title: Evaluation of Non-Structural Protein-1(NS1) positive patients of 2013 dengue outbreak in Khyber Pakhtunkhwa, Pakistan.
abstract: OBJECTIVE
  Dengue infection is an arthropod borne disease caused by Dengue virus in humans. Dengue virus infection has more potential to produce severe form of the disease with more severe symptoms. Proper diagnosis of dengue fever is very important for its safe management. The objective of this study was to evaluate the non structural protein-1 (NS1) positive parameter for identification of dengue fever by using ELISA from 2013 dengue outbreak in Khyber Pakhtunkhwa.
  
  
  METHODS
  It was a cross sectional study conducted among 384 patients tested for dengue admitted to different hospitals of Khyber Pakhtunkhwa April to December 2013 with symptoms related to classical dengue fever. Written informed consent was taken from 100 NS1 positive diagnosed patients, and 3 to 5 ml blood sample was collected for confirmation through ELISA testing. ELISA test for dengue IgG and IgM was performed two time in order to confirm the dengue cases. Data was entered and analyzed by using SPSS version 16.
  
  
  RESULTS
  The study performed on 100 NS1 positive samples of patients, admitted to hospitals with symptoms related to classical dengue fever, indicated that after performing the IgM and IgG capture ELISA test only 76 samples were actually found positive for dengue. The rest of the 24 samples were found negative for both IgM and IgG capture ELISAs. The study also revealed that 90.8 % patients had primary dengue infection and 35.5% patients had secondary dengue infection. Most patients were between the age of 10-20 years (26%), among them19.7% were having primary dengue infection. Among 10-20 years of age 50% female patients were false dengue patients.
  
  
  CONCLUSIONS
  About 24 % NSI protein positive samples were found negative for both IgM and IgG capture ELISAs showed that NS1protein positivity does not confirm actual dengue infection.
authors.affiliation: Dr. Ghosia Lutfullah, PhD Chemistry. Centre of Biotechnology and Microbiology, University of Peshawar, Peshawar, Pakistan.
authors.forename: Ghosia
authors.initials: G
authors.lastname: Lutfullah
authors.affiliation: Dr. Jawad Ahmad, PhD Chemistry. Department of Microbiology, Khyber Medical University Peshawar, Peshawar, Pakistan.
authors.forename: Jawad
authors.initials: J
authors.lastname: Ahmed
authors.affiliation: Mr. Aftab Khan, M. Phil Microbiology. PMRC Research Centre, Khyber Medical College Peshawar, Peshawar, Pakistan.
authors.forename: Aftab
authors.initials: A
authors.lastname: Khan
authors.affiliation: Miss Hina Ihsan, M. Phil. Centre of Biotechnology and Microbiology, University of Peshawar, Peshawar, Pakistan.
authors.forename: Hina
authors.initials: H
authors.lastname: Ihsan
authors.affiliation: Dr. Jamshed Ahmad, PhD Microbiology. Centre of Biotechnology and Microbiology, University of Peshawar, Peshawar, Pakistan.
authors.forename: Jamshed
authors.initials: J
authors.lastname: Ahmad
keywords: Dengue diagnosis; Dengue infection; ELISA; NS1 positive samples