title: Evaluation of dengue NS1 antigen detection for diagnosis in public health laboratories, São Paulo State, 2009.
abstract: The present work evaluated the diagnostic accuracy of detection of Dengue NS1 antigen employing two NS1 assays, an immunochromatographic assay and ELISA, in the diagnostic routine of Public Health laboratories. The results obtained with NS1 assay were compared with virus isolation and, in a subpopulation of cases, they were compared with the IgM-ELISA results obtained with convalescent samples. A total of 2,321 sera samples were analyzed by one of two NS1 techniques from March to October 2009. The samples were divided into five groups: groups I, II and III included samples tested by NS1 and virus isolation, and groups IV and V included patients with a first sample tested by NS1 and a second sample tested by IgM-ELISA. Sensitivity, specificity, positive and negative predictive values, Kappa Index and Kappa Concordance were calculated. The results showed that NS1 testing in groups I, II and III had high sensitivity (98.0%, 99.5% and 99.3%), and predictive values and Kappa index between 0.9 - 1.0. Groups IV and V only had Kappa Concordance calculated, since the samples were analyzed according to the presence of NS1 antigen or IgM antibody. Concordance of 92.1% was observed when comparing the results of NS1-negative samples with IgM-ELISA. Based on the findings, it is possible to suggest that the tests for NS1 detection may be important tools for monitoring the introduction and spread of Dengue serotypes.
authors.affiliation: Instituto Adolfo Lutz, São Paulo, SP, Brazil. ibisordi@yahoo.com.br
authors.forename: Ivani
authors.initials: I
authors.lastname: Bisordi
authors.forename: Iray Maria
authors.initials: IM
authors.lastname: Rocco
authors.forename: Akemi
authors.initials: A
authors.lastname: Suzuki
authors.forename: Gizelda
authors.initials: G
authors.lastname: Katz
authors.forename: Vivian Regina
authors.initials: VR
authors.lastname: Silveira
authors.forename: Adriana Yurika
authors.initials: AY
authors.lastname: Maeda
authors.forename: Renato Pereira de
authors.initials: RP
authors.lastname: Souza
authors.forename: Margarida Georgina
authors.initials: MG
authors.lastname: Bassi
authors.forename: Eloisa Fonseca
authors.initials: EF
authors.lastname: Del Tedesco
authors.forename: Eithma
authors.initials: E
authors.lastname: Freitas
authors.forename: Thirsa Álvares Franco
authors.initials: TÁ
authors.lastname: Bessa
mesh_terms: D000914:Antibodies, Viral / Q000097:blood*; D000956:Antigens, Viral / Q000097:blood*; D002846:Chromatography, Affinity; D003715:Dengue / Q000175:diagnosis* / Q000276:immunology / Q000821:virology; D003716:Dengue Virus / Q000276:immunology*; D004797:Enzyme-Linked Immunosorbent Assay; D006801:Humans; D007075:Immunoglobulin M / Q000097:blood*; D012680:Sensitivity and Specificity; D017361:Viral Nonstructural Proteins / Q000276:immunology*
chemical_list: D000914:Antibodies, Viral; D000956:Antigens, Viral; D007075:Immunoglobulin M; D017361:Viral Nonstructural Proteins