSROCs) were 0.92 and 0.96, respectively. For NS1 combined with an anti-dengue-specific IgM test, the summarized sensitivity, specificity, and HSROC were 83% (95% CI 68-92%), 86% (95% CI 79-91%), and 0.91 (95% CI 0.89-0.93), respectively. The accuracy for serotypes was 50.0-90.9% for DENV-1, 38.5-85.7% for DENV-2, 46.7-91.3% for DENV-3, and 21.7-87.0% for DENV-4.

CONCLUSIONS:

These results support the use of single NS1-based tests; they have good diagnostic utility for confirming dengue and for distinguishing serotypes DENV-1 and 3 from DENV-2 and 4, while they can be used as a screening tool when combined with an IgM test. Moreover, the Dengue NS1 Ag STRIP Kit appears to be the best for confirming and serotyping dengue infection.

• Authors: Hao Zhang, Wei Li, Junjie Wang, Hongjuan Peng, Xiaoyan Che, Xiaoguang Chen, Yuanping Zhou
• Journal: International journal of infectious diseases : IJID : official publication of the International Society for Infectious Diseases (Int J Infect Dis) Vol. 26 Pg. 57-66 (Sep 2014) ISSN: 1878-3511 [Electronic] Canada
• PMID: 24984164 (Publication Type: Evaluation Study, Journal Article, Meta-Analysis, Research Support, N.I.H., Extramural, Research Support, Non-U.S. Gov't)
• Copyright: Copyright © 2014 The Authors. Published by Elsevier Ltd.. All rights reserved.

Chemical References

• Immunoglobulin M
• Reagent Kits, Diagnostic
• Viral Nonstructural Proteins

Topics

• Dengue (diagnosis)
• Dengue Virus (classification, immunology)
• Enzyme-Linked Immunosorbent Assay
• Humans
• Immunoglobulin M
• ROC Curve
• Reagent Kits, Diagnostic
• Sensitivity and Specificity
• Serotyping
• Viral Nonstructural Proteins (immunology)