Diagnostic Performance of Dengue NS1 and Antibodies by Serum Concentration Technique

Abstract

Dengue infection has been a public health problem worldwide, especially in tropical areas. A lack of sensitive diagnostic methods in the early phase of the illness is one of the challenging problems in clinical practices. We, herein, analyzed 86 sera of acute febrile patients, from both dengue and non-dengue febrile illness, to study the diagnostic performance of dengue diagnostics. When compared with detection by Polymerase Chain Reaction (PCR), dengue NS1 detection by enzyme-linked immunosorbent assay (ELISA) had the highest sensitivity of 82.4% (with 94.3% specificity), while NS1 by rapid diagnostic test (RDT) had 76.5% sensitivity. IgM detection by ELISA and RDT showed only 27.5% and 17.9% sensitivity, respectively. The combination of NS1 and IgM in RDT yielded a sensitivity of 78.4%, with 97.1% specificity. One of the essential steps in making a diagnosis from patient samples is the preparation process. At present, a variety of techniques have been used to increase the number of analytes in clinical samples. In this study, we focused on the sample concentration method. The sera were concentrated three times with the ultrafiltration method using a 10 kDa molecular weight cut-off membrane. The results showed an increase in the sensitivity of RDT-NS1 detection at 80.4%, with 100% specificity. When combining NS1 and IgM detection, the concentration method granted RDT an 82.4% sensitivity, with 100% specificity. In conclusion, serum concentration by the ultrafiltration method is a simple and applicable technique. It could increase the diagnostic performance of point-of-care dengue diagnostics.

Etiological characterization of acute undifferentiated febrile illness in Apartadó and Villeta municipalities, Colombia, during COVID-19 pandemic

“…Although in the present study a large number of diagnostic methods have been implemented to determine the etiology of AUFI, all these tests have some limitations. Detection of NS1 and anti-DENV IgM antibodies had a low sensitivity in secondary infections and during the later stages of the disease; furthermore, IgM antibodies are not always detectable in the earliest stages of the disease [68]. Anti-DENV IgG antibodies can persist for several years, thus their results must be interpreted carefully, mainly in secondary infections [68].…”

“…Detection of NS1 and anti-DENV IgM antibodies had a low sensitivity in secondary infections and during the later stages of the disease; furthermore, IgM antibodies are not always detectable in the earliest stages of the disease [68]. Anti-DENV IgG antibodies can persist for several years, thus their results must be interpreted carefully, mainly in secondary infections [68]. Diagnosis of leptospirosis is highly complex since a single method is not sufficient to guarantee a definitive diagnosis [69].…”

Dengue in Bangladesh and neighboring countries: an overview of epidemiology, transmission, control, and prevention

“…In 2023, Luvira et al reported serum concentration by the ultrafiltration method as a simple and applicable technique to improve the diagnostic sensitivity and specificity of NS1 antigen test [24]. Dengue NS1 detection by enzyme-linked immunosorbent assay (ELISA) had the highest sensitivity of 82.4% (and 94.3% specificity), while NS1 by rapid diagnostic test (RDT) had 76.5% sensitivity, when compared with the viral detection by polymerase chain reaction (PCR).…”

The Relationship of Fever Onset with NS1 Examination Results, IgM, and IgG in Dengue Hemorrhagic Fever Patients

“…Until now, there are no specific drugs and vaccines are not widely available (Gusti et al, 2017). A lack of sensitive diagnostic methods in the early phase of the illness is one of the challenging problems in clinical practices (Luvira et al, 2023;Pramatama et al, 2020).…”