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. 2023 Oct;16(10):1546-1551.
doi: 10.25122/jml-2022-0300.

Non-structural protein 1 and hematology parameters as predictors of dengue virus infection severity in Indonesia

I Gusti Agung Ayu Eka Putri Sunari  1 , Aryati Aryati  1 , Faradila Khoirun Nisa Hakim  2 , May Fanny Tanzilia  1 , Nelly Zuroidah  1 , Billy Jordan Wrahatnala  2 , Ali Rohman  3 , Puspa Wardhani  1 , Dominicus Husada  4 , Muhammad Miftahussurur  5   6
Affiliations

Non-structural protein 1 and hematology parameters as predictors of dengue virus infection severity in Indonesia

I Gusti Agung Ayu Eka Putri Sunari et al. J Med Life. 2023 Oct.

Abstract

Dengue virus infection (DVI) remains a significant health challenge, and diagnosis must still be considered. Non-structural protein 1 (NS1) is a potential marker of the dengue virus that can help diagnose DVI. The study aimed to assess the role of NS1 as a predictor of the severity of DVI. We utilized Dengue PCR-confirmed samples and employed semi-quantitative NS1Ag ELISA for NS1 examination, adhering to the World Health Organization South-East Asia Region (WHO-SEARO) 2011 criteria for DVI. We included DVI patients from Indonesia aged 1-65 years. Secondary infections had more severe clinical conditions than primary infections. Leukocyte and platelet levels had a more significant effect on NS1 positivity (6.19 (1.9-30.2); p<0.001; 190 (11-417); p=0.015; respectively). Multivariate analysis revealed leukocytes as a more significant predictor of NS1 values than platelets, with an odds ratio of 5.38 contributing to 30.5% of the NS1 value variation. The NS1 value could distinguish undifferentiated fever and dengue fever in the children group with a sensitivity of 76.0% and specificity of 87.5% (p=0.015). The number of NS1(-) in the severe dengue hemorrhagic fever (DHF) group was higher than NS1(+). DENV-4 type and primary infection were dominant in this study, although they did not significantly differ from the NS1 value. NS1 value can be used as a predictor to determine the severity of DVI in children but not in the adult group. The levels of leukocytes and platelets influenced the NS1 value.

Keywords: NS1; dengue virus; human and disease; infectious disease; severity.

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Conflict of interest statement

The authors declare no conflict of interest.

Figures

Figure 1
Figure 1
ROC curve comparing undifferentiated fever and dengue fever among children
See this image and copyright information in PMC

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