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Báo cáo y học: " Comparison of the diagnostic accuracy of commercial NS1-based diagnostic tests for early dengue infection"

Tuyển tập báo cáo các nghiên cứu khoa học quốc tế ngành y học dành cho các bạn tham khảo đề tài: Comparison of the diagnostic accuracy of commercial NS1-based diagnostic tests for early dengue infection | Osorio et al. Virology Journal 2010 7 361 http www.virologyj.eom content 7 1 361 J VIROLOGY JOURNAL RESEARCH Open Access Comparison of the diagnostic accuracy of commercial NS1-based diagnostic tests for early dengue infection 1 1 2 3 2 Lyda Osorio Meleny Ramirez Anilza Bonelo Luis A Villar Beatriz Parra Abstract Background We compared the diagnostic accuracy and reproducibility of commercially available NS1-based dengue tests and explored factors influencing their sensitivities. Methods Paired analysis of 310 samples previously characterized as positive n 218 and negative n 92 for viral isolation and or RT-PCR and or IgM seroconversion. Masked samples were tested by two observers with Platelia Dengue NS1 Ag second generation Pan-E Dengue Early ELISA SD Dengue NS1 Ag ELISA Dengue NS1 Ag STRIP and SD BIOLINE Dengue Duo NS1 IgM IgG . Results SD BIOLINE NS1 IgM IgG had the highest sensitivity 80.7 95 CI 75-85.7 with likelihood ratios of 7.4 95 CI 4.1-13.8 and 0.21 95 CI 0.16-0.28 . The ELISA-format tests showed comparable sensitivities all below 75 . STRIP and SD NS1 had even lower sensitivities 65 . The sensitivities significantly decreased in samples taken after 3 days of fever onset in secondary infections viral serotypes 2 and 4 and severe dengue. Adding IgM or IgG to SD NS1 increased its sensitivity in all these situations. Conclusions The simultaneous detection of NS1 IgM IgG would be potentially useful for dengue diagnosis in both endemic and non endemic areas. A negative result does not rule out dengue. Further studies are required to assess the performance and impact of early laboratory diagnosis of dengue in the routine clinical setting. Background Dengue is a vector borne disease rapidly spreading in urban areas in tropical and subtropical countries. It is estimated that at least 10 of dengue fever cases evolve to severe and eventually lethal forms of the disease. The clinical and laboratory findings in dengue are very similar to those of other febrile .