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. 2017 Aug 29;17(1):594.
doi: 10.1186/s12879-017-2679-z.

Precisão e confiabilidade de um teste imuno-cromatográfico rápido NS1 para diagnóstico DENV-1 no ponto de atendimento e no laboratório

Verónica Elizabeth Mata  1 , Sonia Regina Lambert Passos  2 , Yara Hahr Marques Hökerberg  2 , Guilherme Miguéis Berardinelli  2 , Maria Angelica Borges Dos Santos  3 , Levy Vilas Boas Fukuoka  2 , Anna Carolina Fontoura Seixas Rangel Maciel  2 , Cintia Damasceno Dos Santos Rodrigues  4 , Aline da Silva Santos  4 , Raquel de Vasconcellos Carvalhaes de Oliveira  2
Affiliations

Precisão e confiabilidade de um teste imuno-cromatográfico rápido NS1 para diagnóstico DENV-1 no ponto de atendimento e no laboratório

Verónica Elizabeth Mata et al. BMC Infect Dis. .

Erratum in

Abstract

Background: Rapid immunochromatographic tests (ICT) for dengue non-structural protein 1 (NS1) have shown good performance for diagnosing acute-phase dengue in serum in laboratory settings, but rarely have been assessed in whole blood and at point of care (POC). This study compare the accuracy and inter- and intra-observer reliability of the NS1 Bioeasy™ ICT in whole blood at POC versus serum in the laboratory, during a DENV-1 epidemic.

Methods: Cross-sectional study involving 144 adults spontaneously demanding care in an emergency department within 4 days of onset of acute febrile illness. Accuracy of NS1 Bioeasy™ ICT was compared in whole blood and serum, both at 15 and 30 min, blinded to the reference RT-PCR or NS1 ELISA. Non-dengue patients were also tested for Zika virus with RT-PCR. Reliability of whole blood and serum readings by the same or different observers was measured by simple kappa (95% CI).

Results: At 15 min, sensitivity (Sn) of NS1 Bioeasy™ ICT in whole blood/POC was 76.7% (95% CI: 68.0-84.1) and specificity (Sp) was 87.0% (95% CI: 66.4-97.2). Sn in serum/laboratory was 82% (95% CI: 74.1-88.6) and Sp 100% (95% CI: 85.8-100). Positive likelihood ratio was 5.9 (95% CI: 2.0-17.0) for whole blood/POC and 19.8 (95% CI: 2.9-135.1) for serum/laboratory. Reliability of matched readings of whole blood/POC and serum/laboratory by the same observer (k = 0.83, 95% CI: 0.74-0.93) or different observers (k = 0.81, 95% CI: 0.72-0.92) was almost perfect, with higher discordant levels in the absence of dengue. Results did not differ statistically at 5%.

Conclusions: NS1 Bioeasy™ ICT in DENV-1 epidemics is a potentially confirmatory test. Invalid results at 15 min should be reread at 30 min. To optimize impact of implementing ICT in the management of false-negatives it should be incorporated into an algorithm according to setting and available specimen.

Trial registration: UTN U1111-1145-9451 .

Keywords: Dengue; Diagnosis; NS1; Point-of-care systems; Reproducibility of results; Sensitivity and specificity.

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Conflict of interest statement

Ethics approval and consent to participate

O estudo foi aprovado pelo Conselho de Revisão Institucional do Instituto de Pesquisa Clínica Evandro Chagas (CAAE 0066.0.009.000-11). Todos os pacientes assinaram o formulário de consentimento livre e esclarecido.

Consentimento para publicação

Não aplicável.

Interesses competitivos

Os autores declaram que não têm interesses concorrentes.

Nota do editor

A Springer Nature permanece neutra em relação a reivindicações jurisdicionais em mapas publicados e afiliações institucionais.

Figures

Fig. 1
Fig. 1
Sample selection and laboratory analysis of 144 suspected dengue cases during a DENV-1 epidemic. a: rapid immunocromatographic test (index test), b: RT-PCR or ELISA NS1 positive (reference test)
See this image and copyright information in PMC

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